sana - nhs hot topics key ideas

England's Fit for the Future 10-Year Plan:

-statistics and reasons why

-waiting list which stands at over 7.3 million as of May 2025 compared to 2.6 million in May 2010

-UK has one of the lowest ratios of doctors per capita compared to other European countries

-BMA currently experiencing some of the worst pressures in 77 years- nhs staff demoralised

englands fit for the future 10 year plan:

-what it involves and how it came about

3rd of July 2025, Kier Starmer's plan based around the NHS's founding principles;

universality, equity, and free at the point of delivery.

The proposal is split into 3 major shifts:

Hospital to community:

-hospital to community centred care by shifting funding from hospitals to 'neighborhood health centres'

-using NHS app more for advice+booking appointments

Analogue to digital:

-most records on sheets/physical

-My Specialist, My Medicines and My Vaccines sections of NHS app so patients have more control over their records+ less admin tasks for staff

Sickness to prevention:

-financially better to prevent sickness than treat it

-more health campaigns eg ban smoking indoors or junk food prevention or tobacco and vapes bill

also investing 120 mil into mental health initatives- like i saw on work experience

englands 10 year fit for future plan:

-problems with it?

-Doctors have experienced pay erosion and face unemployment due to high competition for posts

-technical issues with electronic patient records already

-no help for social care of medicine

-not focusing on the elderly population already facing sickness

backlog + wait times, what is 'hidden backlog'

-theres a shortage of paramedics, ambulance wait times shoot up and A and E wait times do

-over 7 million on wait list in 2025

-'hidden backlog' = people who wouldve chosen to get help but didnt because of long wait times

matters as conditions get worse without treatment- more likely to need urgent care later on+ decreased quality of life

A&E and 4 hour target

-4 hour target introduced in 2004 to reduce overcrowding and improve patient satisfaction

-having 95 percent wait less than 4 hours hasnt been met any month since 2015, some hospitals (gst) even fined for each patient who waits over 4 hours

should we scrap the 4 hour target?

assisted dying bill 2024 and thoughts

legalise assisted dying for terminally ill adults expected to die within six months, under strict safeguards.

different to rejecting treatments, ACTIVELY choosing to end life

solutions for GPs rn for shortage of GPs problem

-'golden hello' scheme GPs paid 20k to start careers in rural areas

-nhs investing 10 mil into expanding GP workforce

-digital solutions (eg link to ten year plan)

organ donation- challenges, systems and outcomes

in 2021, nearly 500 patients died while on a waitlist of 7000 for a donation

many deaths like circulatory death in which the organs are starved of blood do not leave organs viable

opt out system is that people are automatically opted in for organ donation however people can be unaware that they are automatically signed up to donatce their organs.

in wales organ donation went from 58 to 77 percent

abortion- what it is, rules and pro life vs pro choice

termination of pregnancy, can only be carried out if two doctors agree under 1967 abortion act

argument of when abortion is considered murder

Almost all abortions are carried out in the first three months of the pregnancy, at which time the foetus cannot exist independently outside of the mother's womb. Therefore it cannot be regarded as a living organism, and abortion is arguably not murder.

Euthanasia types

active euthanasia- when deliberatly initervening by eg giving someone an overdose to end their life

passive euthanasia- by withdrawing treatment needed to maintain life

voluntary euthanasia- when the person who will die expressed interest in euthanasia

involuntary euthanasia- murder

assisted suicide- when someone eg the physician carries out the act

assisted dying- same idea but the patient is already terminally ill so is speeding up process

consequences of assisted dying bill

currently illegal but about to move to house of lords

- life is something valuable, from what ive seen on work experience, people love life and talking about their lives

- doctors are flawed people who do not know the answers to everything, mistakes can be made on someones life span

-could lead to worse palliative care, people forget their lives are precious and much worse consequences down the line, as more people will feel pressured to take the pill, in a very vunerable place. already VERY underfunded, people give up

