One girl, four interviews - the result

So I haven't done a post regarding the state of my medicine application since I got interview invites from all four universities...

My first interview was in December at Glasgow, and went pretty horrendously. I had never been to Glasgow before but absolutely loved the city! I went up the night before on my own and went to a great vegetarian restaurant called The 13th Note, where I treated myself to vegan haggis, neeps and tatties because when in Scotland right?! Although I was out for dinner on my own, it did not stop me from ordering a sticky toffee pudding!

My next interview was in January at Edinburgh, which I felt went a lot better than the first. Since going for a look around 4 years ago, Edinburgh has always been a little bit of a dream. Again I went up the night before and ended up at really cute, quirky veggie restaurant called Spoon. Here I had a great root veg and pearl barley stew, followed by....another sticky toffee pudding! My interview wasn't until early afternoon, so I treated myself to brunch at The Edinburgh Larder. 

A week after, I had my interview at Birmingham and wow that went horrendously! It was one of those situations where your parents say "I bet it wasn't as bad as you think", but then I explained and they were like "Yeh that does sound pretty bad"! 

So maybe 2 weeks later I got my first rejection and no surprise it was from Birmingham. But I had been expecting it so I wasn't too upset. However, later that week I got rejected from Edinburgh! I was so upset and had had a good feeling about it, so that left me a bit disheartened. Then finally, the week before my Warwick interview in March, came the rejection from Glasgow. Needless to say, I was losing hope. 

When it came to Warwick, it was time to change the way I had been approaching the interview. I had done a lot of preparation for the other interviews but had been thrown when I wasn't able to use specific examples. At Warwick, I tried to relax...I did let a few naughty "like"s slip out but I definitely think my answers came across more natural. I thought most of the stations went OK but did not want to get my hopes up. 

Anyway, back to the point of this post... I GOT AN OFFER FOR WARWICK!
I was at work when I got the email and pretty much had a panic attack on the ward and had to go and calm down! It still has not really sunk in that I will actually be a doctor - though there are many years to come!

Parties' plans for the NHS

Image: Parliament

The NHS has risen to be one of the top voters' priorities for the next UK general election, which is just two months away. However, 65% do not trust either David Cameron or Ed Milliband to ensure the NHS has enough money, according to a poll by ComRes. And with their finding that political parties' policies on the NHS matter more to 59% of voters than economic policies, it's time to look at what each party has in store for the NHS.

Conservative
The Health & Social Care Act 2012 that came into effect under David Cameron's leadership saw a top down reorganisation of the NHS. The original bill was opposed by 90% of doctors and has since been widely criticised. It caused fragmentation of the NHS and privatisation that has been accused of prioritising profit over patient care. Turning the NHS into a commercial activity means it can be included in the Transatlantic Trade and Investment Partnership (TTIP), which is explained in one of my previous posts. With Cameron revealing that the NHS is not one of the parties' six priorities in their manifesto, what are their policies for the NHS?

• An extra £2bn into frontline health services per year
• The ability to see your GP from 8am to 8pm, 7 days a week
• Recruitment of 5,000 more doctors

Image: NHS

Labour

Labour have been quick to criticise the increasing privatisation of the NHS even though it was their own Tony Blair who introduced competition in 2005. It seems they have a lot more planned for the NHS...

• Repeal the Health & Social Care Act - removing privatisation and replacing the competition framework with an "NHS Preferred Provider" framework
• Tougher controls on hospitals' ability to earn Private Patient income, and put NHS patients first
• Ensure the TTIP cannot impose procurement or competition obligations on the NHS
• An extra £2.5bn per year funded by "mansion tax", clamping down on tax avoidance, and new taxes on tobacco companies
• Recruit 20,000 more nurses, 8000 GPs, 3000 midwives, and 5000 more healthcare workers to help patients stay in homes and identify risk of hospitalisation 
• Patients will be able to get a GP appointment within 48 hours
• Patients will not have to wait longer than a week for cancer tests and results
• Integration of health and social care services
• Greater priority to mental health and emphasis on child mental health

To see more of what Labour has in store, check out their 10-year plan for health and care.

And with the likelihood of a coalition, let's take a look at the other parties.

The Liberal Democrats

Nick Clegg has added the NHS to their top five policy priorities, showing they would be central to negotiations for a coalition if there was a hung parliament. 

