Give us your ideas to save NHS money

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If we want to keep an NHS ‘free at the point of delivery’, WE have to fight for this.

It is no use expecting ‘them’ to sort out the NHS’s problems.  It belongs to us – and as ‘our’ service it is up to us to suggest where the cuts come.  Whatever you believe, there are going to be massive cuts, whichever party gets in.  So look around, suggest where the cuts can come – and I will pass on sensible suggestions.

Here are some ideas.  Do send more:

Being a realistic cynic, before the mad Consultants, Ministers and Uncle Tom Cobley are allowed to set up their ‘cost-cutting exercises’, perhaps we can all come up with ideas for saving money without the stupidity of cutting doctors, nurses, technicians etc.

LATEST SUGGESTION :  before the PCT/NHS outsources services, get Staff to discuss these.  One area has outsourced its Ambulance service to a private company.  Fine in theory;  in practice it meant a 101 year old patient was told at 3pm she could go home from A & E.  Sister told her daughter bad news was there wasn’t an Ambulance available until 3 AM – twelve hours wait!  Sister used her contacts, found there was an Ambulance going to another village 2 miles from the patient’s home, and arranged with the Ambulance crew to take two patients. She got stick from the dispatcher – obviously cross that his company had lost a lucrative journey fee.  Staff could have pointed out that this could happen, and something could have been negotiated in the contract.

1. One patient suggests for starters that some of the staff must know where savings could be made, and there should be  rewards for suggestions if taken up.

2. These same staff should be consulted where and when the NHS feels there is a need for change.  Currently, expensive outside Consultants are bought in – if these were ditched – this could save the NHS millions.  Professor Steve Field, Chair of Royal College of General Practictioners,  says NHS spending on external consultants is a ‘scandal’, telling his audience of around 1,000 GPs that the  money should be reinvested in services.

3. How many Ambulances have to turn back because someone has forgotten to put the patients’ notes in with them?  This happened to a friend being transferred between a South London and a North London Hospital.  Setting off at 11pm, the Ambulance finally arrived at its destination around 2.30 AM, having had to turn back for the notes. I dread to think what the overtime bill was for that mistake.   So why not tape a notice HAVE YOU GOT THE PATIENTS’ NOTES? inside Ambulance doors, to act as a simple reminder.

4. Private hospitals work their radiotherapy units 12 hours a day.  The NHS one near me works 8 hours a day.  Radiotherapy machinery is a huge capital cost – so surely it is more efficient to keep this machinery working 12 hours a day, and overheads and capital replacement  costs could be saved if the machinery was working longer hours?  And patients wouldn’t have to wait so long for an appointment.

5. And why is Friday the signal for theatres, physio depts., etc. to close down at mid-day?  Patients still need treatment, and again, private hospitals are often open until 8 pm.

Nurses, doctors, technicians, physios etc. and patients – you must have simple ideas that would save money and stop the need to employ outside Consultants.  Send these to tto@btinternet.com – either anonymously, or if you want to be acknowledged put your name at the end of the email.

And I will even send it on to the appropriate department with the suggestion that this is deserving of a monetary reward.

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3 thoughts on “Give us your ideas to save NHS money

  1. ann muir February 18, 2010 at 8:55 pm Reply

    Why can’t radiotherapy machines go 24/7? this would make it pay better, and cut the waiting times!

  2. John Michael Richards May 15, 2011 at 6:19 pm Reply

    Each year, the implementation of his idea will save the NHS £Millions in unit purchase costs and costs associated with disposal of clinical waste and will go some way to reducing risks to patients and to saving our planet:

    SAVE LIVES, SAVE MONEY, SAVE THE PLANET:

    I was a registered Principal Operating Department Practitioner and over three decades have worked extensively in the NHS and private healthcare sectors in the United Kingdom and overseas. In Great Britain and most of Europe, it is common practice in virtually every administration of a general anaesthetic to use a device called a ‘catheter mount’ which sits between the anaesthetic circuits of the anaesthetic machine and the endotracheal tube (ETT) or laryngeal mask (LM) which is inserted into the patient airway to facilitate breathing during surgical procedures. Twenty years ago it was common practice to use reusable catheter mounts but nowadays virtually all such devices are made of three pieces of welded plastic and these are then thrown away after single use.

