Credit where it is due

[Moulin Yarns]

http://news.gov.scot/news/nhs-staffing-at-new-record-high

I know there are still dozens of vacancies in the NHS in Scotland, but some folks are quick enough to knock the Government a every opportunity. (You know who you are :wink: )

[Geo_1875]

Do you have a link to that story on the BBC News website?

[Moulin Yarns]

Why would the BBC publish a good news story about the SNP? http://www.hibs.net/images/smilies/greengrin2.gif

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2016-12-06/2016-12-06-Workforce-Summary.pdf



As at 30 September 2016:
• The number of staff employed by NHSScotland continues to grow. The headcount of 161,806 staff represents a rise of 0.6% over the last year. Adjusting for part time working, the WTE has risen by 0.7% to 138,651.2. Over the last 10 years the WTE has risen by 9.1%.

WTE is whole time equivalent

[JimBHibees]

i'll await the same attention being given to this by news programmes and press as was the education story earlier in the week. Actually quite incredible when you think of the funding cuts.

[Moulin Yarns]

The full text of the bulletin


New healthcare workforce statistics published


Staffing in Scotland’s NHS has increased by over 1,000 in the last year, taking workforce levels to a new record high.
Figures published today show, at 30 September 2016, 138,651 whole time equivalent (WTE) staff are working in hospitals and community healthcare settings across the country. Under this Government, health service staffing has increased by over 11,500 WTE, equivalent to a 9.1% increase in the last 10 years.
The statistics also show record levels of medical consultants working in the NHS, and record numbers of allied health professionals such as physiotherapists and podiatrists.

Nursing is also at historically high levels, with 2,378 more nursing and midwifery staff under this Government.
Health Secretary Shona Robison said:
“Under this Government, NHS staff numbers have risen to record highs - with more consultants, nurses and midwives now delivering care for the people of Scotland.
“There are now 11,500 more staff working in our NHS, with nearly 1,000 of these recruited in the last year. In the last 10 years we’ve also seen a 42.8% increase in medical and dental consultants. These extra staff will ensure people all across Scotland get the high-quality NHS services that they rightly expect.
“We are also committed to preparing our NHS workforce for the future by increasing student nursing and midwifery intakes for the last four years. That’s helped to see almost 10,000 nurses and midwives in training in 2015.
“With demand on our NHS rising we’re committed to both record investment in our health service and ensuring the necessary reforms to deliver the right staff, with the right skills, in the right place, long into the future.

“We’ll soon be setting out our National Health and Social Care Workforce Plan for discussion, working with individuals and organisations within our NHS and social care services to ensure we have the right skills mix for the future.”

[Allant1981]

Staffing may be up in some areas but wewe are still constantly having to watch what we spend, every penny gets scrutinised, ive had 2 staff leave this year and not been able to recruit but still having to provide the same service

[The Modfather]

Surprised Hibs0666 hasn't been on this thread. He certainly hasn't missed a trick in the goings on in the SNP world lately :devil:

[Moulin Yarns]

Surprised Hibs0666 hasn't been on this thread. He certainly hasn't missed a trick in the goings on in the SNP world lately :devil:

Who do you Think I was alluding to?

[hibs0666]

Who do you Think I was alluding to?

Lol. Good news - are we seeing better health outcomes? Hope so.

[Moulin Yarns]

Lol. Good news - are we seeing better health outcomes? Hope so.

I'm busy selling at a Christmas market in Dunkeld to do the research for you, but fill yer boots

http://www.nhsperforms.scot/

[Mibbes Aye]

I'm busy selling at a Christmas market in Dunkeld to do the research for you, but fill yer boots

http://www.nhsperforms.scot/

I'm not sure what you are selling at Dunkeld but I hope for your sake it's something better :greengrin

Have you really started a thread bigging up the Scottish Government for employing more NHS staff in the last year?

When their own data says we have to wait longer for treatment from the NHS?

More staff doesn't mean a better service.

Longer waiting times means a worse service.

[RyeSloan]

I'm not sure what you are selling at Dunkeld but I hope for your sake it's something better :greengrin

Have you really started a thread bigging up the Scottish Government for employing more NHS staff in the last year?

When their own data says we have to wait longer for treatment from the NHS?

More staff doesn't mean a better service.

Longer waiting times means a worse service.

That's was going to be my point...there seems a fixation on numbers (be that how much is spent or how many employed) when often there can be only a loose correlation to desired outcomes.

