Nhs

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Originally Posted by Just Alf

A key driver for the bed reductions was modern methods and medicine, example being my wife's shoulder replacement op, 1st one years ago she was in almost a week, last time she was out the following evening.

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That would make sense if the fifth tweet doesn't show that we cut more and and a bigger % than most eu nations. We've alot less beds per person than most western nations.

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Originally Posted by Stairway 2 7

That would make sense if the fifth tweet doesn't show that we cut more and and a bigger % than most eu nations. We've alot less beds per person than most western nations.

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I'd love to know how "number of beds" relates to "health outcomes" when it comes to assessing the performance of the NHS.

It strikes me a trite stat that politicians could tweak to make it look like they're doing a better job than they actually are "under this government we have seen the number of hospital beds increase by.... blah, blah" with patients more likely to die in crowded wards when they could be safely discharged home etc, with the money saved being used to fund adequate disease prevention programmes.

Whilst we are correctly cynical about the idea of healthcare money being siphoned off to pay profits, let's not forget that resources and positive health outcomes can be siphoned off elsewhere to pay political capital to those who wish to govern us.

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Originally Posted by Smartie

I'd love to know how "number of beds" relates to "health outcomes" when it comes to assessing the performance of the NHS.

It strikes me a trite stat that politicians could tweak to make it look like they're doing a better job than they actually are "under this government we have seen the number of hospital beds increase by.... blah, blah" with patients more likely to die in crowded wards when they could be safely discharged home etc, with the money saved being used to fund adequate disease prevention programmes.

Whilst we are correctly cynical about the idea of healthcare money being siphoned off to pay profits, let's not forget that resources and positive health outcomes can be siphoned off elsewhere to pay political capital to those who wish to govern us.

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The modern thinking for some time has been fewer hospital beds but try reducing the number without surgeons and the like kicking up a fuss in the local media - more beds higher status as they see it!

The problem, as I see it, is that insufficient resources have been made available to get people out of these incredibly expensive beds and back home or into cheaper to run convalescent type institutions. I personally don't see this new National Care Service achieving this.

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Originally Posted by Smartie

I'd love to know how "number of beds" relates to "health outcomes" when it comes to assessing the performance of the NHS.

It strikes me a trite stat that politicians could tweak to make it look like they're doing a better job than they actually are "under this government we have seen the number of hospital beds increase by.... blah, blah" with patients more likely to die in crowded wards when they could be safely discharged home etc, with the money saved being used to fund adequate disease prevention programmes.

Whilst we are correctly cynical about the idea of healthcare money being siphoned off to pay profits, let's not forget that resources and positive health outcomes can be siphoned off elsewhere to pay political capital to those who wish to govern us.

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Germany has almost double the beds per 10k than us. I'm obviously no expert, but when we have people dying in queues of ambulances sitting outside hospitals waiting for a bed, it's obvious we have to little.

One reason they say Germany did so much better in the first two waves of covid, was the capacity it had for emergencies.

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Originally Posted by Stairway 2 7

That would make sense if the fifth tweet doesn't show that we cut more and and a bigger % than most eu nations. We've alot less beds per person than most western nations.

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Oh I know , not defending the current position at all, more needs done... just pointing out there were clinical reasons for bed reductions (at one point at least)

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Originally Posted by Stairway 2 7

Hospital beds have halved in the last 30 years, but the NHS budget has doubled in real terms

https://mobile.twitter.com/cjsnowdon...48634883092480

In the last 20 years the ministry of health's staff has doubled but nurses only up 7%. Where the money going, mostly on wages

We definitely underspend compared to gdp but we perform worse than we should

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Worth noting that there are a number of reasons why hospital beds numbers have decreased that are deliberately linked to policy, across the UK, especially when looking at it over the last 35 years.

A lot of people receiving mental health care no longer reside in facilities which are deemed to be 'hospital'. with 'hospital beds' (even though they don't look like 'hospitals' from the outside)

A lot of people with learning disabilities no longer reside in facilities which are deemed to be 'hospital'. with 'hospital beds' (even though they don't look like 'hospitals' from the outside)

A lot of people who require nursing care but not necessarily in a hospital setting are no longer badged as 'NHS continuing care' which means that their beds are not described as 'hospital beds'.

Some people who erred on the side of needing a hospital bed are now supported 'at home', whether in 'extra care' housing or with intensive multidisciplinary care at home or with approaches like 'hospital at home'. They are homeowners or tenants and not counted as occupying 'hospital beds'.

So, as per usual, there is a lot more to things than one simple stat or graph, taken out of context.

If nothing else, linking to someone who works for the IEA, Liz and Kwasi's thinktank of choice should have been a warning that all may not be as it seems :greengrin

Hospital bed numbers are a bit like ‘bobbys on the beat’. A number that is used to describe the quality of a service which has no correlation with the quality of that service.


