NHS Reboot

90% of good management and standards and procedures could come from a good comprehensive Constitution and an accompanying regulation list for good practice. [See below]

Not even fooling the people that don't watch the news: The NHS is nearer to NAZI than South America 1945-95.. From management to government impotence! Through ROTTEN mentoring, around standards & procedures, quality claim reassessments, uniform practices & contracts that COUNT.

Comprehensive Safety Regulations - Is Needed.

'It means that clinical negligence costs will consume about £1 in every £3 of the extra funds that the NHS is set to receive annually under plans to raise England’s NHS yearly budget by £20.5 billion by 2023/24.'

The Heart of the matter is "See 1, Do 1, Just get on with it." Mad-Mantra "And you all can be in charge." - Aneurin Bevan.

The wrong way to address the problem would be to cap legal costs and therefore condemn patients further into the hands of a system light weight on Supervision to ensure the development of good practice. Made worse by the added pressures of frunding out of line with poopulation pressures, other increasing demand, no planning and poor planniong and of course the parasitic success of corruption. 

4. The NHS Reboot Ethical Protocols & NHS Standards act:

Louis Theroux

[Work in progress] 

Constitution addendum 4.

1. Permanent Ongoing Efficiency Review Process

 

Waste - Management - Priorities - Limits - Training - Schooling

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Louis Theroux: Talking To Anorexia

It is visibly clearly apparent [without any disguise] from Louis Documentary [and from my extensive and varied experience of my time in the NHS] that the patients are being let down by a shallow linear service approach.

While the NHS is staffed with many very good, qualified and diligent individuals in the system, they are working in a system that was constructed with flowing ineffective conflicts [inefficiencies] from a system of health that favors medicines for symptoms [and anything that is holistic or preventative’ of patients was swept under the carpet along with Hippocrates] and chronic dependence. The systemic conflict of the inefficiencies [rising and random costs] with the central government has allowed the system to reflect a civil war zone, rising. Interestingly the situation does not much effect the Consultants and senior Doctors. NHS doctors are still free to take private patients [which in the chaos is a growing concern] While many may agonize about their limits [imposed or systemic] and may feel angst and become depressed, this mental state was not shared by the doctors involved in the negotiation with [planning’& rushing maneuvers of a desperate] Bevan, to pull off ‘an agreement’ to roll out ‘a service.’

The agreed system favored entirely the doctors. They controlled the whole show until the management was taken away from them and into another bunch of greedy hands and high management centres allowed to multiply like the brooms under the ax in the sorcerer’s apprentice. Meanwhile the Con/Doctors increased their wages reduced their hours [private time no limit or full private!] pushed up prescriptive’ prices’, did nothing about malnutrition in or out of the hospital, watched with silent glee as dependences’ spread, technology growth pushed up costs along with managements cost and the government response was to reduce money [rather than look at system restructuring][the only solution] that leads to cut backs and lower wages, lower staff numbers and therefore beds [or under new labour an unsustainable creep towards overall debt lock and a Greek type government control or the Conservative flavor of thinking] and a constant political football that can change governments, until the incoming government heads the ball through the door goal but on head contact, the ball turns out to be made from a steel jack covered in a sphere of concrete! Ouch!  

Modern medicinal practice focuses on treating symtoms of disease with medicines or surgical intervension. Doctoring value is viewed by doctors and pharmaceutical manufacturers by the prescribing of engineered medicines and the skilled intervension of surgery. Engineered Medicines often favour a particial success to achieve a permanent requirement. Causation of commmon and repetative diseases has been strategically ignored, where causation could be easily altered. [ie diet, excercise, a removal or a reduction of pollutants] 

All of the anorexic patients without exclusion have a condition beyond / underneath the symptom of being unable or unwilling to eat. Nurse /? “Something in her past might have caused her problem with eating” There was not a comment from any professional interviewed that gave evidence for any attitude to psychological pathology individual or overall, Apart from the consultant on her visit’. [Well done Louis] Unfortunately there is no pill prescription to rewire a malfunctioning attitude or dissolve a childhood to adulthood life trauma situation or prescribe a new life situation through freedoms to choose and change with help, Because that would take a different type of doctor. [That could lead to training and a wider implementation] There is very little interest in mental health because there is very little value opportunity there without really hard work. Much easier to get rich slashing your way through the victims of civilizations market economy & or making patients dependant on brilliantly invented’, resourced, tested medicines, priced accordingly for precision choice need.        

