NHS & the Flu (again)

lindsay

lindsay

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Lindsay
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I'm hoping that someone who works in the NHS can explain this to me: why is the NHS never prepared for a large rise in people being admitted to hospital with the flu in the winter, when it happens every single year?

I daresay it has a lot to do with setting staffing and resource levels at an average level across the year, or even paring them down to the lowest levels and hoping for the best, but surely it's just p***-poor planning? Fail to plan = plan to fail. The 6-P's: P***-Poor planning Prevents Proper Performance.

Why does it happen every year?
 
The NHS is just under resourced and you can't conjure up an extra 20% of trained staff for two months of the year, even if there were the empty beds. The bean counters regard surplus capacity as a waste.
 
I did expect that to be the issue, but I don't think it should be just accepted. Seasonal variation of resourcing are a common requirement across many industries, so you plan your revenue and expense budgets to cover them, scaling up and down as necessary. The people do exist, they just need to be motivated and encouraged to take up the jobs (which may not be so easy).

This is where my idea (from the Covid period) possibly has something to offer: a Territorial Nursing Reserve, made up of people who contract, like the reserve military forces, to undertake one weekend a month and two weeks a year (or similar) whilst being trained as nurses to what used to be SEN-level at least, possibly managed by transferred fully qualified medical staff from the RAF and Army nursing services. Such a reserve civilian force of nursing staff could be called in at times of need such as pandemics or winter crises.

I just don't think it should be the same every year. Predictability begs a solution.
 
I read today a lot of it is media making things sound worse than they are..... As usual.

It was along the lines of - 10 flu hospitalisations per 100,000 or something which equalled just under 7,000. Divided by the number of UK NHS hospitals gave an average of about 6 patients per hospital.

Whether that is true or whether the former is true. Who knows for sure?

** Obviously location of a hospital might make a difference......
 
Irrespective of the Flu situation, there was some bad planning during COVID. Locally, the Health Authority commandeered our local BUPA hospital as a reserve for rising COVID cases. They held on to the hospital for 6 months and my wife was due to have her gall bladder removed but this was then cancelled just 3 day before the operation and thus delayed 6 months. Clearly many others were also affected. We could have been more forgiving if there had been any benefits but the NHS did not use the hospital at all during that time.

Dave
 
Nightingale Hospitals were built/commandeered because of the unknown effects of a COVID pandemic. China had been building massive new hospital facilities.

It is comparatively easy to look at situations after the event.

A large proportion of NHS workers won’t take the flu jab. Why should anyone else, if the “pros” won’t? Vaccine ignorance is a real problem.
 
lindsay said:
Such a reserve civilian force of nursing staff could be called in at times of need such as pandemics or winter crises.
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I think that is a very good idea. It would take quite a long time to get up and running but to my mind, that is not a reason to dismiss it but a reason to get it started as soon as possible.

I was a junior member of the St Andrews First Aid for the two years I spent at a Glasgow senior school and I've often regreted not joining the St Johns Ambulance when I found myself in London. Those two organisations could well form the core of your proposed Territorial Nursing Reserve.
 
Under resourcing. UK has insufficient beds for the size and age of the population. My local hospital has been declaring critical incidents as there are so many ambulances waiting.. it's down to the government choosing to keep austerity and not increase staff and finding properly. Things for better in the early 2000s. In the 1970s when I was born nurses would take home hospital linen to wash it as that was even under funded. It's been going on a long time.

Plus more under funding of social care so a load of people are blocking beds when they could be at home. Plus folk catching things in hospital that end up staying days or weeks longer. Everyone working and visiting hospitals should be masked up and hand washing to reduce spread of everything.
 
The UK population explosion is not helping.
 
We need to sort out social care and the integration between health and social care. Too many beds are blocked by people waiting to leave hospital.

More beds as an answer creates other challenges - the beds get filled, all year round. People stay longer in hospital because there are beds available. Spare capacity sounds great, but when it doesn’t get used the bean counters (and the Daily Mail) get up in arms about the wastage.

We also need to greatly improve public health. We have done smoking, now we need to tackle what people eat and their levels of activity.
 
My wife and I attended a demonstration in London April 2016 with around half a million others in support of young doctors and nurses whose numbers were dropping dramatically due to low pay. The PM at the time David Cameron assured us that steps would be taken urgently to address the problem. Someday.
 
Pound Coin said:
Nightingale Hospitals were built/commandeered because of the unknown effects of a COVID pandemic. China had been building massive new hospital facilities.

It is comparatively easy to look at situations after the event.