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Originally Posted by Mibbes Aye

Worth noting that there are a number of reasons why hospital beds numbers have decreased that are deliberately linked to policy, across the UK, especially when looking at it over the last 35 years.

A lot of people receiving mental health care no longer reside in facilities which are deemed to be 'hospital'. with 'hospital beds' (even though they don't look like 'hospitals' from the outside)

A lot of people with learning disabilities no longer reside in facilities which are deemed to be 'hospital'. with 'hospital beds' (even though they don't look like 'hospitals' from the outside)

A lot of people who require nursing care but not necessarily in a hospital setting are no longer badged as 'NHS continuing care' which means that their beds are not described as 'hospital beds'.

Some people who erred on the side of needing a hospital bed are now supported 'at home', whether in 'extra care' housing or with intensive multidisciplinary care at home or with approaches like 'hospital at home'. They are homeowners or tenants and not counted as occupying 'hospital beds'.

So, as per usual, there is a lot more to things than one simple stat or graph, taken out of context.

If nothing else, linking to someone who works for the IEA, Liz and Kwasi's thinktank of choice should have been a warning that all may not be as it seems :greengrin

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That's all window dressing and can explain a tiny amount. How about icu hospital beds only. Uk has 228 per 100k Germany 621 per 100k. Tories are running nhs to the ground. Nurse numbers, nurses wages and hospital beds have collapsed compared to western Europe. Finances haven't, it's about time the explained where the money has gone

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Originally Posted by Stairway 2 7

That's all window dressing and can explain a tiny amount. How about icu hospital beds only. Uk has 228 per 100k Germany 621 per 100k. Tories are running nhs to the ground. Nurse numbers, nurses wages and hospital beds have collapsed compared to western Europe. Finances haven't, it's about time the explained where the money has gone

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Do Germanys, or any other country you might throw up, include high dependency beds and what the different criteria is between them and ICU is?

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Originally Posted by Stairway 2 7

Hospital beds have halved in the last 30 years, but the NHS budget has doubled in real terms

https://mobile.twitter.com/cjsnowdon...48634883092480

In the last 20 years the ministry of health's staff has doubled but nurses only up 7%. Where the money going, mostly on wages

We definitely underspend compared to gdp but we perform worse than we should

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If it is anything like the Civil Service it will have went on a huge amount of administrators telling workers what to do, a massive increase in the numbers employed as managers most of who will know nothing about the work, procurement staff making contracts where the items would be cheaper at the local shop and a multitude of failed IT software and IT workers who appear to make more money if they are unsuccessful that if they provide what was requested. So much money is spent on working out how to deliver and the actual delivering workers are starved of funds and usually undervalued in the pay structure. Where I work we spend approximately the same on what I would deem to be productive workers wages as we do on those not directly involved in producing

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Originally Posted by Jack

Do Germanys, or any other country you might throw up, include high dependency beds and what the different criteria is between them and ICU is?

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Here's great but shocking article from the bma showing how poor our hospital bed numbers are compared to the rest of Europe. We've also got a lot less critical care beds per head. It also shows its not down to reclassification of beds either

https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis

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Originally Posted by Stairway 2 7

Here's great but shocking article from the bma showing how poor our hospital bed numbers are compared to the rest of Europe. We've also got a lot less critical care beds per head. It also shows its not down to reclassification of beds either

https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis

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So you've moved the goal posts from ICU to critical care. You regularly do similar.

I'm in no way defending what the torys have done to the NHS in England.

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Originally Posted by Jack

So you've moved the goal posts from ICU to critical care. You regularly do similar.

I'm in no way defending what the torys have done to the NHS in England.

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What you mumbling about as usual, the charts says we have a fraction of both icu and critical care compared to peers. It was constantly reported throughout covid that we did so bad due to much less icu capacity than other Western European countries. Did you read the bma article because your disputing what they say

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Originally Posted by Ozyhibby

https://www.bbc.co.uk/news/uk-scotla...r_name=twitter

They’ll get slated for this but new thinking is needed.


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They might then find some money to give us a decent pay rise!

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Originally Posted by Stairway 2 7

What you mumbling about as usual, the charts says we have a fraction of both icu and critical care compared to peers. It was constantly reported throughout covid that we did so bad due to much less icu capacity than other Western European countries. Did you read the bma article because your disputing what they say

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You said

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Originally Posted by Stairway 2 7

That's all window dressing and can explain a tiny amount. How about icu hospital beds only. Uk has 228 per 100k Germany 621 per 100k.