There was evidence in Louis Docu that there was a lacking of qualified and trained staff working in an environment of analysis and analysis support, in a food training style of delicious top quality cuisine skillfully designed individually around preferences and favorite treats. It costs more than 1 quid a head but not by much [with catering schools turning out staff & hotels with 5,000 rooms able to deliver gastronomy to any room in under an hour 24/7] and as for schools – “Education, Education, Education” is the NHS' need of the future. 

http://www.howardhawk.co.uk/437967798

The Hippocratic Oath GB UK 2017: {A comlete oath with right priorities}

{Done}: 

I Swear to Fulfill, to the best of my ability and judgment, This Covenant;

I Will Apply, for the benefit of the sick, all measures which are required, treating my patients as though myself in health value. I will avoid under treatment, over treatment and harmfull treatment that is without health outcome merit.

I will, at the centre of my doctoring have a personal view and relationship with everyone patient, giving my best practice equally.

I will offer the best prescription for best outcomes regardless of cost, for patient consideration. And offer second and third and all options for treatment where needed or appropriiate for patient / client / guardian consideration.

I will respect the privacy of my patients, for their problems are not disclosed to me for me to disclose to others. Outside medical personel with a need to know basis. This is the basis of Doctor patient confidentiality.

Most especially must I tread with care in matters of life and death. Above all, I must not act to bring about death upon my own judgement. Where the end of sufferring is requested and permitted I will follow the regulation of a region [personal faith permitting] to proovide an end to sufferring with death. [Or I will refer the patient request / situation to able collegues]

I will not be ashamed to say "I Do Not know" nor will I fail to call in my colleagues when the skills of another are needed for a patient's diagnosis, treatment, or recovery. I will accept that in many circumstances my service will be as part of a team. And by teaming expertice cooperativly, efficiency of expertice is increased and mistakes decreased. This compatriate team work will be the ethos for all my collaborative future.

When a mistake has been made I will honestly do my best to correct the error and minimise any harm or damage. I will not allow a patient to suffer by covering up my own or a collegues error or cover up a faulty system in place. I will ensure that my professional conduct is covered by insurance for full remuneration and compensation.

Where systems or actions are detected that are faulty / dangerous / hamful or lethal I will take actions to correct those faults. I will not accept criticism or prejudice by my good actions. Neither shall the governing body of my profession.

I will remember that there is art to health & medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. And remember that mental health states is subject to a spectrum of psychologies of stresses, in that only sensitive observation can aid diagnosis or avoidance strategies and that good practice for any patient requires this dilligence.

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow, in accordance with best evolving practice set in agreed and respected best practice regulation.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being.

I will prevent disease whenever I can, for prevention is preferable to cure. I will advise all patients of preventative measures of nutricianal choices and an excercise life style and to avoid or minimise unhealthy choices and habits - In an holistic view of lifes long health - to avoid unnessesary chronic dependencies upon medicines.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body and otherwise as well as the infirm.

If I do not violate this oath, may I enjoy my life and art, respected while I live and am remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and never to disshonour my trade or the governing body. May I long experience the joy of healing those who seek my help.

Comment: Analysis of psycholgy & flaws:

Negligence, Malpractice, Errors and Repeating Errors and Compansation in the NHS.   

Doctors have been allowed to be a law unto themselves. They have shown their selves to be conceited, vulnerable when criticised and fearful of trust in their abilities being questioned when mistakes happen. 
So they have lurched into a culture of defensive evasion. Ironically the training and professional assessment process or incomplete and lack of, is now dominoing under service and funding stresses, more and more into the open.

Much like the pilot crisis in the airline industry in the 1970’s [When a large number of pilot came from an air force background and brought with them their Captain’s commander attitude] that was resulting in poor communication and dominating to subservient relationship structures [where hostility and resentment festers quietly under the surface and over the professional priority of a safe service for the passengers.] The CAA started a review and with the consultancy help of NASA initiated a redesign of training, using the key foundation of team building and team work to fly airliners. Critically [and poignantly] problem management, from assessment to solution was also key to increasing airline flight safety. The NTSB also plays a valuable part in assessing all accidents [and in its initial years, assessing all flights, as a diagnostic learning process] and focussing [with pure professionalism] on causation to ascertain maximum prevention, for passenger safety and trust in air travel.