A large proportion of NHS workers won’t take the flu jab. Why should anyone else, if the “pros” won’t? Vaccine ignorance is a real problem.
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I dont have the flu jab, even though I can get it. I am fit, healthy and see no reason to get a jab that may not work. Sure, for serious things I will get jabbed but I dont see a need for this for me
 
Having been injected for Cholera, Typhoid, Tetanus, Yellow Fever, Hepatitis, and probably others I've forgotten, due to my travels, plus flu and covid, I'll take what I can get if there's a chance I can avoid being ill. When I was younger, it was to avoid being off work so not earning, now it's because I may not have the physical strength to stand up to something nasty. Each to their own, but I do think it's irresponsible for health and social care workers not to have preventative jabs, which may additionally stop them passing an illness on to those in their care.
 
lindsay said:
I did expect that to be the issue, but I don't think it should be just accepted. Seasonal variation of resourcing are a common requirement across many industries, so you plan your revenue and expense budgets to cover them, scaling up and down as necessary. The people do exist, they just need to be motivated and encouraged to take up the jobs (which may not be so easy).

This is where my idea (from the Covid period) possibly has something to offer: a Territorial Nursing Reserve, made up of people who contract, like the reserve military forces, to undertake one weekend a month and two weeks a year (or similar) whilst being trained as nurses to what used to be SEN-level at least, possibly managed by transferred fully qualified medical staff from the RAF and Army nursing services. Such a reserve civilian force of nursing staff could be called in at times of need such as pandemics or winter crises.

I just don't think it should be the same every year. Predictability begs a solution.
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A lot of military Doctors, Nurses, etc currently do secondments to the NHS already. A lot of TA medical service personnel already work within the NHS as their fulltime job.
 
lindsay said:
Having been injected for Cholera, Typhoid, Tetanus, Yellow Fever, Hepatitis, and probably others I've forgotten, due to my travels, plus flu and covid, I'll take what I can get if there's a chance I can avoid being ill. When I was younger, it was to avoid being off work so not earning, now it's because I may not have the physical strength to stand up to something nasty. Each to their own, but I do think it's irresponsible for health and social care workers not to have preventative jabs, which may additionally stop them passing an illness on to those in their care.
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Apparently, the latest flu strain that is causing the latest spike, isn't the same strain that this years flu jab is deemed to work against.
Interestingly I was speaking to two Paramedics over the weekend. One of the paramedics Trust has advised the wearing of masks for all patient contact. The other has said carry on as normal. Was at our local hospital over the weekend, no staff were wearing any form of masks.
 
A friend of my wife, has had 3 members of their family hospitalised with this flu. One was that poorly he was blue lighted to hospital.
It also meant his wife had to go to hospital as he is her primary carer and with the rest of family poorly with this flu, there was no one to look after her. But as the hospital was full there was no where for her to go and had to spend a couple of days in various corridors and side rooms. She was told if she needed to go to the toilet to just wet herself as there wasn't the staff to get her onto a bedpan.
 
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munch said:
A lot of military Doctors, Nurses, etc currently do secondments to the NHS already. A lot of TA medical service personnel already work within the NHS as their fulltime job.
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Indeed, I was looked after by an RAF nurse a few years ago at the Nuffield in Oxford.
My suggestion is that there be a Nursing service run along the same lines as the TA / RAF/RN Volunteer Reserves, which not only provides a healthcatre reserve when needed, but also upskills a lot of people in the community and gives a job opportunity for those who want to take it up full time whether in the public or private sector. Surely better than constantly stealing skilled staff from Asia and Africa?

We have been thinking of starting to wear masks when out shopping - thankfully it's just the normal food shopping we have left to do now, so not too many people to mix with (we shop in small local places)
 
cambsno said:
I dont have the flu jab, even though I can get it. I am fit, healthy and see no reason to get a jab that may not work. Sure, for serious things I will get jabbed but I dont see a need for this for me
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No you don't see the need for you but what about others? I am one of the category of very vulnerable as I have a very weak immune system and I am old. If you catch COVID, it may not affect you much but could kill some of those who you pass it on to. Even though fully immunised, I usually wear a mask when in public places to try to protect myself from people like you.

Dave
 
Dave Canon said:
No you don't see the need for you but what about others? I am one of the category of very vulnerable as I have a very weak immune system and I am old. If you catch COVID, it may not affect you much but could kill some of those who you pass it on to. Even though fully immunised, I usually wear a mask when in public places to try to protect myself from people like you.

Dave
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I can't see people taking jabs themselves to protect others. That's not how a lot of people work. And didn't someone say that this year's flu is a different variant to what the jab resists anyway?
 
