Hope & Aspiration

Happy new year!

What are your biggest concerns, hopes & aspirations?

What’s on your mind? What do you hope 2023 brings?

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Hope: I hope the NHS received the necessary funding and attention as it can no longer provide satisfactory care. What I read in the news is shocking.
Concern: The raising inequality been driven by high inflation and the impact on families and businesses.
Aspiration: For my family to have a healthy year, I really can’t ask for anything more.
On a happier note my wine aspiration is to expand my Barbaresco reserves with quantity, quality and new wines.

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That Putin, Trump, Xi, Orban, Johnson, Netanyahu, and various others exit the stage one way or another!

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My aspiration is that enough people wake up to the fact that to this is being done to them - it is, after all our health service that we collectively all own, fund and use - by the very people they likely voted for. In short, democracy needs to be engaged with in a little more of a savvy manner for it to function properly.

Beyond that, I hope Nigel Garage requires rescuing by the RNLI sometime this year. I mean him no harm, just some pictures of him being helped by people worth a billion of him. Hopefully the Royal Navy won’t be in attendance, as I fear the offices of the daily mail might spontaneously combust.

My ‘concern’ - and it’s really a Venn diagram contained in the first two - is that toxic politics and opinions are standing in the way of a fairly easy route to dealing with climate change. In short, I suppose I just wish people were better at seeing what’s important in the grand scheme of things - to make that easy to understand, someone eating avocado and tofu on toast really doesn’t bother me in the same way as say mass extinctions of species, or the potential for my house being washed away by flooding. I can but hope.

So, in short, just maybe we could have a better, more forward looking world this year? Hope springs eternal :grinning:

(And a Happy and healthy new year to one and all)

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Sorry I must be awfully shallow (although just a little hungover/tired) but when I read the initial title of this thread I thought it was wine related :innocent: Sorry. I’ll go for world peace, even though it makes me sound like Miss World (by the way is that still a thing).

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I’ll go for world peace too, using Charles Chaplin’s monologue on the Great Dictator as a frame of reference.

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That this is being done to “us”, was brought home to me very powerfully over Christmas, trying to get medical attention for my 96 yo dad with a nasty chest infection. Not life-threatening, but at that age it could easily become so if untreated. 111 wasn’t working properly (call back requests lost), and an ambulance (called by a duty doctor) didn’t arrive in the few days we waited. It took 12hrs, on the phone and waiting for 111 call backs, to get a simple initial prescription for anti-biotics, and we nearly had to wait over night to get the pills because the late-night pharmacies were closing. The horror stories from A&E staff are just the tip of the iceberg.

My hope is that NHS emergency services (at the very least) get fixed. I find it a very scary situation. What happens if someone is badly injured in a car accident? Or if there is a terrorist incident like the Manchester Area bombing? It doesn’t bear thinking about.

Secondly I hope Putin is defeated one way or another, and the people of Ukraine get to live in peace again.

I know there is a lot of misery and suffering otherwise, and that shouldn’t be dismissed lightly. But to be honest, those two issues are at the top of my “agenda”.

PS Dad is now recovering well :slight_smile:

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Concern: I think at the moment, there are a lot of concerns in the world. Ukraine, Putin, North Korea, The cost of Living, the price of gas/electricity, the NHS, the health and well-being of loved ones. It’s hard to pick one concern out of the above. If anything, it would be Putin and the Ukraine as that has a direct influence on the majority of the above. My Grandfather is currently in the care of the NHS and I know how broken it is from one of my ex-girlfriends. It’s not just the government though, this has been coming for years and years - yes - the government hasn’t helped but see also chronic mismanagement, an aging population, a lack of funding, inability to attract/retain workers. It’s a perfect storm for any organisation.

Hope:

To avoid seeing my name in a headline anywhere!!! In seriousness, I had a promotion over Christmas which has resulted in me getting my first Command/Captaincy of an aircraft. If I can avoid any paperwork or worse, it’d be a great start. I also hope for the continued health and well-being of my family and loved ones.

Aspiration:

To save enough money to be able to take my family on holiday and afford a bigger house!!!

Now… my wine ones:

Concern: That i’ve got too many white wines to drink now and I fear some of them might be in their twilight months.

Hope: That somehow, I manage to tick off a few of my “bucket list wines” - you know the ones!

Aspiration: to own another wine storage fridge/cabinet!

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I keep hearing about how each successive government is ruining the NHS (by the way it’s boll***s to call it ‘ours’).

Until the NHS is taken out of one party politics (make it apolitical) and properly funded (that means WE pay more for it) these sort of arguments will continue. Come the time when no political party can call out the other for mismanagement of the NHS is the time when progress might be made. And contributions should be increased right from starting work, which for an increasing amount of people is in their late twenties following uni/going walkabout!

Now where’s my blood pressure monitor?

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My experience of working as a nurse until I figuratively ran screaming from the building with my hair on fire a few years ago was first coming into a trashed and almost Victorian style care system in the nineties, a gradual recovery in the early noughties followed by a throttling off of funding and the wholesale closure of social care systems beginning in 2010. Do you notice a pattern emerging? Yes I’m afraid it is about party politics and the choices they make on our behalf.

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Maybe some of you know that, post retirement, I still work limited hours as an out of hours GP in Norfolk, I’ve been doing this for the past 32 years. Currently I work weekend shifts for the GP triage service which in turn is fed calls from 111 which they can’t decide what to do with short of sending an ambulance. Right through from Xmas day to yesterday the whole service was completely overwhelmed; by far the worst I have ever seen. Patients calling 111 and waiting for a GP callback were waiting for anything between 8 hours when we’d started to get on top of things, to 16 hours; usually for calls which had come in the later afternoon or evening and remained on the callback list overnight.