A similar process should be initiated by government, once they have taken control to govern, standards and the correction and prevention of these critical safety flaws, continuing, to increase.

http://www.bbc.co.uk/news/health-42833028?SThisFB

 

The Hippocratic Oath {Common modern version}

The Hippocratic Oath has been superseded as a document of professional ethics by more extensive, regularly updated ethical codes issued by national medical associations. 

 
The oath has been modified numerous times. (First adopted in 1847) 
 
One of the most significant revisions was first drafted in 1948 by the World Medical Association (WMA), called the Declaration of Geneva.
 
'At the time of being admitted as a member of the medical profession: AS A MEMBER OF THE MEDICAL PROFESSION:
  • I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
  • THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
  • I WILL RESPECT the autonomy and dignity of my patient;
  • I WILL MAINTAIN the utmost respect for human life;
  • I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
  • I WILL RESPECT the secrets that are confided in me, even after the patient has died;
  • I WILL PRACTISE my profession with conscience and dignity and in accordance with good medical practice;
  • I WILL FOSTER the honour and noble traditions of the medical profession;
  • I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;
  • I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;
  • I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;
  • I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;
  • I MAKE THESE PROMISES solemnly, freely and upon my honour.'

 

Hardware update exploitation

I recently went to an NHS hospital for another ultrasound on my kidneys or coetaneous posteriors as I have done since 1994 when I arrived at Stoke Mandeville. It was a particularly interesting occasion – in the room was a nurse [to prep me for the arrival of the untraologist] interesting because there was another person present dressed otherwise – I asked who are you in all of this – she said; I’m here to help with this latest ultrasound. I said is it any different from the other three ultrasound units that are blacked-off in here? This one does more.

I like it. So does GE Health [marked on as the latest winner of Edison Screw – under the market opportunities presented and available]

My view as tank commander general of acquisitions in the mission of being competitive in the Monte Carlo rally is not to buy every latest version of the 911. Every model example in my experience from 1994 was very good, did the job, told the story under the skin and to this day my kidneys look like the sky at night that needs the eyes of Patrick Moore to tell me a renal nephron from a papilla [as in the differences from a 911 to the 997 to the 963 to the 992, 911. – Jessica Tate, Mary Campbell similarity]

As your [HM] general I would advise keeping each 911 model for 10 years [at least] before reviewing the latest model.

[None of them detected the age/spinal injured related deterioration that I can feel and see] beyond the level of the image interpretation of the ultrasound that was used on my lungs in India in 1978.]

Much cheaper not to blindly buy every model of the Porsche Beatle 911 every year? Did they make other models for market blindness? Cayman chop-chomp 2? The American government have a healthy appetite for grass feeding buffalos in every colour world wide.

spare

spare

Patient Prevention Responsibility

Parent

It is a sad and regretful truth of the situation that the great british people have been let down by their [governments] when it comes to schooling / teaching each generation an embedded example of healthy diet and life-style.

This failing and giving in to free market forces has led to the development of consumer desire training and rewards. The HNS suffers, They [the exessively poluted] suffer and we the tax payer suffer.

With or without a re-gigging of the school system to include diet & Life-style training troughout schooling, the obese and physically unhealthy should be forced to take responsibility for the error of [their] ways. 

A tax should be introduced to prior to HNS treatment [A Heafty Fee] per proceedure, for the ^obese, ^smokers, and ^alchoholics. [^With a free service extended for those who are willing to undergo rehabilitation training and be assessed after a year - for remaining medical need.]

Bonkers Innadequate Britrain:

https://www.bbc.co.uk/news/health-46093750

 

Reducing the cost of an NHS: [Per patient & overall]

A productive attitude

Increasing systems efficiency & reducing systems where possible & approapriate:

{Work in pogress} [Full work upon request:]

System Design Resoration:

 

General Thoughts on current system imrovement:

Reducing costs within the NHS:

Purchase efficiency & {The elimination of the Corruption of purchasing Costs}

Surgical contract training & review 'changes' safety procedure. [Regulation for certification gradings for sugical quality assurance and openness for patients.]

Management structure review – NHS ethos & NHS ethical constitutional adherent guide.

Preventative ethos – Gov. pre patient responsibility – condition treatment restriction & ethical controls. [Doctors should adhere to stricter qualification of 'medical needed' procedures]

Eliminate non medical treatments. [Doctor's that breach 'medical needed / uneeded' should be imprisioned for 6 months per breach auto on conviction.] 

