Do people realise how bad the Ambulance service is right now?

Caporegime
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Wasn't it you suggesting medics that really cared should be working for minimum wage just the other day?

Now your saying pay is a barrier to entry to medicine? :cry:

No. Read what I said. I said the fees were the barrier.

Reading comprehension clearly isn't a requirement though!
 
Caporegime
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And the wage hit at the start? And reaching parity with your previous pay.

Then there's the wage hit at the start and a potential posting to a hospital/practice far away. I think I worked out it would probably have cost me about 500k in lost salary alone before I was back on what I was earning. That was fine, I and others I worked with were happy to take that hit

Ta da.

You'll notice I also didn't say they should be working for minimum wage. I said if patients were their number 1 priority they would. You then succinctly proved my point by stating your family were your number 1 priority. I don't disagree with your morals there at all, that's perfectly fine.
 
Caporegime
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Ta da.

You'll notice I also didn't say they should be working for minimum wage. I said if patients were their number 1 priority they would. You then succinctly proved my point by stating your family were your number 1 priority. I don't disagree with your morals there at all, that's perfectly fine.

It was utter tripe previously and your arguments haven't matured since the last time. We probably should just leave it be.

Clearly you recognise the financial implications of medical training and as a career long term because it stopped you from doing it, as it stops many other people. That's progress atleast. This is where the Government falls down. It doesn't train enough people, it doesn't value them financially or professionally, it makes little effort to keep the staff it's got.

A national training programme of funded university places for STEM/medicine/nursing/teaching would be such a sensible approach and yet it seems impossible to contemplate the Government doing it.
 
Caporegime
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It was utter tripe previously and your arguments haven't matured well. We probably should just leave it be.

Clearly you recognise the financial implications of medical training and as a career long term because it stopped you from doing it, as it stops many other people. That's progress atleast.

The financial implications for someone moving from another career who has to pay for training up front, not via student loans. Which also having existing student loans. A key difference.
 
Caporegime
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The financial implications for someone moving from another career who has to pay for training up front, not via student loans. Which also having existing student loans. A key difference.
Even without a previous career people have to way up the long training, debt, pay, working conditions, progression etc vs alternatives. That's what I did, naively at 18. I could have earnt more elsewhere but medicine wasn't too bad overall (it has changed substantially since). Many of my peers went elsewhere for shorter training and far higher pay.

Student loans aren't free money, you've got to pay them back. I had a good 45K of debt by the end of med school and that was almost 15 years ago.

A previous career makes that potentially a more expensive move but also you may be at a more financial secure point of your life.

At the end of the day, we just don't invest in local training or existing staff and nothing has changed regarding this in my time in medicine.
 
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Caporegime
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Even without a previous career people have to way up the long training, debt, pay, working conditions, progression etc vs alternatives. That's what I did, naively at 18. I could habe earnt more elsewhere but medicine wasn't too bad overall. Many of my peers went elsewhere for shorter training and far higher pay.

Student loans aren't free money, you've got to pay them back. I had a good 45K of debt by the end of med school and that was almost 15 years ago.

A previous career makes that potentially a more expensive move but also you may be at a more financial secure point of your life.
Or people have kids, mortgages, loans etc by that point.
There's a big difference between a student loan when you're 18, which you don't have to pay off until you're earning above the threshold, and paying 10k per year when you're not earning.
 
Soldato
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I've sadly had to go in to A&E multiple times on emergency.

I don't actually know why they take so long to assess people. I know there is delays if they admit you to find a spare bed in the hospital.

But if its just doing blood tests and ECG's then I dont understand why it takes a few hours.
 
Soldato
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The situation is dire, I work for the NHS as a pharmacist and have friends that are paramedics, doctors etc and there is a severe shortage of staff. For instance the same job has gone out on 3 separate occasions and on two occasions nobody applied and on the 3rd occasion someone applied but when I interviewed them they were not suitable for the role at all.

Paramedics, pharmacists and nurses are now finding work in GP surgeries as they get a desk to themselves instead of running around the wards all day. Normal 9 to 5/6 and protected learning time. I don't blame them for doing it.

I hate to be political but it does come down to Government funding.
 
Caporegime
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I've sadly had to go in to A&E multiple times on emergency.

I don't actually know why they take so long to assess people. I know there is delays if they admit you to find a spare bed in the hospital.

But if its just doing blood tests and ECG's then I dont understand why it takes a few hours.
Your typical ED team is pretty small compared to the number of patients and emergency can easily soak up most of your staff. The vast majority of ED patients never see resus so don't see the emergency care having to provided whilst the masses sit around in Majors/Minors.
 
