IOM DHSC & MANX CARE

[wrighty]

1 hour ago, WTF said:

BUT if people weren't kept alive against their own wishes ( wrighty avoided that point )  

I didn't deliberately side-step that bit, just wasn't the point I was trying to make.

For what it's worth I'm all for autonomy when it comes to end of life care.  It should be possible to say when you've had enough and, apologies for the indelicate language, be terminated. Either at the time, if of sound mind, or by advance directive if not.

However, legislating for this in a way that ensures it's not the beginning of a slippery slope towards compulsory euthanasia for the elderly, disabled, mentally infirm, unemployed... is an absolute nightmare.  I had a discussion with a respected colleague who is on the other side of the debate to me, and he certainly made me think about the forthcoming assisted dying bill and whether it is a good idea.

As for your other point - the number of nurses engaged in palliative care of patients being kept alive against their will is miniscule as a proportion of the whole of healthcare, so even if they were all 'put down', I don't think it would be much help to the current staffing crisis.

[Albert Tatlock]

1 hour ago, wrighty said:

For what it's worth I'm all for autonomy when it comes to end of life care.

Ironic...since it is all ends up with the autonomic system not working 😀 

[Apple]

Questions for written answer for David Ashford on Tynwald website. Either gamekeeper turned Rottweiler or is he on his way back .... no-one else is asking anything,like these questions. 

Some changes to be announced this week I hear.....

	What pay scales are for (a) nurses and (b) doctors; and how do these compare with neighbouring jurisdictions.
	What MRI provision there is for stroke patients on bank holidays and weekends; on each day from from 24th December 2022 to 2nd January 2023 inclusive: a) what provision and capacity was available; b) how many MRI referrals for stroke patients were made; c) how many MRI’s were undertaken; and c) how many stroke patients waited more than 24 hours for an MRI.
	For each of the GP practices that operate a call monitoring system: a) how many incoming calls were received; b) how many calls went unanswered; and c) what the average wait was for a call to be answered in each of the last six months.
	What percentage of Noble's Hospital ward shifts were a) fully staffed; b) less than 80% staffed; and c) less than 50% staffed in each of the last 12 months.
	What percentage of Accident & Emergency shifts were: a) fully staffed; b) less than 80% staffed; and c) less than 50% staffed in each of the last 12 months.
	What the Opal status of Nobles Hospital has been on each day since 1st April 2021

[wrighty]

Supplementary - how much Manx Care time does it take to find out the answers to all these questions, and how will it change anything at all?

(PS suspected stroke patients don’t generally have an MRI as the first imaging - it’s a CT)

Edited January 15, 2023 by wrighty
And it’s OPEL. No idea what the opal state is - a mischievous person might say something about the name changing to Starburst

[Max Power]

@wrighty What are your thoughts on a seven days a week, 365 a year hospital service? 

I ask in view of David Ashford's question regarding MRI availability for stroke patients. I was recently kept in for six days awaiting a scan, not stroke related, which if I'd been able to get it, I'd have been discharged. Surely this is a bed blocking and expensive alternative at Bank Holiday and weekend times?

[wrighty]

8 minutes ago, Max Power said:

@wrighty What are your thoughts on a seven days a week, 365 a year hospital service? 

I ask in view of David Ashford's question regarding MRI availability for stroke patients. I was recently kept in for six days awaiting a scan, not stroke related, which if I'd been able to get it, I'd have been discharged. Surely this is a bed blocking and expensive alternative at Bank Holiday and weekend times?

We have a 24/7 hospital already, just not the same levels of service at 4am on a Sunday morning than at 10am Tuesday. 
 

It’s all about staffing. If we’re struggling to man routine services 9-5 M-F, how do you think we’d go with a full 7 day service?

[Max Power]

13 minutes ago, wrighty said:

We have a 24/7 hospital already, just not the same levels of service at 4am on a Sunday morning than at 10am Tuesday. 
 

It’s all about staffing. If we’re struggling to man routine services 9-5 M-F, how do you think we’d go with a full 7 day service?

I'm only wondering what the thoughts of someone such as yourself would be as I've read articles preaching that a seven day service would reduce waiting times, have better outcomes etc etc?