I read recently that VW employs almost twice as many people as Toyota but produces a similar amount of cars. Does that make VW twice as effective or twice as inefficient as Toyota at car making?

[Mibbes Aye]

That's was going to be my point...there seems a fixation on numbers (be that how much is spent or how many employed) when often there can be only a loose correlation to desired outcomes.

I read recently that VW employs almost twice as many people as Toyota but produces a similar amount of cars. Does that make VW twice as effective or twice as inefficient as Toyota at car making?

It's crazy!!

There are many measures out there about how the Scottish NHS is performing. I've never seen the number of staff being used as one. It's meaningless!!!

I use the NHS, my family use the NHS, my friends and neighbours use the NHS. We all use the NHS.

The number of employees is irrelevant. Getting treated in the right time is.

Their own stats say they are going backwards on this. What's going on?

[Nameless]

I work for NHS Lothian, and I'd say I have averaged a 60 hour week this year. My wages haven't changed in about 3 years, in fact I think I'm actually a few ££ down on what I was earning in 2012. I have no prospect of recruiting in the new financial year, and my workload increases every year. Despite all that, I am still fiercely proud to work for the NHS. I see people every day who dedicate themselves to caring for a stranger - I genuinely believe nurses should be among the highest paid professionals in the world. I wish we got a few positive stories in the media occasionally, as the constant negative spin is not representative of the hard work, kindness and dedication that is displayed every single day.

[Allant1981]

I work for NHS Lothian, and I'd say I have averaged a 60 hour week this year. My wages haven't changed in about 3 years, in fact I think I'm actually a few ££ down on what I was earning in 2012. I have no prospect of recruiting in the new financial year, and my workload increases every year. Despite all that, I am still fiercely proud to work for the NHS. I see people every day who dedicate themselves to caring for a stranger - I genuinely believe nurses should be among the highest paid professionals in the world. I wish we got a few positive stories in the media occasionally, as the constant negative spin is not representative of the hard work, kindness and dedication that is displayed every single day.

Your wages would have changed every april, granted not much but defo a pay rise

[Nameless]

Your wages would have changed every april, granted not much but defo a pay rise
No, they haven't. No cost of living rise for NHS staff above a certain grade for the last few years, and that grade isn't particularly high. I did notice that MPs have just awarded themselves a wee rise though.

[Allant1981]

No, they haven't. No cost of living rise for NHS staff above a certain grade for the last few years, and that grade isn't particularly high. I did notice that MPs have just awarded themselves a wee rise though.

Everyone above 22k gets a 1% pay rise, ive worked for the nhs for 19 years and never not had a pay rise,im a band 6 and got one last year and im at the top of my band, you must be on mega bucks then not to get a pay rise!!

[Nameless]

Everyone above 22k gets a 1% pay rise, ive worked for the nhs for 19 years and never not had a pay rise,im a band 6 and got one last year and im at the top of my band, you must be on mega bucks then not to get a pay rise!!
I'm a band 5, and I have every pay slip since I started 15 years ago. I hit the top of my banding in 2012, and my gross has not moved since - am I getting shafted then?

[Allant1981]

I'm a band 5, and I have every pay slip since I started 15 years ago. I hit the top of my banding in 2012, and my gross has not moved since - am I getting shafted then?

I would speak to payroll as everyone over 22k which you as a band 5 are should get 1% if you are on an AFC contract, not sure about nursing staff if thats what you are

[Nameless]

I would speak to payroll as everyone over 22k which you as a band 5 are should get 1% if you are on an AFC contract, not sure about nursing staff if thats what you are
E-health - I'll drop an email to payroll on Monday, thanks.

[Mibbes Aye]

I work for NHS Lothian, and I'd say I have averaged a 60 hour week this year. My wages haven't changed in about 3 years, in fact I think I'm actually a few ££ down on what I was earning in 2012. I have no prospect of recruiting in the new financial year, and my workload increases every year. Despite all that, I am still fiercely proud to work for the NHS. I see people every day who dedicate themselves to caring for a stranger - I genuinely believe nurses should be among the highest paid professionals in the world. I wish we got a few positive stories in the media occasionally, as the constant negative spin is not representative of the hard work, kindness and dedication that is displayed every single day.

You're right.

And bear in mind,most negative stories about NHSL are to do with senior management, not frontline staff

It's a societal thing in this country - we don't value healthcare or social care until we need it. Or our parents or grandparents need it. And then we realise it's an absolute shambles.

