IOM DHSC & MANX CARE

[Gladys]

3 minutes ago, asitis said:

Time we divested the taxpayers of these two, that would pay for three nurses ! a lot more use of the money imo.

Whilst I agree with the sentiment, (at least for one), not sure how you would achieve that. 

[asitis]

51 minutes ago, Gladys said:

Whilst I agree with the sentiment, (at least for one), not sure how you would achieve that. 

Neither am I,  one can but dream !

[WTF]

1 hour ago, Gladys said:

Whilst I agree with the sentiment, (at least for one), not sure how you would achieve that. 

finlo has an idea in another thread that could work....................

[Apple]

5 hours ago, Fluffy said:

How long do you think it takes to turn around 10+ years of DHSC mismanagement- it was 2012 when colorectal surgery got suspended. Were things perfect before that happened?

No, nothing is ever perfect as we know. Health care is a complex and widespread organisation. It's too easy though to blame any particular group of people. There are numerous reasons why changes have been needed in my opinion. These are a few.

Over the years there has been increases in specialising in health care, more expectations of what can be delivered, more demand from patients and the public. Every new initiative announced - eg new Consultant appointment, new equipment, new Service models, new recommendations - all bring about raised emphasis on what could / should be provided and raise the publics expectations.  More people needed to be seen, more clinical interventions and demand for diagnostic services etc has grown and continued to do so. For Example -the developments such bowel cancer screening programmes required extra endoscopes, more staff and specialised computerised equipment to function. 

Therefore the need for more staff, more teams, more training, more demands for everyone trying  to cope with the demands as best they could. Then of course the hospital had started mostly with brand new equipment and some specialised stuff needed replacing, some past their shelf life and some for health and safety reasons. They had to purchase all new beds iirc. 

Actually the list is endless. Demands  just never stops it seems, and not just from patients. And the meetings... the communications across such a wide organisation...unable to discharge patients...legislation was so far behind the pace of change needed just to keep up was lacking... I really think some people do not understand how widespread the responsibilities stretch. ..patients transfers..off island services... on call staff arrangements ...IPRs ...As I say, it is endless. And that was without a pandemic.

More importantly though after all that in my view the political strategy we have been on and are currently on is flawed. However of course it can not be questioned as it would be a reflection on the previous administration, and God forbid that could happen.!. What works in the UK, or doesn't, will also not be productive on the island but we can not be seen to be changing direction. Even though we are in the best place to develop a really good service. Everyday I hear from some current and ex staff (medical, nursing, even managers) that things are still not as well as they should be. Changes to Minister, changes to Senior Managers (or Executive Directors as they call some of them) don't help. The feedback I get is that some people do not even know who their line manager is, or was, or may be next. Morale does seem to be an issue with some staff. I have seen it myself as a patient recently the apparent indifference to patients, the public and staff. If that is the 'culture' they want to tackle then they will not achieve it that way. 

For the public, we are only just now getting a new complaints Omsbudsman system demanded by Government years ago. It seems that despite Mr Hoopers statement in Tynwald before Christmas it is still not yet operational. Thing like this do not help build trust and confidence with is essential as we have limited choice on where we can get health care from.

It's also clear from the Board papers this week that costs are not under effective control. More staff will apparently be appointed. Money is being asked for but no details of what for are given Costs savings are listed but how have the savings been achieved. The indications to me is that details of planned services changes and developments are not being shared with the public. It is to the transparent approach we we told would happen.

Sorry to go on...and on...but you did ask. There will be some posters that see things from a different perspective and that's their view. Fair enough. I don't work there anymore so I don't have to tow the line any more. For patients,  some people have had excellent experiences from the health and care services and that is without question. There are sadly though people who have had bad experiences but the complaints system is in my view is weighted against them. 

Finally, the recent issue of Assisted Dying has enabled many posters and on the radio today to share their experiences with end of life care for family members. It has been a sad eye opener to read and hear about how significant and widespread the anguish and heartbreak has been in some cases. With a funded hospice and facilities with excellent palliative care teams why have theses issues only now come to light. 

 

Edited January 14, 2023 by Apple
typos

[Gladys]

9 minutes ago, Apple said:

No, nothing is ever perfect as we know. Health care is a complex and widespread organisation. It's too easy though to blame any particular group of people. There are numerous reasons why changes have been needed in my opinion. These are a few.