• An extra £8bn per year by 2020 funded by proceeds of economic growth and making higher earners pay more tax on their shares
• Starting with an extra £1bn per year, half of this will be spent on mental health services
• Pool the health and social care budgets

The Green Party

• Funding diverted to community healthcare, illness prevention and health promotion
• Abolish privatisation
• Abolish prescription charges
• Introduce a dedicated NHS tax to go straight to the health services
• Ban proactive recruitment of non-British NHS staff from overseas
• Ban promotion of alcohol and tobacco

Image: ITV

UKIP

• An extra £3bn per year funded by quitting the EU and "middle management' cuts
• Keep the NHS free at point of delivery
• Stop further private finance initiatives
• £200m to be spent on abolishing hospital parking charges
• CQC to be replaced by elected county health boards
• Stop spending £90m per year on gastric bands and breast enhancement operations
• £130m per year for Dementia funding (double the Tories pledge and in line with what Alzheimer's Research UK say they will need)
• Merging health and social care
• Scrap tuition fees for medical students (on a means tested basis)

You can follow updates on health and social care issues with The King's Fund Health and Social Care Election Tracker. 

Greater Manchester to control its own health and social care budget

After the bed blocking that occurred this Winter, with patients unable to be discharged due to lack of appropriate facilities, it is clear that the NHS and council-run social care needs to be more integrated. In an attempt to tackle this, Greater Manchester has become the first English region to get full control of its health spending. Set to come into force in April 2016, the region's councils and health groups will be responsible for the £6bn health and social care budget.

Image: Full Fact

With the ageing population and the need to care for those with long-term conditions, there is an increasing demand for care homes and care in the community. Linking the NHS and social care could improve facilities, direct money to where it needs to be spent and improve communication between primary and secondary care. However, should this be done regionally?

Image: Imperial College Health Partners 

If this spreads so that all regions in England control their own health and social care budget, this will surely go against what it meant to be a National health service. Therefore, leading to further break up of the NHS. Not only this, but it is handing over a huge amount of money and responsibility.

Is the NHS ready for yet another reform?!

Highest suicide rates in men since 2001

It has been reported today that the number of men committing suicide is at an all time high since 2001. In 2013, 78% of suicides were in men, compared to 63% in 1981. Additionally, the age category showing the highest suicide rate for men (and women) was 45-59 year olds, where it was previously 30-44 year olds. 

Suicide is the leading cause of death in men aged 20-34, and represented 24% of deaths in 2013! Joe Ferns from the Samaritans said "The news is sadly not surprising to us given the context of a challenging economic environment and the social impact that brings". However, this does not mean these deaths are not preventable, and something needs to be done. 

Image: Daniel Fryer

As I have said in a previous post about mental health (Let's talk about it), we need to make it ok for people suffering from mental illness to seek help and encourage them to do so. But we also need to provide much better support from GPs, hospitals and other care settings, as well as getting families and friends involved. 

So what is being done to try to cut the number of suicides? It was reported earlier this year that the deputy prime minister Nick Clegg wants to adopt a similar strategy pioneered in Detroit that is being implemented in Merseycare NHS trust in Liverpool. 
This strategy includes:

• creating a Safe from Suicide Team, a 24/7 group of experts which rapidly and thoroughly assesses patients who are having suicidal thoughts
• improving the care of people who present with self-harm injuries at accident and emergency units, offering them therapies on the spot and following up with them when they go home
• improving data collection on patients to get a better understanding of how and where patients are most at risk of suicide and then targeting resources at them

Image: Mental Healthy

However, this strategy cannot work unless the government takes mental health seriously and allows the necessary funding for such a prominent problem. 

Protecting whistleblowers

Today, Jeremy Hunt, the Secretary of State for Health, has issued a message to staff in the NHS concerning whistleblowing. This is following the report published by Sir Robert Francis on the Freedom to Speak to Speak Up review. Sir Robert Francis, who published a report into the Mid Staffordshire inquiry, identified it to be an ongoing problem in the NHS, with staff being deterred from speaking up due to consequences that happen when they do.

Image: Skills on Toast

Six hundred people shared their experiences with the review and over 19,000 staff members responded to an independent online survey. They shared stories of victimisation when raising concerns, facing isolation and bullying. Others did not speak up as they feared not being listened to.