[overdrive]

You're right.

And bear in mind,most negative stories about NHSL are to do with senior management, not frontline staff

It's a societal thing in this country - we don't value healthcare or social care until we need it. Or our parents or grandparents need it. And then we realise it's an absolute shambles.

Then equally you encounter healthcare abroad and you realise how good the NHS actually is. My mother in law ended up quite seriously ill in a Spanish hospital earlier in the year. By all accounts it was awful. She was in for just over 2 weeks and was washed once I think. Nothing moved very fast and it according to my sister in law (a doctor), who went out there in the end, it was all very haphazard in terms of tests, etc.

[cabbageandribs1875]

credit where it's due (part 2730178516)

https://jdrf.org.uk/news/10m-type-1-diabetes-tech-provision-pledged-scottish-government/

A new plan to improve the management of type 1 diabetes will be backed by £10 million of Scottish Government investment.
The additional funding will be used to increase the provision of insulin pumps, which deliver insulin into the body without the need for injections.


I for one have greatly benefitted from the use of an insulin pump, one painless injection every 3 days instead of 5 injections/day(for me) also takes a considerable amount of pain away as well, any type 1 diabetics on here should get their name down on the waiting list at their local clinic :aok: these things do cost a lot of money to the NHS, the one I have would have cost 3K to purchase privately and the accessories/supplies add another £6-7 hundred every 4 months, without help from the Scottish government the costs involved would be out of reach for the majority of type 1's, their is a little work involved in acquiring a pump though...a course(DAFNE) lasting 5 days for training/knowledge etc...get your name on that list :agree:


p.s. sorry to the OP for starting another 'credit where it's due' topic on the same thread, I didn't want the holy ground forum being taken up by all the 'credit where it's due' threads this Scottish Government deserves :greengrin

[Moulin Yarns]

credit where it's due (part 2730178516)

https://jdrf.org.uk/news/10m-type-1-diabetes-tech-provision-pledged-scottish-government/

A new plan to improve the management of type 1 diabetes will be backed by £10 million of Scottish Government investment.
The additional funding will be used to increase the provision of insulin pumps, which deliver insulin into the body without the need for injections.


I for one have greatly benefitted from the use of an insulin pump, one painless injection every 3 days instead of 5 injections/day(for me) also takes a considerable amount of pain away as well, any type 1 diabetics on here should get their name down on the waiting list at their local clinic :aok: these things do cost a lot of money to the NHS, the one I have would have cost 3K to purchase privately and the accessories/supplies add another £6-7 hundred every 4 months, without help from the Scottish government the costs involved would be out of reach for the majority of type 1's, their is a little work involved in acquiring a pump though...a course(DAFNE) lasting 5 days for training/knowledge etc...get your name on that list :agree:


p.s. sorry to the OP for starting another 'credit where it's due' topic on the same thread, I didn't want the holy ground forum being taken up by all the 'credit where it's due' threads this Scottish Government deserves :greengrin

Good news. No matter which thread it appears on. Glad it has worked out for you, and you have highlighted what is involved :aok:

[lyonhibs]

You're right.

And bear in mind,most negative stories about NHSL are to do with senior management, not frontline staff

It's a societal thing in this country - we don't value healthcare or social care until we need it. Or our parents or grandparents need it. And then we realise it's an absolute shambles.

This is liable to take this thread in another direction, but to say that the care provided by front line staff in the NHS is "an absolute shambles" is offensive nonsense.

[ronaldo7]

credit where it's due (part 2730178516)

https://jdrf.org.uk/news/10m-type-1-diabetes-tech-provision-pledged-scottish-government/

A new plan to improve the management of type 1 diabetes will be backed by £10 million of Scottish Government investment.
The additional funding will be used to increase the provision of insulin pumps, which deliver insulin into the body without the need for injections.


I for one have greatly benefitted from the use of an insulin pump, one painless injection every 3 days instead of 5 injections/day(for me) also takes a considerable amount of pain away as well, any type 1 diabetics on here should get their name down on the waiting list at their local clinic :aok: these things do cost a lot of money to the NHS, the one I have would have cost 3K to purchase privately and the accessories/supplies add another £6-7 hundred every 4 months, without help from the Scottish government the costs involved would be out of reach for the majority of type 1's, their is a little work involved in acquiring a pump though...a course(DAFNE) lasting 5 days for training/knowledge etc...get your name on that list :agree:


p.s. sorry to the OP for starting another 'credit where it's due' topic on the same thread, I didn't want the holy ground forum being taken up by all the 'credit where it's due' threads this Scottish Government deserves :greengrin

You've missed a few:greengrin

Watch out though, someone will be along soon to say we're in crisis, or it's a shambles, and all this with the budget being cut from Westminster, they never seem to mention that eh.