Over the years there has been increases in specialising in health care, more expectations of what can be delivered, more demand from patients and the public. Every new initiative announced - eg new Consultant appointment, new equipment, new Service models, new recommendations - all bring about raised emphasis on what could / should be provided and raise the publics expectations.  More people needed to be seen, more clinical interventions and demand for diagnostic services etc has grown and continued to do so. For Example -the developments such bowel cancer screening programmes required extra endoscopes, more staff and specialised computerised equipment to function. 

Therefore the need for more staff, more teams, more training, more demands for everyone trying  to cope with the demands as best they could. Then of course the hospital had started mostly with brand new equipment and some specialised stuff needed replacing, some past their shelf life and some for health and safety reasons. They had to purchase all new beds iirc. 

Actually the list is endless. Demands not just never stops it seems, and not just from patients. And the meetings... the communications across such a wide organisation...unable to discharge patients...legislation was so far behind the pace of change needed just to keep up was lacking... I really don't think some do not understand how widespread the responsibilities stretch. ..patients transfers..off island services... on call staff arrangements ...IPRs ...As I say, it is endless. And that was without a pandemic.

More importantly though after all that in my view the political strategy we have been on and are currently on is flawed. However of course it can not be questioned as it would be a reflection on the previous administration, and God forbid that could happen.!. What works in the UK, or doesn't, will also not be productive on the island but we can not be seen to be changing direction. Even though we are in the best place to develop a really good service. Everyday I hear from some current and ex staff (medical, nursing, even managers) that things are still not as well as they should be. Changes to Minister, changes to Senior Managers (or Executive Directors as they call some of them) don't help. The feedback I get is that some people do not even know who their line manager is, or was, or may be next. Morale does seem to be an issue with some staff. I have seen it myself and a patient recently the apparent indifference to patients, the public and staff. If that is the 'culture' they want to tackle then they will not achieve it that way. 

For the public, we are only just now getting a new complaints Omsbudsman system demanded by Government years ago. It seems that despite Mr Hoopers statement in Tynwald before Christmas it is still not yet operational. Thing like this do not help build trust and confidence with is essential as we have limited choice on where we can get health care from.

It's also clear from the Board papers this week that costs are not under effective control. More staff will apparently be appointed. Money is being asked for but no details of what for are given Costs savings are listed but how have the savings been achieved. The indications to me is that details of planned services changes and developments are not being shared with the public. It is to the transparent approach we we told would happen.

Sorry to go on...and on...but you did ask. There will be some posters that see things from a different perspective and that's their view. Fair enough. I don't work there anymore so I don't have to tow the line any more. For patients,  some people have had excellent experiences from the health and care services and that is without question. There are sadly though people who have had bad experiences but the complaints system is in my view is weighted against them. 

Finally, the recent issue of Assisted Dying has enabled many posters and on the radio today to share their experiences with end of life care for family members. It has been a sad eye opener to read and hear about how significant and widespread the anguish and heartbreak has been in some cases. With a funded hospice and facilities with excellent palliative care teams why have theses issues only now come to light. 

 

On your first points about the reasons healthcare is under such pressure, one of the issues that you allude to is the ever increasing advances in medicine which creates a demand for them.  It is a hard one, but you have to wonder if the stark reality is that the NHS should only provide basic care, energency response, relief of pain and the 'easy fixes'.  Anything else cannot be provided within a public service. 

Of course, that approach will be divisive and terribly unfair where those with the wherewithal can get all the treatment they can afford.  But the alternative that we have now is a public healthcare system that can,  on paper,  offer all kinds of treatments  but cannot actually deliver on that offering. 

That then moves on to the assisted dying debate and I listened to MR today with some awful stories.  The last caller was particularly articulate about his mother, a former nurse who after several strokes was bedridden and wasted away for 7 years.  Her wish was to be able to depart on her own terms, not to be kept alive with an intolerable quality of life.  IIRC she had agreed to DNR, but her medical treatment deferred the inevitable of nature taking its course.  He also said that if it was an animal in the same circumstances, the owner would not wish to prolong its suffering and would be criticised for trying. 

The two issues are not unconnected, IMO.  Medicine should not be so focused on prolonging life, but on ensuring the best quality of life, even if it is short.

