IOM DHSC & MANX CARE

[Two-lane]

On 11/26/2022 at 8:04 PM, Dr. Grumpy said:

BTW what's happening with the ex-pol investigation? Is the report out yet?

"The tribunal has asked all parties to keep three days in November (8-10) available to consider additional evidence to help inform its decision on the damages Dr Ranson will receive."

I didn't see that anything happened on those dates. Expol started on the job in July, so they surely must have produced  report by now.

[hampsterkahn]

On 11/26/2022 at 11:03 PM, wrighty said:

Patients themselves rarely deliberately bed-block, but on occasion their families do so on their behalf, refusing perfectly good community care packages or nursing home placements for a variety of reasons ranging from inconvenience (“we will only accept a nursing home in our own town”) to an unwillingness to sort funding.

Nursing homes themselves are sometimes difficult when it comes to taking their own residents back (“we need to assess his care needs again, and can only come a week on Thursday, you’ll have to keep him until at least then”)

It gets frustrating at times, but you’re right that it’s the broken system generally. However, as far as I can tell this particular system has never worked - ‘broken’ implies it used to. Not in my medical lifetime. 

“Bed Blocker” -a term that would not be acceptable if such casual prejudice and abuse was directed  against any other section of our society.

These are vulnerable people- They  are us, perhaps given a few years.

They are not a different species.

They should not be used as the scapegoat for the inadequacies of a flawed system.

The NHS, born in 1948 was established with the slogan of “Cradle to Grave” care.

But .. There is something very fundamental here - and it comes as a real shock to many - especially their relatives:

The NHS, for all its very laudable virtues, does not, and never has covered “Social Care ”- ie looking after you if you are unable  to do so yourself.

And there is the reason for at last some of the “Delayed discharges”

The ideal would be a system whereby the funding follows the individual to provide the care they require, whatever their needs, and wherever they need to to receive it.

 

 

 

 

Edited November 29, 2022 by hampsterkahn

[Apple]

On 11/25/2022 at 11:56 AM, Dr. Grumpy said:

A mate in the know tells me Richard Wild has left Manx Care. Is this correct? If so, what's the back story?

Apparently the style and tone of the email announcing his departure late on a Friday and very much short and to the point speaks to the sentiment to his departure.

He clearly made the right choice and I wish him well.

[Apple]

With regard to the posts on the Daily Mail thread and the comments about NHS protected disclosures the article on the BBC website today highlights some of the issues and stances some clinicians may take to report failings...and the potential consequences. 

As posted, Nobles were right to pursue the case described and have done so vigorously in other cases iirc. 

https://www.bbc.co.uk/news/uk-england-63827648

 

[asitis]

https://www.manxradio.com/news/isle-of-man-news/nobles-hospital-under-extreme-pressure/

Doesn't look like Nobles is faring too well at the moment !

 

[Manx Resident]

2 hours ago, asitis said:

https://www.manxradio.com/news/isle-of-man-news/nobles-hospital-under-extreme-pressure/

Doesn't look like Nobles is faring too well at the moment !

 

What isn’t reported is the impact the lack of staff and beds is having on the £18m programme to clear waiting lists. Operations can’t be done if there is nowhere for patient recovery. People have had pre-ops and are waiting for a date while the medics who have been contracted are treading water because bed availability is an issue?. 

[thommo2010]

3 hours ago, asitis said:

https://www.manxradio.com/news/isle-of-man-news/nobles-hospital-under-extreme-pressure/

Doesn't look like Nobles is faring too well at the moment !

 

It's the same every winter

[Boris Johnson]

1 hour ago, Manx Resident said:

What isn’t reported is the impact the lack of staff and beds is having on the £18m programme to clear waiting lists. Operations can’t be done if there is nowhere for patient recovery. People have had pre-ops and are waiting for a date while the medics who have been contracted are treading water because bed availability is an issue?. 

People are getting quoted week commencing for big operations at the moment. 

Is that normal?

I have had a couple, not here thank god,  and was always quoted as a day, not a week commencing.

[0bserver]

Noble's is in the mud. 

[Gladys]

Where do they get the locums from?  Is there any check?  Not going to go into detail, but a consultant let my family down  very badly. 

It was a straw that broke the camel's back, apparently. 

What that means more widely, is whether we carry out checks?  Or are we just grateful for any help, whether it is good or bad?