[marinello59]

You've missed a few:greengrin

Watch out though, someone will be along soon to say we're in crisis, or it's a shambles, and all this with the budget being cut from Westminster, they never seem to mention that eh.

It's OK Ronnie. Most of us realise that this thread is not about debate and any less than supportive voices will be dismissed as Nat bashing.

[SHODAN]

Say what you want about our government but I'm really glad we have a safeguard from what is happening to the NHS down south.

[Betty Boop]

No credit from me I'm afraid, waited a year for two MRI scans.

[ronaldo7]

It's OK Ronnie. Most of us realise that this thread is not about debate and any less than supportive voices will be dismissed as Nat bashing.

Crack on Jon. Have you found another train breakdown?

[Beefster]

This is liable to take this thread in another direction, but to say that the care provided by front line staff in the NHS is "an absolute shambles" is offensive nonsense.

He didn't say that. In fact, I think the exact opposite point was being made.

IMHO, the lack of any real debate on the NHS because of the incessant need to praise/not offend front-line NHS staff and pretend that they are all wonderful is part of the problem. Either directly or indirectly, I've experienced great care, including staff who have gone well above and beyond, and I've experienced absolutely horrendous care, including gross incompetence and neglect.

Like any organisation, some folk are good at their jobs, some not so good at their jobs.

[lyonhibs]

He didn't say that. In fact, I think the exact opposite point was being made.

IMHO, the lack of any real debate on the NHS because of the incessant need to praise/not offend front-line NHS staff and pretend that they are all wonderful is part of the problem. Either directly or indirectly, I've experienced great care, including staff who have gone well above and beyond, and I've experienced absolutely horrendous care, including gross incompetence and neglect.

Like any organisation, some folk are good at their jobs, some not so good at their jobs.

Agree entirely but, unless I'm missing some very refined nuance in the post I quoted, what was effectively said was "when you or your loved ones actually need care from the NHS (or social services), it's an absolute shambles" which is, to put it mildly, painting with excessively broad strokes IMO.

Out of interest, what level/angle of debate on the NHS are you talking about? Whether it is a fundamentally good/worthwhile thing? Or whether it in it's current state/with the current governance in place it's all that it could/should be?

No doubt that it's far from perfect, but - with, granted, more notable exceptions (that always make the front pages) than anyone would ideally like - frontline staff are the last ones who should be having their work capabilities called into question. Again IMO.

[RyeSloan]

Agree entirely but, unless I'm missing some very refined nuance in the post I quoted, what was effectively said was "when you or your loved ones actually need care from the NHS (or social services), it's an absolute shambles" which is, to put it mildly, painting with excessively broad strokes IMO.

Out of interest, what level/angle of debate on the NHS are you talking about? Whether it is a fundamentally good/worthwhile thing? Or whether it in it's current state/with the current governance in place it's all that it could/should be?

No doubt that it's far from perfect, but - with, granted, more notable exceptions (that always make the front pages) than anyone would ideally like - frontline staff are the last ones who should be having their work capabilities called into question. Again IMO.

I agree it's a ridiculous broad brush but I also agree with the earlier post that alludes to the fact that it seems somewhat ingrained that just because you work for the NHS you are somehow automatically classed as 'hard working' or the like.

You say frontline staff are the last ones who should have their capabilities questioned...considering how many people that must cover is that too not a ridiculously broad brush.

As others have alluded to I have seen excellent and terrible care administered by the NHS and a dramatic difference in the attitude and aptitude of the front line staff...to me it's one of the NHS's biggest failings is its inconsistency when delivering it's service.

[Beefster]

Agree entirely but, unless I'm missing some very refined nuance in the post I quoted, what was effectively said was "when you or your loved ones actually need care from the NHS (or social services), it's an absolute shambles" which is, to put it mildly, painting with excessively broad strokes IMO.

Out of interest, what level/angle of debate on the NHS are you talking about? Whether it is a fundamentally good/worthwhile thing? Or whether it in it's current state/with the current governance in place it's all that it could/should be?