There used to be an old criticism of doctors 'playing God'.  That was at a time,  perhaps, when difficult choices were made by medics, because the options, resources and capabilities were limited.

There is a very tricky ethical debate to be had, but it must be had.

[Moghrey Mie]

21 hours ago, Two-lane said:

I assume the UK company was not in a true partnership, but was simply contracted/paid by Manx Care to do certain work.

The recovery programme is of course worthwhile, but I do not see that there is any inventiveness, creativity or originality in this process. The MHKs have decided to sign a few blank cheques, and Manx Care is spending that money.

When Manx Care started they issued a glossy advertising-agency-created brochure which, apart from lots of photos, had the sentence "If we exceed the budget we will have failed" (that brochure has disappeared off the face of the Internet). I though that was a stupid comment to make, as it was clear that the lack of money was a significant problem.

So how did that come about? Why, with the creation of Manx Care, has there suddenly been a few big cheques floating around?

[I had a low opinion of that glossy brochure because the style was that used in selling tins of baked beans, which I did not think appropriate for a group solely concerned with people's health]

 

At the latest board meeting they reported that Synaptik had worked in co-operation with local Manx Care staff to do the operations.

[Moghrey Mie]

https://www.youtube.com/watch?v=6gZ30fA26jU

I still think these people are very focussed and know what they are doing.

[buncha wankas]

53 minutes ago, Roxanne said:

I only watched twenty minutes of that but I was extremely impressed by what I saw and heard. Good stuff. My faith has been restored a little.

What are you impressed with

i heard a lot of measured waffle with no substance 

[Blade Runner]

18 hours ago, Apple said:

No, nothing is ever perfect as we know. Health care is a complex and widespread organisation. It's too easy though to blame any particular group of people. There are numerous reasons why changes have been needed in my opinion. These are a few.

Over the years there has been increases in specialising in health care, more expectations of what can be delivered, more demand from patients and the public. Every new initiative announced - eg new Consultant appointment, new equipment, new Service models, new recommendations - all bring about raised emphasis on what could / should be provided and raise the publics expectations.  More people needed to be seen, more clinical interventions and demand for diagnostic services etc has grown and continued to do so. For Example -the developments such bowel cancer screening programmes required extra endoscopes, more staff and specialised computerised equipment to function. 

Therefore the need for more staff, more teams, more training, more demands for everyone trying  to cope with the demands as best they could. Then of course the hospital had started mostly with brand new equipment and some specialised stuff needed replacing, some past their shelf life and some for health and safety reasons. They had to purchase all new beds iirc. 

Actually the list is endless. Demands  just never stops it seems, and not just from patients. And the meetings... the communications across such a wide organisation...unable to discharge patients...legislation was so far behind the pace of change needed just to keep up was lacking... I really think some people do not understand how widespread the responsibilities stretch. ..patients transfers..off island services... on call staff arrangements ...IPRs ...As I say, it is endless. And that was without a pandemic.

More importantly though after all that in my view the political strategy we have been on and are currently on is flawed. However of course it can not be questioned as it would be a reflection on the previous administration, and God forbid that could happen.!. What works in the UK, or doesn't, will also not be productive on the island but we can not be seen to be changing direction. Even though we are in the best place to develop a really good service. Everyday I hear from some current and ex staff (medical, nursing, even managers) that things are still not as well as they should be. Changes to Minister, changes to Senior Managers (or Executive Directors as they call some of them) don't help. The feedback I get is that some people do not even know who their line manager is, or was, or may be next. Morale does seem to be an issue with some staff. I have seen it myself as a patient recently the apparent indifference to patients, the public and staff. If that is the 'culture' they want to tackle then they will not achieve it that way. 

For the public, we are only just now getting a new complaints Omsbudsman system demanded by Government years ago. It seems that despite Mr Hoopers statement in Tynwald before Christmas it is still not yet operational. Thing like this do not help build trust and confidence with is essential as we have limited choice on where we can get health care from.

It's also clear from the Board papers this week that costs are not under effective control. More staff will apparently be appointed. Money is being asked for but no details of what for are given Costs savings are listed but how have the savings been achieved. The indications to me is that details of planned services changes and developments are not being shared with the public. It is to the transparent approach we we told would happen.