Sir Robert Francis has come up with proposals to support whistleblowers in the NHS, which includes:

• action at every level of the NHS to make raising concerns part of every member of staff’s normal working life
• a Freedom to Speak Up Guardian in every NHS trust – a named person in every hospital to give independent support and advice to staff who want to speak up and hold the board to account it fails to focus on the patient safety issue.
• a National Independent Officer who can support local Guardians, to intervene when cases are going wrong and identify any failing to address dangers to patient safety, the integrity of he NHS or injustice to staff
• a new support scheme to help good NHS staff who have found themselves out of a job as a result of raising concerns get back into work.

Image: Freedom to Speak up

These proposals aim to encourage staff to speak up and feel safe about doing so, and for all concerns to be heard and investigated properly. For more information on the review and what it means for staff in the NHS and patients, go to the Freedom to Speak Up website.

Tackling the pressures on A&E

England's target of 95% of patients in A&E being seen within 4 hours is at an all time low, with only 87.6% being seen in this time last week. One of the main causes of this problem is the increased number of people going to A&E. In the last 4 weeks there have been 1.7 million admissions to A&E, a 7% rise compared to the same period last year. Some hospitals have declared major incidents, calling in extra staff, cancelling operations and diverting ambulances away from A&E as they've been seen queuing outside. 

So why are more people going to A&E? First, when people find it difficult to get appointments with their doctors, the next place they think to go is A&E. Secondly, the ageing population is a big impact, as two thirds of A&E admissions are over the age of 65. Thirdly, few healthcare professionals take calls at the 111 helpline (the replacement of NHS direct), resulting in many being told to go to A&E or to call for an ambulance.  

Image: Trust Medical

Another major factor causing England to fail to reach its target is lack of staff. A&E struggles to recruit and maintain staff - both doctors and nurses. Each unit should have 10 consultants, with larger trusts needing 16, but most trusts average at just seven.

A page on the BBC allows you to see how your hospital is doing in comparison to the average and other hospitals in England. It also shows attendance to A&E and numbers of how many had to wait more than 4 hours. This shows 133 major trusts missing the 95% target, and only 7 meeting the target! So what can be done to improve the A&E waiting times?

A&E stands for accident and emergency, but that is not what it is being used for. People need to be made aware of other services they can use if they are unable to get doctors appointments, such as minor injuries units and walk in centres. When people need sound advice and ring the 111 helpline, less experienced non-clinical staff who follow a computer is not what is best. It may seem cheaper but causes far too many calling for ambulances and going to A&E. There is also a problem with social care as patients are not being discharged until appropriate facilities in are in place, causing there not to be enough beds.

Image: Farely Medical

With the NHS and A&E being such a concern in the news at the moment, it is a major topic in the run  up to this year's election. Let's hope that someone comes up with a reasonable plan to improve the current situation!

Private medical school opens

The first private medical school has opened in the UK, with students paying £36,000 per year for tuition fees. Studying at the University of Buckingham will have a total cost of more than £157,000 just on tuition fees - four times the amount of public medical schools.

Image: Geanow

Medical school is already a huge financial commitment, with students on undergraduate courses having to fund two more years than most courses. Even more so for graduate applicants who get no tuition fee loans if they get accepted on an undergraduate course, as opposed to a graduate course where tuition fee loans and NHS bursaries are available.

In the process of applying for medical school, applicants must take aptitude tests costing £80-250.
An initial advantage is given to those lucky enough to pay for test preparation and interview courses, which may cost up to £400. Are private medical schools just another way to make medicine elitist?

The University of Buckingham will have the same entry standards as public medical schools. However, the University of Central Lancashire, due to open a private medical school in September, will only require two As and a B at A levels. Therefore, it gives the opportunity to those worse academically, but who can afford to pay such fees. The National Union of Students has said it would "rank the course among the most expensive on earth", with only the wealthiest being able afford it. An extra privilege in applying to a private medical school is that students are able to do so in addition to the four through UCAS, giving those who can afford it an extra shot at becoming a doctor.

Image: Daily Record

UCAS figures show that 1780 school leavers with straight As at A levels failed to get into medical school last year. Is it fair patients will be left doctors who are not necessarily of the highest standard, but got into medical school due to their financial status?