-
The NHS is a great success story:
-
On average UK citizens now enjoy much longer, healthier, pain-free lives
-
Treatments offered are far better and time in hospital has been dramatically reduced thanks to better methods like day and key-hole surgery
-
Nevertheless, the majority of people are now less than happy with the service they get from the NHS
-
-
In fact, most NHS staff work hard and are keen to do their best for patients (most of the time) – so why haven’t output volumes improved too?
-
Usually, it’s because of the methods and procedures that managers and inspectors have imposed on the staff – ones which prevent them offering a better service e.g.
-
Too much back-office paperwork admin cutting front-line services signed up for
-
Too few useful performance measures
-
Too much focus on government measures and meeting their targets
-
Too many blockages/ handovers/ delays involved in ‘patient flow’
-
Too much corralling of patients together in hospital or GP waiting rooms where they infect each other
-
Too much recirculation of warm air to save on energy costs which also means one sick contagious patient can infect many more
-
-
Areas where there’s scope to improve include:
-
Nurses’ time with patients, which is often too little, versus on paperwork
-
Admission/ discharge processes to reduce turnaround times
-
Use of email/ phone communications with patients versus face-to-face
-
Better use of spare capacity of operating theatres, special equipment and skilled people – much is wasted because of budgetary constraints and some hospital managers only doing what they can afford at the time
-
Removing the incentive for some doctors who spend a percentage of their time on lucrative, private practice work to not reduce NHS waiting times but offer patients their same services with no waiting if they go privately
-
-
Lastly, it should be widely recognised that the success of the NHS has meant there’s many more people living to old age so, perversely, old-age diseases take many more medical resources to deal with than those suffered by younger folk
Overall, the NHS is a victim of its own success – and, without major process changes, costs per episode are bound to rise and productivity bound to fall
Outcomes the public wants of the NHS – by Dr A Inwald
- Easy access to and sympathetic time with his GP
- If necessary, referral to a good quality consultant at his local hospital
- An appointment within 4 weeks for most conditions, and this appointment not to be cancelled or postponed at the last minute
- To be seen on time, and be given enough time with the consultant:
- To explain his condition
- To be examined
- To have a discussion about the treatment needed
- To have all investigations, including blood tests, X-rays and scans etc completed within 2 to 4 weeks
- If need to be admitted, to be given an admission date and time within 2 to 4 weeks which will not be postponed or cancelled – not to be told to go home and come back another day when a bed might become available
- To be welcomed to a clean, single-sex ward managed by an experienced sister with authority over all the staff in her ward, including cleaners and junior doctors
- The toilets and ward to conform to the highest standards of hygiene
- If need surgery, to know that administrative staff cannot close the operating theatres to save money or postpone surgery because there aren’t enough post-op beds available
- If have to attend the A&E department in an emergency, to receive prompt care in a clean and well-run hygienic facility
- And any surgery or treatment to be successful