LeeRatters said:
I can't see people taking jabs themselves to protect others. That's not how a lot of people work. And didn't someone say that this year's flu is a different variant to what the jab resists anyway?
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My issue is that the flu jab does make you ill initially - and you may not get flu anyway!
 
Dave Canon said:
No you don't see the need for you but what about others? I am one of the category of very vulnerable as I have a very weak immune system and I am old. If you catch COVID, it may not affect you much but could kill some of those who you pass it on to. Even though fully immunised, I usually wear a mask when in public places to try to protect myself from people like you.

Dave
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I have some news for you, nobody is ever fully immunised.
 
Dave Canon said:
No you don't see the need for you but what about others? I am one of the category of very vulnerable as I have a very weak immune system and I am old. If you catch COVID, it may not affect you much but could kill some of those who you pass it on to. Even though fully immunised, I usually wear a mask when in public places to try to protect myself from people like you.

Dave
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IIRC most people cannot get an updated covid jab - only those at risk.

On covid, there are people on here who have been negatively affected by the jab. Am not an anti-vaxer but would think twice about having one if offered as its more likely to be riskier fo rme to have it than not.
 
cambsno said:
My issue is that the flu jab does make you ill initially - and you may not get flu anyway!
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The last few times my wife and I have had the flu jab we haven't had any reaction to them.
 
People conflate themselves getting ill with disease levels in the population. It's much the same as with masks and the COVID jab, and many others. It's not about a binary single person, it is about epidemiology across the whole population. Vaccines make a difference.

My flu jab didn't make me ill.
 
cambsno said:
IIRC most people cannot get an updated covid jab - only those at risk.

On covid, there are people on here who have been negatively affected by the jab. Am not an anti-vaxer but would think twice about having one if offered as its more likely to be riskier fo rme to have it than not.
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Up until this year I was classed as being "high Risk" this year apparently I am no longer on their assessment of high risk. But my wife who previously had no notification about being "high risk" is now eligible as one of the drugs she takes following her breast cancer puts her "at risk." Her medication hasn't changed since when COVID first arrived.
 
The trouble with anti-vaxxers appears to be that they take the single person approach, and don't have a great understanding of immunity or epidemiology.
 
cambsno said:
IIRC most people cannot get an updated covid jab - only those at risk.

On covid, there are people on here who have been negatively affected by the jab. Am not an anti-vaxer but would think twice about having one if offered as its more likely to be riskier fo rme to have it than not.
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Unfortunately, that is similar to saying "I don't wear a seatbelt because if there is a fire, I might be trapped" when not looking at the total effect of seatbelts on the total population of car crashes.
 
The NHS needs massive reform, including to stem the tide of the thousands who leave every year to work abroad. I believe record numbers of doctors and nurses left in 23/2024. It'll be interesting to see if that upward trend is continuing and what pay and conditions would stop the flow to the US, Australia and New Zealand and if the UK can ever offer the lifestyle offered by these countries. Well, we can't match the weather in some destinations but pay and conditions, maybe.
 
Pound Coin said:
Unfortunately, that is similar to saying "I don't wear a seatbelt because if there is a fire, I might be trapped" when not looking at the total effect of seatbelts on the total population of car crashes.
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Not really as not wearing the seatbelt poses a much greater risk to a person.
 
cambsno said:
Not really as not wearing the seatbelt poses a much greater risk to a person.
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That is not what goes through the mind of someone who doesn't wear a seatbelt.
 
munch said:
Up until this year I was classed as being "high Risk" this year apparently I am no longer on their assessment of high risk. But my wife who previously had no notification about being "high risk" is now eligible as one of the drugs she takes following her breast cancer puts her "at risk." Her medication hasn't changed since when COVID first arrived.
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Earlier this year I was diagnosed with a respiratory condition and in September received notifications about I may be eligible for this Flu and COVID jabs, so I called in at the pharmacy to see if I was eligible for both and they said I was....... Booked on-line and got an appointment for the first day for COVID jab campaign.....A few days after I had the jabs I found out that my condition was not considered High Risk and I shouldn't have been given the jab.... :oops: :$
 
cambsno said:
My issue is that the flu jab does make you ill initially - and you may not get flu anyway!
Click to expand...

Pound Coin said:
The trouble with anti-vaxxers appears to be that they take the single person approach, and don't have a great understanding of immunity or epidemiology.
Click to expand...

My mum and stepdad have the flu jab every year. Every year they are ill afterwards. They have the Covid jab too and guess what? They are ill from it. So much so, my mum has been admitted to hospital with high temperature and palpitations as well as general unwellness on two occasions (at least) but they still bloody have them every year.....!!