They compare the NHS to businesses which operate on a seven day basis. I can understand that this would mean massive recruitment and would bring problems with continuity of treatment of individual patients, but it may work out more cost effective and reduce the pressures within the NHS environment?

[Gladys]

Time and again we come back to the problem being recruitment and retention, and those are not issues peculiar to our health service.  

[wrighty]

6 minutes ago, Max Power said:

I'm only wondering what the thoughts of someone such as yourself would be as I've read articles preaching that a seven day service would reduce waiting times, have better outcomes etc etc?

They compare the NHS to businesses which operate on a seven day basis. I can understand that this would mean massive recruitment and would bring problems with continuity of treatment of individual patients, but it may work out more cost effective and reduce the pressures within the NHS environment?

Comparing the NHS to a business is where it’s all gone wrong. Businesses make profit. If working longer hours by appointing more people makes more money they will do it. The NHS just costs money. Offer more hours of service will just cost more. 

[Albert Tatlock]

2 minutes ago, Gladys said:

Time and again we come back to the problem being recruitment and retention, and those are not issues peculiar to our health service.  

No...they're worldwide issues.

Few care anymore...especially for no money.

Carers are a dying breed.

[Moghrey Mie]

4 minutes ago, wrighty said:

Comparing the NHS to a business is where it’s all gone wrong. Businesses make profit. If working longer hours by appointing more people makes more money they will do it. The NHS just costs money. Offer more hours of service will just cost more. 

I see in the UK agencies are making money out of finding places in care homes. It is costing the NHS thousands of pounds but they are desperate to get 'delayed transfer of care' people out of hospitals.

It is wrong that people are making money out of this situation.

 

 

[Mercenary]

4 minutes ago, Moghrey Mie said:

I see in the UK agencies are making money out of finding places in care homes. It is costing the NHS thousands of pounds but they are desperate to get 'delayed transfer of care' people out of hospitals.

It is wrong that people are making money out of this situation.

 

 

As in making money off saving the NHS money? Why is that a bad thing? It costs thousands to have people sitting in beds waiting for discharge. 

[Moghrey Mie]

7 minutes ago, Mercenary said:

As in making money off saving the NHS money? Why is that a bad thing? It costs thousands to have people sitting in beds waiting for discharge. 

It's a desperate measure that won't solve the problem in the long term.

[Roger Mexico]

1 hour ago, Apple said:

Questions for written answer for David Ashford on Tynwald website. Either gamekeeper turned Rottweiler or is he on his way back .... no-one else is asking anything,like these questions. 

Some changes to be announced this week I hear.....

	What pay scales are for (a) nurses and (b) doctors; and how do these compare with neighbouring jurisdictions.
	What MRI provision there is for stroke patients on bank holidays and weekends; on each day from from 24th December 2022 to 2nd January 2023 inclusive: a) what provision and capacity was available; b) how many MRI referrals for stroke patients were made; c) how many MRI’s were undertaken; and c) how many stroke patients waited more than 24 hours for an MRI.
	For each of the GP practices that operate a call monitoring system: a) how many incoming calls were received; b) how many calls went unanswered; and c) what the average wait was for a call to be answered in each of the last six months.
	What percentage of Noble's Hospital ward shifts were a) fully staffed; b) less than 80% staffed; and c) less than 50% staffed in each of the last 12 months.
	What percentage of Accident & Emergency shifts were: a) fully staffed; b) less than 80% staffed; and c) less than 50% staffed in each of the last 12 months.
	What the Opal status of Nobles Hospital has been on each day since 1st April 2021

Ashford has been churning out these sort of questions since pretty soon after he was sacked in May.  The main characteristic of them seems to be the asking of vast amounts of data that will be incredibly time-consuming to produce, but not necessarily meaningful.  Occasionally he will ask for something that is already available publicly, but more likely it will be something that isn't even possible or demonstrates that he doesn't really understand what he is asking for. 

It's not just on health matters, though when they are you end up wondering just what he actually did or learnt there in his four years.  And what sort of answer he expects that doesn't implicate himself as well in any mess uncovered.  But a lot of them are just stupid and most of the rest could be better phrased to get a useful response.

Of course the real point of these questions isn't actually to get information, it's to show how hard-working and knowledgeable Ashford is - it's all just grandstanding.

[quilp]

Walter seeks mittygation.