Similarly our own urgent care clinics and home visiting service were totally swamped, 111 has the Power to appoint cases to our urgent care bases without clinical endorsement and many of these patients could have been managed by advice only; which is often all they wanted in the first place.

But here’s the thing. 111 doesn’t work because it is so risk averse and rigid. NHS Direct was much better as it was front-ended by trained nurses, but now it is lay call-handlers following a script and an algorithm, and the staff turnover is very rapid. So, our callback lists are mainly minor coughs and colds, forgotten medication, feeling sad, lonely or stressed, or something must be done about granny when the relatives who visit twice a year turn up. Oh and the latest twist is patients calling us at a weekend for routine GP care because they hadn’t been able to make contact with their own GP in the week…

The other cohort we are asked to manage are the Category 2 and 3 dispositions which 111 has provisionally allocated, but we can review them within the hour to see whether a non-ambulance response is indicated, which it usually is about 90% of the time. But after an hour the disposition stands and the ambulance is requested, and due to the overload we were not getting back to these calls in time, adding to the ambulance pressures. Moreover, very frequently an attending crew, having been inappropriately sent by 111 for a non-urgent case will place a call back to us to discuss not taking the patient to hospital but we were not getting to those in time either, forcing the crew to abandon the call back and taking the patient in anyway.

We have to call the patients back in “breach time” order; a call is triggered to “breach” by the original 111 disposition which had applied an arbitrary callback time depending on what 111 perceived as the level of urgency.

But 111 is very poor at spotting the genuine urgent cases and too frequently I’d be calling back a patient or a carer for a case which should have had much higher priority many hours later, but 111 simply didn’t spot it, and whereas the majority of callbacks are assigned a far too “urgent” priority on account of trigger phrases like “bleeding” or “difficulty breathing” which could apply, for example, to a nose bleed or a common cold, respectively.

So unless call volumes are low, the whole 111 / GP out of hours is a total omnishambles and not fit for purpose. We GPs do our best but it’s a treacle wading situation, and not helped by the perennial fact that a high proportion of shifts are never filled due to a lack of GPs wanting to take on this line of work.

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Thanks for the insight.

We did indeed have a confusing set of 111 responses over the space of about a week - from a call back from a doctor (who gave us the prescription), to a doctor just turning up (the one that called 999), to a visit by an ambulance crew of three (two of which were in training, who initially said we needed anti-biotics).

But in our case, on two occasions when we chased up a late call back from 111, we were told “we have no record of the call back request in our system”, so we had to start again from scratch. If the IT system is at all designed sensibly, I suspect someone was not being entirely truthful at some point.

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I remember this vividly. I rang 111 with an upset stomach, pain and fever on a Sunday (had started on Saturday afternoon and wasn’t shifting). They told me to wait to see my GP on Monday. I was lucky to get an appointment and he sent me straight to A&E. My appendix burst that evening in hospital.

Ahhhh, welcome to public sector IT. At least 95% is not designed sensibly, so the odds are not on your side. Senior management “teams” (if you’re a team then the responsibility is shared and nobody carries the can…) are generally sufficiently bamboozled by the managers below them to accept IT solutions without too much challenge.

Those managers, in turn, are either bamboozled themselves by external consultants (fair play to them - they have a job to do) or have an eye on “future external career opportunities”, and will propose and back solutions based on that.

When the failings appear, the senior team then back the original system as this is “overcoming challenges”, which is Competency Evidence for the Next Step. The system is then delivered below reasonable user spec, and the service the public receive is predictably poor.

In all of this I’m always in awe of the heroes that deliver the 5% of systems that are genuinely excellent - often for little reward. There is no Competency Evidence in being competent.

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I’m hoping for lower taxes, less public spending, smaller government, less wokery, protected speech, competent governance, better weather, politicians who understand technology, reversal of Brexit, an end to LTNs, sensible energy policy and the chance to enjoy some great wines.

One can hope, right?

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mmmmmmmmmmm! 111 eh?

During my heart related problems I woke with a raised (but steady) heart rate of 110 (usually 55). Concerned I rang 111 for advice. The operative’s first gambit floored me completely “Were you having a bad dream”?

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At least they didn’t ask you anything ruder…! :wink:

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Just to present the other side of the case, my wife had been sick and in pain for some days and had been told not to worry by the doctor on three occasions. As it got worse and worse we phoned 111, who tod her to go to A&E, where she was found to be seriously ill with a blocked intestine and admitted straight away.

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Nothing works as it should anymore from my experience over the last 12 months. The NHS has been an absolute nightmare to deal with concerning a couple of issues I’ve had myself of late.
I’ve also had problems with HSBC Bank who gave bad advice which has caused me untold problems. They closed down a complaint I’d raised having not listened to any of my reasoning and worst of all refused to send me copies of documents I supposedly signed but I have no memory of doing so. I’ve needed to resort to sending them a DSAR demanding access. They’ve now frozen the account to do an account investigation but said they couldn’t tell me how long this would take.
I think last year I’ve spent between 10 and 20 man days on the phone listening to being told my call is important and thanking me for my patience which ran out a long long time ago.
A mate of mine has been embroiled in a tricky situation with the HMRC who have it on their records that his dear old mum of 93 is dead but they are still demanding a tax return from her. He’s been going round and round in circles with it for months and months, unbelievable as Victor would say.
I was hoping a semblance of normality would prevail for another 15 to 20 years until I carp it. But we’re set on a downward spiral set at such a steep decline it’ll have us into 3rd world levels of mismanagement and chaos way before then.
I thank heavens I dont have any kids i need to worry about.

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Must admit I too have had good experiences with 111, including sound advice from their website after a series of questions.