- in canada, people with ptsd/ depression who can often recover, are offered assisted suicide and take it because they arent in the right frame of mind. physical illness can have a similar effect on the mental wellbeing

+ does whats best for the patient by giving them autonomy over their life and it being their choice

+ reduces suffering of people who might not want to suffer

lucy letby (nhs whistleblowing) and the issues with the NHS highlighted by it

senior doctors repeatedly raised concerns about neonatal deaths which were suppressed by the hospital trust, earlier this year she was found guilty

- culture of isolating whistleblowers prevents whistleblowing and could detriment patient safety

- efficacy of internal and external communications in the nhs mean issues go unchanged for a long time

-

Harold Shipman case (nhs whistleblowing) how it changed issues the nhs

GP who is thought to have murdered at least 250 if not 500 of his predominantly elderly female patients with lethal doses of diamorphine (heroin)

was not struck off when he prescribed morphine to himself

- brought to light lack of effective monitoring of unusual death rates and drug usage

- strong culture of unquestioned trust in healthcare, all his fellow GPs were shocked

GMC criticised, given more power to investigate complaints about doctors' conduct.

more tracking doctors' prescribing habits.

There should be better training for doctors in ethics and patient safety + mental health

shropshire maternity scandal- what was ethically wrong with how they treated patients and lack of whistleblowing

nurses did not treat patients with dignity, told to 'keep noise down' as babies were dying.

wanted to hit "normal" birth targets and therefore denying C-sections to patients who required them. led to broken bones and physical trauma, brain damage and asphyxation

mothers not told the risks and benefits of different birth options, a breach of their autonomy by not allowing them the information required to provide informed consent.

mothers not given the best options for the health of their babies, not beneficence

mothers ended up with their babies in harm just to meet targets, non maleficence not

mothers in shropshire trust provided with less options, not justice

general lack of patient safety, accountability and transparency

a patients family was the first to speak up, made people lose trust in nhs as no one else brought it up

6 Cs highlighted in francis reports (mid staffs scandal) and what went wrong in mid staffs scandal

Care: Caring defines the NHS and is its core purpose

Compassion: Dignity should be afforded to patients without exception, and everyone should be treated with kindness

Competence: All those involved in patient care must have the capacity and understanding to carry out their responsibilities effectively

Communication: Good communication is essential for ensuring that MDTs work well

Courage: Medical professionals must be able to speak up and speak out against wrongdoing

Commitment: The NHS must be committed to its patients and purpose

swept reports of wrongdoing under the rug, and encouraged a culture of meeting specific performance targets whilst completely neglecting other aspects of patient care that led to excess deaths and suffering on a scale that we still haven't been able to fully quantify

charlie gard case ethical considerations

Distributive justice - the question of whether it was fair to allocate limited medical resources, such as access to experimental treatment, to one individual at the expense of others

Autonomy - the question of whether Charlie's parents had the right to make decisions about their child's medical care, even if those decisions were different to the recommendations of medical professionals is something that was prominent throughout the ongoing debate.

6 NHS core values and how to demonstrate them in interviews

Respect and dignity- using language that is polite in your interview answers, always maintaining eye contact, and listening well to questions and feedback, eg care home

Commitment to quality of care- highlight any steps you have taken to ensure that the care you are providing is consistently high like stay up-to-date with the latest innovations, eg shropshire maternity scandal

Compassion- talk about any training or education you have received in communication skills or patient-centred care

Improving lives

Working together for patients

Everyone counts

nobel prize winners in medicine 2025

brunkow, ramsdell and sakaguchi uncovered how the immune system is kept in check so that it does not attack our own tissues

earlier focus had been on central tolerance (elimination of self-reactive immune cells during development in the thymus). But these laureates revealed a second line of defence: peripheral immune tolerance where regulatory T cells supress over-active responses to these self-reactive immune cells

connected FOXP3 mutation to autoimmune diseases, which can be applied to improved organ transplants/ treatments for autoimmune disease like type 1 diabetes