Sorry to go on...and on...but you did ask. There will be some posters that see things from a different perspective and that's their view. Fair enough. I don't work there anymore so I don't have to tow the line any more. For patients,  some people have had excellent experiences from the health and care services and that is without question. There are sadly though people who have had bad experiences but the complaints system is in my view is weighted against them. 

Finally, the recent issue of Assisted Dying has enabled many posters and on the radio today to share their experiences with end of life care for family members. It has been a sad eye opener to read and hear about how significant and widespread the anguish and heartbreak has been in some cases. With a funded hospice and facilities with excellent palliative care teams why have theses issues only now come to light. 

 

Tis' why I left the rock with my family.

Health care is getting more and more specialised and there is no way the little hospital on the island can give you the best care.

If they just admitted it, and turned Nobles into a stabilize  and ship off island to a specialist centre I would be willing to bet that more families would be willing to move to your island and help with your financial problems.

That is not going to happen though - due to the islands daft "independent" beliefs -  so you will all suffer shorter lives than you would if you lived on the mainland and will die in more pain..................................

[GD4ELI]

15 minutes ago, Blade Runner said:

Tis' why I left the rock with my family.

Health care is getting more and more specialised and there is no way the little hospital on the island can give you the best care.

If they just admitted it, and turned Nobles into a stabilize  and ship off island to a specialist centre I would be willing to bet that more families would be willing to move to your island and help with your financial problems.

That is not going to happen though - due to the islands daft "independent" beliefs -  so you will all suffer shorter lives than you would if you lived on the mainland and will die in more pain..................................

Sort of same here - I didn't return to the rock due to 1) Health provision, and 2) Crappy internet. Those were two show-stoppers.

[Gladys]

24 minutes ago, Blade Runner said:

Tis' why I left the rock with my family.

Health care is getting more and more specialised and there is no way the little hospital on the island can give you the best care.

If they just admitted it, and turned Nobles into a stabilize  and ship off island to a specialist centre I would be willing to bet that more families would be willing to move to your island and help with your financial problems.

That is not going to happen though - due to the islands daft "independent" beliefs -  so you will all suffer shorter lives than you would if you lived on the mainland and will die in more pain..................................

Agreed, apart from the last bit.  The problem with a national health service is the focus on longevity rather than quality. 

[Two-lane]

2 hours ago, Moghrey Mie said:

At the latest board meeting they reported that Synaptik had worked in co-operation with local Manx Care staff to do the operations.

No doubt something is getting done, but I read Synaptik's  LinkedIn cv and just got confused:

"Synaptik are not an agency nor are we a nursing bank, we are an intermediary who provide a flexible work Schedule for HCP’s that can coincide with their substantive posts"

substantive post -> the staff members permanent post prior to the secondment

coincide -> occur at the same time.

Providing flexible work is what an agency does. Providing work to be done at the same time as a permanent job just confuses me.

 

[wrighty]

4 hours ago, GD4ELI said:

Sort of same here - I didn't return to the rock due to 1) Health provision, and 2) Crappy internet. Those were two show-stoppers.

You’re probably further away from 1st class healthcare in Cornwall than we are here to be honest. 

[GD4ELI]

6 hours ago, wrighty said:

You’re probably further away from 1st class healthcare in Cornwall than we are here to be honest. 

Heard of the private Duchy hospital perhaps? Treliske in Truro? Only a two hour drive to Plymouth, four to Southampton. No bloody boats or planes involved.

Also excellent health care at Penryn surgery.

[John Wright]

8 hours ago, wrighty said:

You’re probably further away from 1st class healthcare in Cornwall than we are here to be honest. 

Exactly.

2 hours ago, GD4ELI said:

Heard of the private Duchy hospital perhaps? Treliske in Truro? Only a two hour drive to Plymouth, four to Southampton. No bloody boats or planes involved.

Also excellent health care at Penryn surgery.

Private health care and hospitals are only available for the few and offer limited ranges of treatment.

Arent half the partners at Penryn qualified as vets, half the patients registered being sheep?

Seriously, when I was on twice a week chemo and flying over every Tuesday and Friday, my journey time front door to hospital was less than some of the other patients who were being brought in by ambulance service transport from North Lancashire, South Cumbria or North Wales. And they were no more reliable.

Wouldn't want to do your neck of the woods to Southampton in a patient transport ambulance, twice a week, or even to have to drive myself, receive treatment, then drive home.