No doubt that it's far from perfect, but - with, granted, more notable exceptions (that always make the front pages) than anyone would ideally like - frontline staff are the last ones who should be having their work capabilities called into question. Again IMO.

I think the NHS is fundamentally a 'good thing' so any debate that needs to be had is, IMHO, around how it is improved and adequately funded.

Your last paragraph sort of reinforces my point about the difficulty of debating its failings though.

[beensaidbefore]

The real question should be how much money is wasted employing 3rd parties who operate purely for profit? The amount of different care agencies attending to older people is a huge drain when 1 company could do the same work, employ fewer carers, and avoid needless travelling time between clients.

I know for a fact that on a daily basis 5 agencies supply upwards of 8 different carers every day to come in for 15 & 30 minute visits to 1 sheltered housing block, rather than 1 agency visiting all of these needing care and support to dress take meds and shower etc. Some people are visited 4 times per day by the same carer, who then has to dash to the next client whist not being paid for the time between visits. Some carers are starting at 6.30 and working until 10pm and only being paid for about 8 hours work.

If anyone can explain why things are done this way other than to generate profit for the agencies I'd be interested to hear.

[Mibbes Aye]

This is liable to take this thread in another direction, but to say that the care provided by front line staff in the NHS is "an absolute shambles" is offensive nonsense.

I think you've seriously misinterpreted my post. Having said that I could have explained my point fully, so I'm not saying you are at fault.

If you reread my post I am not calling the care provided by frontline staff "an absolute shambles". In fact I start my post agreeing with someone who is praising nurses! Beefster's right though, there is a narrative which doesn't allow for criticism and that is a very dangerous thing.

In my post I talked about people coming into direct contact with healthcare and social care. I put the two together deliberately and also deliberately referred to our older relatives because the thrust of my point was healthcare and social care for older people. You can't separate the two in this regard, hence why the SNP and the other main parties have all explicitly committed to integration of the two for several years now.

Why do I think it's an absolute shambles?

The OP talked about the growth in staff over the last year. But when you look at the key measures of what an older person's experience is like, across the country, it's hard to see improvement and easy to see decline.

Key measures like the time it takes from being referred for treatment to actually getting the treatment. Not just are health boards all over the country failing to meet the target, they're getting further away from it.

Delayed discharges - when someone doesn't need to be in hospital for medical reasons but can't leave because they can't get the home care they need or a care home place. So they're stuck in a ward, blocking a bed and massively increasing their chances of becoming unwell from hospital-acquired infections. Just to put this in context for those unfamiliar with it - this has consistently been one of the biggest healthcare priorities of government,regardless of party. It's not got any better either and has trended worse over the last few years.

Hospitals like the Royal Victoria and Liberton were scheduled for closure, described by the senior managers as 'outmoded' and 'outdated'. In fact the Royal Vic was closed, then had to be reopened to deal with the issues described above.

NHS boards around the country, Scotland and UK, are incapable of balancing their budgets and can't say where they will find the savings this financial year to balance their budgets despite us being three-quarters of the way through it.

Out of the hospitals and into the community, we have GP practices. GPs are the gatekeepers for access to healthcare and should have a major role in reducing hospital admissions for older people. Up and down the country, practices are folding, or closing their lists to new patients because they can't deal with demand.

Care home provision stumbles from one crisis to another. While there are some excellent care homes, they are few and far between and the average quality grades in this area are well below other areas of social care. More worryingly, most care home provision is in the private sector, often owned by private equity funds. This goes back to the days when they were seen as steady profit-makers. Those days went a long time ago and the financial model is not fit for purpose, which is why one major owner, Southern Cross went out of business and others have been rumoured to be in desperate trouble. Bear in mind that these are the homes of the most vulnerable older people in our communities.

For those who can continue to live at home but require care, things aren't less precarious. The majority of home care is delivered by the private sector, using public money. However, these firms cannot recruit and retain staff, meaning people can go months without the care they have been assessed as needing (family having to cover, presumably) and when the care is in place there are constant issues about reliability and consistency.

The last two paragraphs describe care that is the responsibility of the integrated health and social care partnerships, which are meant to be the NHS board and the local council working in partnership. Both the boards and councils are having to deliver savings on an unprecedented scale, during a time when the evidence says that performance isn't good enough and there is no sign of additional money any time soon.