Edited December 3, 2022 by Gladys

[WTF]

44 minutes ago, Gladys said:

 

 Or are we just grateful for any help, whether it is good or bad?

bad help isn't help , it's a liability.

[Apple]

1 hour ago, Gladys said:

Where do they get the locums from?  Is there any check?  Not going to go into detail, but a consultant let my family down  very badly. 

It was a straw that broke the camel's back, apparently. 

What that means more widely, is whether we carry out checks?  Or are we just grateful for any help, whether it is good or bad?

That is sad to hear about your family issue but recently has become a familiar lament. I know of two other similar type cases.

The question about checks on agency and locum medical and clinical staff from off island is an important one and probably would be better aired in HoK. The problem is though is that MHK's now are reluctant to raise problems about Manx Care because this costly transition project as it stands can not be seen to be found wanting. And yet it is. 

The style of Manx care's introduction, the communication problems, staff leaving, and a myriad of other mismanagement issues now has to be seriously reviewed. The mandate is too far off and the islands population needs better than what it is getting now. That pressure will only continue to grow. 

Technocrats bussed in from off island has not worked. We need a new and adult conversation about our health and care services and those at the top of Manx Care do not seem to be coping well at all. Staff I speak to are mostly nursing and medical are somewhat disillusioned about what is happening on the ground but cannot / dare not speak out.

The question needs to be asked - is it time for change of style and direction or continue to battle against some of the difficulties that patients and families are now experiencing? It is they who are paying the cost.

The Government has to step in I think now. Not to do so exposes their manifesto pledges too improve health services for the people of the Isle of Man as a step too far.

 

Edited December 3, 2022 by Apple

[Gladys]

3 hours ago, Apple said:

That is sad to hear about your family issue but recently has become a familiar lament. I know of two other similar type cases.

The question about checks on agency and locum medical and clinical staff from off island is an important one and probably would be better aired in HoK. The problem is though is that MHK's now are reluctant to raise problems about Manx Care because this costly transition project as it stands can not be seen to be found wanting. And yet it is. 

The style of Manx care's introduction, the communication problems, staff leaving, and a myriad of other mismanagement issues now has to be seriously reviewed. The mandate is too far off and the islands population needs better than what it is getting now. That pressure will only continue to grow. 

Technocrats bussed in from off island has not worked. We need a new and adult conversation about our health and care services and those at the top of Manx Care do not seem to be coping well at all. Staff I speak to are mostly nursing and medical are somewhat disillusioned about what is happening on the ground but cannot / dare not speak out.

The question needs to be asked - is it time for change of style and direction or continue to battle against some of the difficulties that patients and families are now experiencing? It is they who are paying the cost.

The Government has to step in I think now. Not to do so exposes their manifesto pledges too improve health services for the people of the Isle of Man as a step too far.

 

Thanks Apple.  Rotten situation,  but it was actually dealt with quickly, sympathetically and with a real outcome rather than a quagmire of investigation.  For that, hats off to Manx Care. 

Edited December 4, 2022 by Gladys
Remove the grocer's apostrophe.

[wrighty]

5 hours ago, Gladys said:

Where do they get the locums from?  Is there any check?  Not going to go into detail, but a consultant let my family down  very badly. 

It can be very difficult to vet locums. I used to say that there’s only two reasons to be a locum - you’re a money grabbing ******, or no bloody good. 
 

We get their CVs and a bunch of references. References are not worth the paper they’re written on as nobody in their right mind would submit a bad one. Whenever I get asked to vet a locum I look at where they’ve worked and for how long. And make sure their age is commensurate with the seniority of position they’re applying for. If you’re in your 60s and applying for very junior doctor posts there’s something wrong. Call me ageist if you like - but I think I’m right. 
 

In some specialties the selection is fairly slim pickings. So what do we do? Appoint nobody and cancel services, or appoint anybody and deal with the consequences? It’s often a no-win situation, and in hindsight the decisions made can sometimes be obviously wrong. Not easy when you’re in the moment though. 

[GD4ELI]

5 hours ago, wrighty said:

It can be very difficult to vet locums. I used to say that there’s only two reasons to be a locum - you’re a money grabbing ******, or no bloody good. 

Or you like to move around, enjoy different parts of the country / world? You can also avoid a lot of politics.