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... and I challenged you about the criteria for an ICU bed the UK and Germany. You then quoted a report about critical care, high dependency and ICU beds. That report is not ICU specific. Nor does it say what the difference is between UK ICU beds and their German equivalent. Note UK critical care and high dependency are not ICU beds.

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Originally Posted by Stairway 2 7

What you mumbling about as usual, the charts says we have a fraction of both icu and critical care compared to peers. It was constantly reported throughout covid that we did so bad due to much less icu capacity than other Western European countries. Did you read the bma article because your disputing what they say

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F sake man, Jack clearly has worked in the sector, why do you regularly get things wrong due to not checking your facts properly, and then never ever back down?

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Originally Posted by Jack

You said



... and I challenged you about the criteria for an ICU bed the UK and Germany. You then quoted a report about critical care, high dependency and ICU beds. That report is not ICU specific. Nor does it say what the difference is between UK ICU beds and their German equivalent. Note UK critical care and high dependency are not ICU beds.

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I haven't got the definition but every report including WHO says Germany has multiple times more icu beds than the UK.

This report into icu beds puts Germany at population 82 million, hospitals with icu beds 1260, icu beds per 100k 31.8
Uk , 62 million, 290, 7.5 per 100k

I only put up critical care because it show we have a fraction on every metric icu beds, critical care and hospital beds


It's a weird hill for you to die on. Were you not involved in the NHS surely you knew we were behind our peers. It was widely reported regularly during covid that we had less icu beds and hospital beds than most western European nations

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Originally Posted by Stairway 2 7

I haven't got the definition but every report including WHO says Germany has multiple times more icu beds than the UK.

This report into icu beds puts Germany at population 82 million, hospitals with icu beds 1260, icu beds per 100k 31.8
Uk , 62 million, 290, 7.5 per 100k

I only put up critical care because it show we have a fraction on every metric icu beds, critical care and hospital beds


It's a weird hill for you to die on. Were you not involved in the NHS surely you knew we were behind our peers. It was widely reported regularly during covid that we had less icu beds and hospital beds than most western European nations

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I was involved with the NHS and that's how I know there's a difference and so making straight comparisons misleading. It's been mentioned before. Not by me!

All this discussion about beds is just about measuring inputs. It’s outcomes that are most important and here we are getting our arse kicked by most of Europe.


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Originally Posted by Ozyhibby

All this discussion about beds is just about measuring inputs. It’s outcomes that are most important and here we are getting our arse kicked by most of Europe.


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But one begets the other. The bma said having less icu beds in comparison to most other Western European countries directly caused deaths in the first covid waves. Every winter were pushing over capacity add in covid pressure and it breaks us. Hospitals have regular queues of ambulances with people in them needing beds this also directly causes deaths.

I'd again recommend reading the bma plea for more beds. We have 2.4 per 1000 hospital beds the EU average is almost double at 4.6. Do you reckon they are all wrong and we are right.

https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis

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Originally Posted by Jack

I was involved with the NHS and that's how I know there's a difference and so making straight comparisons misleading. It's been mentioned before. Not by me!

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Who mentioned it. The bma and Chris Hopson chief of nhs England also say we're near the bottom of the list of eu countries

https://www.google.com/amp/s/amp.the...al-bosses-warn

https://www.google.com/amp/s/amp.the...al-bosses-warn

My wife works in A&E and, simplistically, the reducing in bed numbers and lack of available beds has a direct correlation with the issues A&E departments are experiencing.

They are primarily measured in wait time, but the significantly lower wait times being experienced now are significantly impacted by the reduction in bed numbers in the hospital. If there isn't a bed available in ICU, or CCU, the patient can't be moved out of A&E which means that they breach the 4 hour limit as well as the person behind them in the treatment queue also breaching.

It isn't the only reason clearly, but making more beds available either by employing more staff, or clearing bed blockers or to community care would have a massive impact on the quality of care in A&E.

It doesn't help the perception that there is too many managers/administrators when there are two floors in the hospital up here previously used as wards with 40 odd beds that are now offices for the managers in the hospital and can not be opened up for patient care.

I'm not really sure what the answer is to be honest, but more nursing, doctor and support staff would certainly make a massive difference. To do that they need to pay these staff a fair wage and not keep gradually eroding their wages.

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Originally Posted by Sergio sledge

My wife works in A&E and, simplistically, the reducing in bed numbers and lack of available beds has a direct correlation with the issues A&E departments are experiencing.

They are primarily measured in wait time, but the significantly lower wait times being experienced now are significantly impacted by the reduction in bed numbers in the hospital. If there isn't a bed available in ICU, or CCU, the patient can't be moved out of A&E which means that they breach the 4 hour limit as well as the person behind them in the treatment queue also breaching.