I wish I didn't have the initial two Covid jabs.
 
LeeRatters said:
My mum and stepdad have the flu jab every year. Every year they are ill afterwards. They have the Covid jab too and guess what? They are ill from it. So much so, my mum has been admitted to hospital with high temperature and palpitations as well as general unwellness on two occasions (at least) but they still bloody have them every year.....!!

I wish I didn't have the initial two Covid jabs.
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Yes, I understand that some people are ill.

But it doesn't get away from the fact that vaccination is a population-wide healthcare treatment, not an individual one.
 
cambsno said:
My issue is that the flu jab does make you ill initially - and you may not get flu anyway!
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All vaccines will trigger a reaction to a lesser or greater degree, part of the reaction is the additive in the vaccine to increase the immune response.

So, feelings of unwell & discomfort are not uncommon but will not make you ill as in having an infection.

In regard to your having the vaccine, it is not just about protecting you but to reduce & avoid your potentially spreading the disease even if you are asymptomatic.
 
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I'm a little late with it but I've just had the flu vaccine today. Whilst I'd probably do ok with the flu, I'd still rather avoid it and if I can reduce the odds for the sake of a little jab in the arm then that's fine with me. The current stats for Scotland are showing that for children who are vaccinated they are 78% less likely to be admitted to hospital and for adults it's 37%. The link

Forgive my ignorance, but from what I understand there are three main strains circulating, but it's the subclade K H3N2 one that's the issue because of the late mutation? I'm presuming that the flu vaccine will still provide some protection with reducing the symptoms of a mutated variant?
 
lindsay said:
I'm hoping that someone who works in the NHS can explain this to me: why is the NHS never prepared for a large rise in people being admitted to hospital with the flu in the winter, when it happens every single year?
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The take up of the flu vaccine is abysmally low. Despite publicity, inviting those in the target demographic etc.

Add in the underspending on health (I refuse to call anything involving staffing costs "investment"), the ever increasing demands on the NHS, the constant reorganizations.

Before anyone suggests the doctors should be in charge: forget it. With two exceptions in a decade every single GP I've encountered professionally (at least it was professional on my side) has totally unreasonable demands pretty much full time (GP businesses are all private contractors - they appear to expect everything to be provided centrally by the NHS *and* to get paid for it). As Bevan said in 1948, he was only able to accomplish his goal “by stuffing their [doctors’] mouths with gold.”. Plus ça change.

That doesn't mean there isn't a massive (overpaid) layer of middle management that could be excised but wheedling them out would be a mammoth undertaking.
 
cambsno said:
My issue is that the flu jab does make you ill initially - and you may not get flu anyway!
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It doesn’t, Had one in October with no issues but it appears a waste of time as it doesn’t cover the current variant that is causing the issues.

I’m not anti vax but disagree completely with having a vaccine to “protect others”. I have a vaccine to protect me if I think it is necessary. I only ever had two Covid vaccines and the second was only so I could go to Greece.

Just had typhoid, tetanus, polio, hepatitis, diphtheria to travel.

Was at the hospital yesterday and very few masks. It was just a check up for a fracture, doctor saw me for approx one minute, said it was fine and told me to “get out of here before I catch something”!
 
hunnymonster said:
The take up of the flu vaccine is abysmally low. Despite publicity, inviting those in the target demographic etc.

Add in the underspending on health (I refuse to call anything involving staffing costs "investment"), the ever increasing demands on the NHS, the constant reorganizations.

Before anyone suggests the doctors should be in charge: forget it. With two exceptions in a decade every single GP I've encountered professionally (at least it was professional on my side) has totally unreasonable demands pretty much full time (GP businesses are all private contractors - they appear to expect everything to be provided centrally by the NHS *and* to get paid for it). As Bevan said in 1948, he was only able to accomplish his goal “by stuffing their [doctors’] mouths with gold.”. Plus ça change.

That doesn't mean there isn't a massive (overpaid) layer of middle management that could be excised but wheedling them out would be a mammoth undertaking.
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A reorganisation costs money, both actual and in efficiencies. Then it increases the number of managers that are not necessarily best for their role. There is interruption on the management of poor performance. For managers live on through reorganisations.

Politicians shout for reorganisation, without know that much about organisations. They want instant hit wins. But they create the opposite, then move on.
 
What I don’t understand from the figures is that on average 3000 patients were in hospital with flu last week. There are approx 900 hospitals which gives an average of around 3 patients per hospital. In doesn’t sound overwhelming.
 
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