Oh, and to make matters worse, the older population is growing exponentially. Over-75s pretty much doubling over the next twenty years, over-90s trebling. So the demand goes up, while the means to address it is static or reducing.

And it's actually worse than those stats because our acute healthcare and advances in drugs mean we are able to keep people alive for longer, but in ill-health. So people are living on with an increasing range of long-term conditions or life-limiting conditions (think coronary heart disease, COPD, diabetes etc). These conditions need support from services, putting further strain on what's available.

These are some (and nowhere near all) the reasons I described the situation as an absolute shambles. It's quite good timing that since I made my last post, this debate has blown up down in England!

Still, as someone said earlier, I guess these are just broad brushstrokes.......

[beensaidbefore]

I think you've seriously misinterpreted my post. Having said that I could have explained my point fully, so I'm not saying you are at fault.

If you reread my post I am not calling the care provided by frontline staff "an absolute shambles". In fact I start my post agreeing with someone who is praising nurses! Beefster's right though, there is a narrative which doesn't allow for criticism and that is a very dangerous thing.

In my post I talked about people coming into direct contact with healthcare and social care. I put the two together deliberately and also deliberately referred to our older relatives because the thrust of my point was healthcare and social care for older people. You can't separate the two in this regard, hence why the SNP and the other main parties have all explicitly committed to integration of the two for several years now.

Why do I think it's an absolute shambles?

The OP talked about the growth in staff over the last year. But when you look at the key measures of what an older person's experience is like, across the country, it's hard to see improvement and easy to see decline.

Key measures like the time it takes from being referred for treatment to actually getting the treatment. Not just are health boards all over the country failing to meet the target, they're getting further away from it.

Delayed discharges - when someone doesn't need to be in hospital for medical reasons but can't leave because they can't get the home care they need or a care home place. So they're stuck in a ward, blocking a bed and massively increasing their chances of becoming unwell from hospital-acquired infections. Just to put this in context for those unfamiliar with it - this has consistently been one of the biggest healthcare priorities of government,regardless of party. It's not got any better either and has trended worse over the last few years.

Hospitals like the Royal Victoria and Liberton were scheduled for closure, described by the senior managers as 'outmoded' and 'outdated'. In fact the Royal Vic was closed, then had to be reopened to deal with the issues described above.

NHS boards around the country, Scotland and UK, are incapable of balancing their budgets and can't say where they will find the savings this financial year to balance their budgets despite us being three-quarters of the way through it.

Out of the hospitals and into the community, we have GP practices. GPs are the gatekeepers for access to healthcare and should have a major role in reducing hospital admissions for older people. Up and down the country, practices are folding, or closing their lists to new patients because they can't deal with demand.

Care home provision stumbles from one crisis to another. While there are some excellent care homes, they are few and far between and the average quality grades in this area are well below other areas of social care. More worryingly, most care home provision is in the private sector, often owned by private equity funds. This goes back to the days when they were seen as steady profit-makers. Those days went a long time ago and the financial model is not fit for purpose, which is why one major owner, Southern Cross went out of business and others have been rumoured to be in desperate trouble. Bear in mind that these are the homes of the most vulnerable older people in our communities.

For those who can continue to live at home but require care, things aren't less precarious. The majority of home care is delivered by the private sector, using public money. However, these firms cannot recruit and retain staff, meaning people can go months without the care they have been assessed as needing (family having to cover, presumably) and when the care is in place there are constant issues about reliability and consistency.

The last two paragraphs describe care that is the responsibility of the integrated health and social care partnerships, which are meant to be the NHS board and the local council working in partnership. Both the boards and councils are having to deliver savings on an unprecedented scale, during a time when the evidence says that performance isn't good enough and there is no sign of additional money any time soon.

Oh, and to make matters worse, the older population is growing exponentially. Over-75s pretty much doubling over the next twenty years, over-90s trebling. So the demand goes up, while the means to address it is static or reducing.

And it's actually worse than those stats because our acute healthcare and advances in drugs mean we are able to keep people alive for longer, but in ill-health. So people are living on with an increasing range of long-term conditions or life-limiting conditions (think coronary heart disease, COPD, diabetes etc). These conditions need support from services, putting further strain on what's available.

These are some (and nowhere near all) the reasons I described the situation as an absolute shambles. It's quite good timing that since I made my last post, this debate has blown up down in England!

Still, as someone said earlier, I guess these are just broad brushstrokes.......

Great post. Explained things far better than I could have.