    The average cost per unit to the NHS is £1.50 but this does not include the costs associated with disposal; catheter mounts are treated as medical waste so have to go into yellow clinical waste bags which cost considerably more to dispose of than do traditional black refuse bags.

    Catheter mount usage in the UK and Europe is largely a remnant of the days when red rubber tubes and heavy anaesthetic circuits (made of thick and heavy corrugated carbonised rubber with stainless steel couplings) were used during anaesthesia. The red rubber rubber endotracheal tube which was around 32 cm long when new, was prone to soften when it became warm with the patient’s respired gasses and was likely to kink or occlude, especially under the weight of the heavy anaesthetic circuit tubesm thus presenting serious risk to the patient; to minimise this, anaesthetists would cut the endotracheal tubes to a shorter (around 21 – 24cm in adults) length and then insert a catheter mount to take up the strain and fill the gap between the endotracheal tube and the heavy anaesthetic circuit. However, modern anaesthetic circuits are made of lightweight plastics and adult endotracheal tubes come in lengths of around 30 cm and are more rigid, and thus less inclined to kink, than their red rubber forerunners.

    Yet it remains ubiquitous practice in the United Kingdom and across Europe to cut around 6 – 8cm off these adult tubes and then attach a catheter mount of some 6 – 8cm. It is a ludicrous practice which has continued without challenge. Yet in paediatric anaesthesia it is rare that a catheter mount would be used in the UK. In the USA (which is a culture renowned for being risk averse in medicine) catheter mounts for adults are virtually unheard of; the endotracheal tubes are left uncut and connected directly to the anaesthetic circuit. Not only does this reduce purchase costs and waste sent to incineration and ultimately to landfill, it also removes a source of possible disconnection of the catheter mount; such disconnections are one of the most common cause of peri-anaesthetic fatalities and morbidity. Removing them removes a risk. Catheter mounts also introduce a component known as ‘dead-space’ into the anaesthetic delivery system; dead-space can be problematic and even fatal in certain categories of patient, particularly the very young and those with chronic obstructive pulmonary disease (a common ailment of patients in the the industrial northwest and northeast). Again, removing the catheter mount removes the risk.

    There remain a very few instances in which there would be a use for a catheter mount – for example in neurosurgery and surgery of the head and neck. But even in these cases the use of a different type of endotracheal tube; for example a ‘RAE’ or reinforced or ‘armoured’ endotracheal tube could more safely be used.

    A catheter mount is used in almost every operation undertaken under general anaesthesia. They are also used on almost all patients in intensive care and those who, under sedation or general anaesthesia, are transferred by ambulance from one hospital unit to another or from one hospital department to another. Thus I believe savings would be many millions of pounds per year.

    This idea should be raised with the appropriate people in government. It would likely also be of tremendous interest to NHS and private healthcare executive management and to members of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland. Anaesthetists are creature of habit – and for good reason too as regular adherence to protocols go some way to upholding safe practice – but this instance is one of bad habit that is outdated.

    I have available a number of images of catheter mounts and their attachment to a typical endotracheal tube which would further illustrate the scenarios.

    In summary, I believe implementing this proposal would;

    1. Reduce fatalities and morbidity
    2. Reduce peri-operative risks to patients undergoing general anaesthesia for surgical and diagnostic procedure
    3. Reduce significantly the costs incurred by the NHS and private sector in procurement and disposal
    4. Reduce waste incinerated and/or sent to landfill.

    • Verite Reily Collins May 17, 2011 at 12:40 pm Reply

      As a patient with no medical knowledge, it would be interesting to know why this idea doesn’t seem to have found favour with NHS Admin?

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