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Post by bracknellboy on Aug 12, 2019 17:37:43 GMT
So you think the NHS (whether centrally or individual trusts) is voluntarily choosing to waste multi-zero-millions of potential revenue...? Because it simply CBA?Essentially for many years, yes: though in part its cock up theory / natural consequence of structure of the system, as usual: see my updates in above post
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adrianc
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Post by adrianc on Aug 12, 2019 18:06:05 GMT
Edit 2: I also just found this interesting link. Only partly read it but rather illuminating. EHIC Incentive SchemeWhat a surprise. It would appear that part of the problem is that there was no financial incentive for NHS trusts to collect and report the required information: they were not compensated for the additional administration involved, and did not directly receive any of the collected compensation. Did you notice the publication date on it? September 2014. Five years ago next month. (I've tidied your URL to point directly to the PDF, rather than via Google)
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registerme
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Post by registerme on Aug 12, 2019 19:10:45 GMT
Possibly an even better example are "no shows". My two doctor friends illustrate this well. One is a psychiatrist, where you might expect more "no shows" than, say, other branches of the medical profession. Still, when a patient doesn't show up for an appointment that's still somebody else who can't be seen, somebody else who is often in significant distress. The other is a radiologist, and when a patient doesn't show up for an appointment that's another patient who can't be seen, and millions of pounds worth of equipment sat idle for the duration (and all the potential downstream disruption eg surgery can't be scheduled because no scan was available etc). The last one he showed me (without any identifying data) was "Mother showed up without daughter. Scan was booked for daughter". Anything that helped address this would have a significant impact on the "productivity" of the NHS. But what do you actually do? Overbook and leave some unfortunate waiting? Charge for appointments to encourage a more disciplined approach from patients (and deal with the hue and cry for charging for the NHS etc)? I don't know. I'm not sure what branch IFISAcava is but I'd be interested to know their thoughts on this. EDIT: I think my psychiatrist friend has something like a 40% no show rate, and the radiologist around a 20% rate. Not all of their time is spent with patients (eg the radiologist spends an awful lot of time reviewing other more junior doctors' scans) but still.....
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Godanubis
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Anubis is known as the god of death and is the oldest and most popular of ancient Egyptian deities.
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Post by Godanubis on Aug 12, 2019 19:23:49 GMT
Possibly an even better example are "no shows". My two doctor friends illustrate this well. One is a psychiatrist, where you might expect more "no shows" than, say, other branches of the medical profession. Still, when a patient doesn't show up for an appointment that's still somebody else who can't be seen, somebody else who is often in significant distress. The other is a radiologist, and when a patient doesn't show up for an appointment that's another patient who can't be seen, and millions of pounds worth of equipment sat idle for the duration (and all the potential downstream disruption eg surgery can't be scheduled because no scan was available etc). The last one he showed me (without any identifying data) was "Mother showed up without daughter. Scan was booked for daughter". Anything that helped address this would have a significant impact on the "productivity" of the NHS. But what do you actually do? Overbook and leave some unfortunate waiting? Charge for appointments to encourage a more disciplined approach from patients (and deal with the hue and cry for charging for the NHS etc)? I don't know. I'm not sure what branch IFISAcava is but I'd be interested to know their thoughts on this. EDIT: I think my psychiatrist friend has something like a 40% no show rate, and the radiologist around a 20% rate. Not all of their time is spent with patients (eg the radiologist spends an awful lot of time reviewing other more junior doctors' scans) but still..... Working over 40 years in NHS I agree charge for an appointment if no show or call or text to say you won't attend.
Text register of patients willing to attend at very short notice could assist as some may be able to attend if someone is a no show. Just like flight bookings. Keep a few places at the end of a clinic for either late (Go to back of line) or for those willing to come at short notice. Text sent asking for person to fill appointment then first reply gets appointmant. Text sent to others saying now filled. No show = no repeat appointment.
It is time to stand up to just pure ignorance and bad manners. (JR Mogg values should be manditory)
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Post by bracknellboy on Aug 12, 2019 19:29:55 GMT
Did you notice the publication date on it? September 2014. Five years ago next month. Yep. and how long was the arrangement in place before that ? I recall E111 forms for example decades ago. I would be surprised if we went from role model claimants to delinquent claimants before waking up again. I may of course be wrong.
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IFISAcava
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Post by IFISAcava on Aug 13, 2019 9:41:19 GMT
Charging has always been part of the NHS (prescriptions, dentistry, optometry etc). And charges are part of all publicly funded health services, usually with protections for those who can't pay. So no moral issue.
But
Charging for appointments makes a fundamental change to the relationship between doctor and patient, and would accelerate the already more consumerist aspects of medicine. And the hassle and cost of collecting nominal sums would not be worth the revenue it raised. I would resist it.
Missed appointments are a pain, but are often factored into clinics (if everyone turns up the clinic will tend to overrun - and the missed appointment can compensate for the one that was more complicated and took longer). Spare time (if the computers are working) can usually be used for admin, dictation, calls etc.
The NHS has loads of issues, to do with underfunding, too high expectations, lack of transparency on the need to ration resources, etc - missed appointments are a mere blip in the ocean. Better to try and minimise problems with eg automated SMS reminders, target repeat offenders (although they are often those most in need of care) and focus in the bigger issues.
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Post by Deleted on Aug 13, 2019 10:57:51 GMT
I suspect the biggest problem the NHS has is that it has sh#t customers.
The customers (us) like the idea of free at the point of use health service, but completely ignore the "deal".
The deal with the NHS is that you take the whole service not just the bits you want.
So what are the bits the customers are not taking?
THE LIFE STYLE ADVICE
The food advice, the activity advice, the no-smoking, the reduced alcohol and the no drugs advice.
Basically, the UK citizen refuses to keep their weight correct, drinks and eats the wrong things and then goes to "mum" to be made better.
It may seem obvious, but if the NHS had more healthy customers it would not be running out of resources.
Do your bit, stay healthy!
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adrianc
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Post by adrianc on Aug 13, 2019 11:38:36 GMT
I suspect the biggest problem the NHS has is that it has sh#t customers.
...
It may seem obvious, but if the NHS had more healthy customers it would not be running out of resources.
Do your bit, stay healthy!
Very true. Perhaps the starkest illustration of that... Diabetes accounts for roughly 10% of the NHS budget. There are, to nick somebody else's wording, two types of diabetes - type 1 and "the type that's your own fault". Three guesses which type 90% of diabetics are, and which is rising rapidly. Meanwhile, remember what medicine was like when the NHS started...? Antibiotics were still relatively novel - penicillin still had to be grown, not synthetically manufactured. Compare that to today... Medical science continues to advance rapidly, to the point that with enough money you could probably keep a bag of mince alive indefinitely. Many modern treatments are phenomenally expensive - yesterday's headlines included Cystic Fibrosis drugs at a cost of over £100k per patient per year. They aren't even a cure - they merely relieve symptoms and slow the progression of the disease. Should there be reasonable returns for the massive R&D expense in pharmaceuticals? Of course there should. That's different to basically price-gouging where you have a monopoly on a captive market. www.theguardian.com/society/2019/aug/12/drug-maker-will-make-21bn-from-treating-cystic-fibrosis
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