It isn't the only reason clearly, but making more beds available either by employing more staff, or clearing bed blockers or to community care would have a massive impact on the quality of care in A&E.

It doesn't help the perception that there is too many managers/administrators when there are two floors in the hospital up here previously used as wards with 40 odd beds that are now offices for the managers in the hospital and can not be opened up for patient care.

I'm not really sure what the answer is to be honest, but more nursing, doctor and support staff would certainly make a massive difference. To do that they need to pay these staff a fair wage and not keep gradually eroding their wages.

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A+E is definitely a department where a shortage of beds would have a significant impact.

A+E is a weird one though, in that it's a department that comes under huge pressure at some times and can be relatively quiet at others. Whilst we're all demanding value for the taxpayer it can be quite hard to tally up Friday and Saturday night mayhem with relatively quiet times through the week (although I reckon they've probably closed down most of the A+E departments that would have historically fitted this description).

The point was made elsewhere though that there are conditions that previously would have been treated by having patients in hospital, in beds, where that is no longer the case. It's for the best for the patient that this is no longer the case, it's not just Tories saving money.

So whilst "beds" will tell you so much and shouldn't be dismissed out of hand, it's only one of thousands of measurables that will go towards assessing the value for money and effectiveness of a health service.

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Originally Posted by hibsbollah

F sake man, Jack clearly has worked in the sector, why do you regularly get things wrong due to not checking your facts properly, and then never ever back down?

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Just noticed this wee welp. How have I got it wrong every single source including the head of nhs England agrees with me. Last time you said I was wrong was when you said Russia was going to start a new front in Kherson. About 2 weeks later they lost half of the oblast ha. Just you keep fact checking yourself son

Rishi goes to a private gp practice, not unexpected

https://www.theguardian.com/politics...e_iOSApp_Other

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Originally Posted by Stairway 2 7

Germany has almost double the beds per 10k than us. I'm obviously no expert, but when we have people dying in queues of ambulances sitting outside hospitals waiting for a bed, it's obvious we have to little.

One reason they say Germany did so much better in the first two waves of covid, was the capacity it had for emergencies.

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You probably need to look at the politics of Germany to get a better understanding. I'm no expert but since the war Germany has either had CDU, SPD or coalition government. The CDU seem to be more akin to labour under Blair/starmer whereas the SPD seem more like labour. I'm sure Hibrandenberg can correct me but I don't think they have elected anything as right wing as post '79 conservative party.

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Originally Posted by degenerated

You probably need to look at the politics of Germany to get a better understanding. I'm no expert but since the war Germany has either had CDU, SPD or coalition government. The CDU seem to be more akin to labour under Blair/starmer whereas the SPD seem more like labour. I'm sure Hibrandenberg can correct me but I don't think they have elected anything as right wing as post '79 conservative party.

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That could be correct for Germany but we've dropped below Poland, Hungary, Austria, Switzerland and France who all have very right wing government often.

I think the tories are truly a special brand of self serving filth. They use the blanket of keeping a free NHS whilst running it into the ground

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Originally Posted by Stairway 2 7

That could be correct for Germany but we've dropped below Poland, Hungary, Austria, Switzerland and France who all have very right wing government often.

I think the tories are truly a special brand of self serving filth. They use the blanket of keeping a free NHS whilst running it into the ground

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We keep electing them though.

Or, we struggle to find people to make a compelling enough argument for doing things differently.

I share your general despair for the state of healthcare in the UK. I can't quite get my head around how and why we're getting it so wrong.

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Originally Posted by degenerated

You probably need to look at the politics of Germany to get a better understanding. I'm no expert but since the war Germany has either had CDU, SPD or coalition government. The CDU seem to be more akin to labour under Blair/starmer whereas the SPD seem more like labour. I'm sure Hibrandenberg can correct me but I don't think they have elected anything as right wing as post '79 conservative party.

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:agree: That's a decent analysis, the Tories in their current constellation are further right than the AfD. On the other hand, the German health service resembles more the Tory vision of how it should be rather than the left's, it's definitely 2 tier however even the lower tier comes at a high price compared to that in the UK. All in all most people are happy enough to pay more for a decent health service.

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Originally Posted by Hibrandenburg

:agree: That's a decent analysis, the Tories in their current constellation are further right than the AfD. On the other hand, the German health service resembles more the Tory vision of how it should be rather than the left's, it's definitely 2 tier however even the lower tier comes at a high price compared to that in the UK. All in all most people are happy enough to pay more for a decent health service.

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Sunak’s government just aren't further right than afd. Their last manifesto wanted to ban gay marriage, said climate change wasn't man made, wants to ban the burqa and call to prayer and put all imams through vetting. They are both awful on immigration although afd are worse on their views on multiculturalism.

Tories are definitely brutally right wing still