Soldato
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I doubt many, including those of us who work in Ambulance Services, really understand the issues at play but I have a few observations:

1: Demand has increased, though I suspect that staffing numbers have increased too. I don't think it's fair to blame users of the service for the problems. At least not exclusively.
2: Ambulance Services are under greater pressure than ever to treat at scene. When I started over 11 years ago the main focus was on safely transporting patients to hospital. If you were a diabetic having a hypo you quite possibly went to hospital. Now you'll quite likely be treated at home. This is usually great for those patients, and should be recognised as good patient care but it does mean crews spend longer on scene than they used to and may mean that additional staff attend to facilitate treatment the first crew on scene recognise is likely to allow the patient to be left at home but can't administer themselves, thus reducing the nu!bet of available resources.
3: As mentioned turn around times at A/E are longer than they have been. If there are no beds in A/E for patients arriving by ambulance and they're too unwell or vulnerable to wait in the waiting room crews can't free up. There's no space in A/E because there's no beds for the patients in A/E to be moved into and those beds aren't free, in part, because social care is a mess and those requiring it spend longer than clinically necessary in hospitals while it is arranged.
4: Demand and (at least perceived) disinterest and unacceptable delays accessing primary health care either from NHS111/NHS24 or GPs is 'forcing' some to call 999 for things they perhaps wouldn't otherwise call for. This could also be said for social problems too. While these calls don't always generate an ambulance response they do take up service time and resources regardless. This is partly down to a lack of GPS and other primary health care practitioners.
5: A higher percentage of patients are more ill than they perhaps need to be. Whether that's because chronic condition management and routine testing stopped during the early Covid pandemic and therefore problems went unnoticed until they became emergencies or for other reasons I don't know.
6: Staff sickness and retention is a problem. I make roughly the living wage and I have delivered babies, I have talked people through CPR more times than I can count, including on babies and children and in a variety of horrific circumstances. Working overnight at Tesco stacking shelves would be a lot less responsibility and stress for not really that much less money. I know of many people in my service who have left or are actively looking to leave. Vocation or not, there comes a point when enough is enough. I
7: Poverty with its associated poor mental, substance misuse, crime, poor diet and low exercise levels, is also a factor I think. Poor people are really struggling and that affects their health.

I'm not sure how you fix things. Addressing some of these things, or all of them would help I think. It takes money but it also takes a longer term, joined up approach - something government's are poor at. You can't look at any one part of our social matrix in isolation. You can't fix the ambulance service with improving social care, without improving social equality, without improving education etc. It's all connected

It’s terrible that your skills and care are worth just enough to get by. Like you say nightshift in Tesco stacking shelves with no responsibility and a podcast on and you wouldn’t lose much overall. This cannot continue.
 
I can haz 3090?
Don
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I've cleaned this thread up and reopened it. Sorry if I've had to delete a few posts that maybe only borderline warranted it, but I had to ditch the whole conversation after it started going down a certain route.

To the rest of you, you know who you are. I'm not in the mood today, any more of your knuckle-dragging nonsense dragging yet another thread into an argument, and it's hammertime. A week minimum - we'll go up from there.
 
Soldato
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I wonder how much of it is a backlog from GP's directing people to other places?

I'm not sure if people can walk in to my GP surgery without an appointment.

I'd imagine if an A&E unit is bombarded with low risk people then unless they want to start removing people from beds I'd have thought it would eventually have an impact on people coming in with Ambulances?

Is the backlog with Ambulances caused by them having to wait at the A&E?

I've heard the main issue with bed numbers isn't the physical beds available, but how many people are supposed to cover a number of beds. Can't the government temporary change the law to allow for it to be more beds per nurse than it currently is to free up more beds available?
 
Soldato
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I wonder how much of it is a backlog from GP's directing people to other places?

I'm not sure if people can walk in to my GP surgery without an appointment.

I'd imagine if an A&E unit is bombarded with low risk people then unless they want to start removing people from beds I'd have thought it would eventually have an impact on people coming in with Ambulances?

Is the backlog with Ambulances caused by them having to wait at the A&E?

I've heard the main issue with bed numbers isn't the physical beds available, but how many people are supposed to cover a number of beds. Can't the government temporary change the law to allow for it to be more beds per nurse than it currently is to free up more beds available?

Yes GPs are adding to the additional load. If they won't even see you then what option do you have? Might as well take yourself to A&E and wait it out.
 
Soldato
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I've heard the main issue with bed numbers isn't the physical beds available, but how many people are supposed to cover a number of beds. Can't the government temporary change the law to allow for it to be more beds per nurse than it currently is to free up more beds available?

Problem we have at the moment is staff (particularly nurses) leaving due to being overworked and stressed so giving them even more patients to look after won't go down well.

The NHS needs more staff, recruitment from abroad is still attracting applicants but we need to do more to support people here who want to become a nurse, doctor etc.

Nearly half of the new nurses and midwives registered to work in the UK in the past year have come from abroad.
The total - more than 23,000 - is a record high and comes as the UK has struggled to increase the number of home-grown nurses joining the register.
Nurse leaders questioned whether international recruitment on this scale was sustainable.
The Nursing and Midwifery Council data for 2021-22 also showed the numbers leaving the profession had risen.
More than 27,000 left the register last year, up 13% on the year before and reversing a downward trend in leavers over recent years.
In many ways this was always expected as significant numbers of staff put off retirement to help out in the emergency phase of the pandemic.
And retirement was certainly the main factor - more than four in 10 cited this - although nearly one in five also blamed too much pressure.
Overall the numbers on the register, which also includes a small number of nursing associates, rose by nearly 26,500 to more than 758,000, the highest number ever. One in five are from abroad.
Nearly all of the international recruits that have arrived in the past year were trained in countries from outside Europe - before Brexit Europe supplied more than the rest of the world. India and the Philippines are the countries which are supplying the most.
 
Caporegime
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The economy and society is likely going to implode soon.

The greed of the rich will be to blame.
 
Soldato
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Hihe economy and society is likely going to implode soon.

The greed of the rich will be to blame.

The impractical aspirations that the poor have been given, especially the poor younger generations is also blameworthy. It has left at least two generations disgruntled with their lots
 
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