Low Self esteam should not be corrected with surgery by surgeons or unqualified surgeons. [All surgical procedure in Britain must be carried out by qualified, certified, registered active & insured surgeons] {A Basic No Brainer} 

Make educational inclusion & life style investments

Introduce diet nutritional national health standard institutional regulation. [C addendum 4]

Introduce Life style training an inclucive occupational service time for psychiatric patients post accute treatment.

Introduce national procedure harmonisation.

Introduce patient treatment cost point of use cost account procedure.

Eliminate global free service, service attitude, systems and conduct.

[Government] Address pharmaceutical cost / profit limit regulation. [Review international options including UN Position]

 

 

Announce 20% increase in national bed capacity - Fully Staffed Shifts - Pay rise mp matched - Pay reviews every 2 years.

Announce 2. central control with capiliary units region wide -

Cancell & abandon current management - 1. half saleries & serverences subject to successful 2. handover within agreed timing.

Announce efficiency review - Purchase efficiency & uniform practice review & 3. operational policy & int billing system - 4. Quality standards & practice regulation division.

Instant saving 1. 2. objective 25% surpluss from exhisting input. 3. 10% further surpluss 4. Priorities, ability, moderated quality training & assurance Error reduction 95% costs.

Old subward bed release hospital high cost enviroment saving..

Equity release optional consideration upgrade regional village resort care.

What Do You Mean, the NHS Can't Afford to pay for the new drug for my new symptom?! I Have Human Rights!!

Obese, - Get Off The NHS!

Labour's Tom Watson 'reversed' type-2 diabetes, through diet and exercise.

https://www.bbc.co.uk/news/uk-politics-45495384

 

I do not agree with all of this method but it works and most importantly it is underpinned by a very good and strong attitude. It is a version of the 5-2 diet but with a inbalaned and a pandering self-rewarding beginning.

https://www.youtube.com/watch?v=NelIXCuuSZ0

The NHS Constitution - [2023-]

[work in progress]

NHS USA

"Warmth & Enthusiasm" Arh the special relationship - Don't forget what Churchill had to Give-Up to get FDR's - ['need to sweeten up congress' prior to lend lease that was then made available to all of the ally's] – ‘Help.’
 
'Business is business' is a never a truer phrase when it comes to white combined American's.
 
Chlorine washed chicken [despite the effectiveness] will be negotiable - The British National Health Service will be a Deal Maker [smiles sweetly / gentle but firm warm hand shake]
 
On the One hand the NHS will immediately benefit from experienced U.S hospital Corporate Management which will bring in [the strangely absent uniform hospital practice use throughout and strict standards and procedures. {Especially where it causes financial losses or irregular high costs}
 
This will benefit patient safety with higher standards by strict doctor training standards and an improvements in outcomes with a reduction [currently an un-reactive response to surgical errors] compensation payments. [government / court response to deal with the rising problem has been a compensation amount reduction regulation.]
 
Nurses and junior doctor's will benefit from a better working experience, with a feeling of working in a much more professionally run organisation. [Rather than the bend over backwards government use of vocational good will to keep the service from continuous periodic ward collapses and closures]
 
The wages for doctors and other professional staff will rise – and the cost of the medical services will rise to come to parity with the prices of U.S high service standards. This will be essential and unavoidable because it is a fact that [despite the multiple management cost of the NHS and the highly suspect procurement sector and the absence of a cost procurement division and the unusual financial relationships with the pharmaceutical manufacturers and suppliers] the NHS is cheap / under charging / being paid for medical services throughout.
 
When this is made blatantly plain to the British government the British government [assuming the U.S interest in acquiring the hospital / the British medical industry has not been rebuffed as ‘Not an option’] the British government will forgo a price cap on the out-dated cost and charging complexity of this complicated old situation.
 
On the other hand,The British government [Britain] will then see the cost of [medical procedures] go up in prices to them [to match U.S pricing] of [currently around 350% higher] add to that the inevitable temptation [without a hawkish medical insurance cost policing and negotiating practice in place] will be like asking a bunch of baboons {just to be clear, 'British government' / national management structure and training} to run a casino. The British tax payer bill for medical services will rise by 510% with the costs of the old and dilapidated stock of hospital buildings, obviously not included.
 
Why this management approach is not achievable in Britain by a British management restructuring and training [reward] strategy is [below & beyond] a mystery – and would avoid the next act of U.S medical history and method.
 
'Warm and Enthusiastic' [LOL] A boxing glove on the fist of a Godzilla sized Tyson shaking hands with a Joe Bugner sized Frank Bruno with a similar destiny.
 
You have been warned and their 'form' is departmental history.