Friday, 24 October 2014

October 2014 - the state of the NHS

There are probably hundreds of not thousands of blogs like this across the Internet. So let me add my two-penneth!

Here's some facts for you, taken from this website 

  • The NHS employs 1.7 million people. Including:
    • 39,780 general practitioners (GPs)
    • 370,327 nurses
    • 18,687 ambulance staff
    • 105,711 hospital and community health service (HCHS) medical and dental staff
  • Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and Indian Railways directly employ more people
  • Funding for 2012/13 was around £108.9 billion

Reading the media over the last year or so, you cannot fail to have noticed all the chatter about the state of the NHS, how it is going to fail soon with the stress of workload and lack of funding. Then coupled with that all the articles about 'eat this' 'don't eat that' 'miracle cure for this' and various scaremongering stories. Also people seemingly routinely choosing to go to A&E to get seen quickly rather than using their own GP surgery or the 111 NHS phone service. I really don't know what to believe from stories in the media, and I can see how the general public must be completely confused over what to do or not to do, and whether or not the NHS really is in the level of crisis suggested. But as the old saying goes "there's no smoke without fire", I'm sure at various levels things need fixing, but on a day to day basis can things really be THAT bad?

I think speaking as a patient, I can only comment on my experiences which have been generally good, or very good with just the odd gripe here and there. But at an individual level, every NHS worker I came into contact with has just had the 'will' to care and look after patients at their very core. Whether I'm talking about my local GP/surgery, the people that diligently cleaned the hospital wards I was on, served the meals, the nurses, the doctors and the consultants....all showed the will to provide that care. 

I went to our local hospital open day recently and had a tour of both the radiotherapy dept. showing off their amazing machines used to treat cancer and also the mortuary. Speaking to NHS staff in the radiotherapy dept. they spoke with expertise and passion about the job they did and how they put plans in place to treat patients and how precise the treatment was. The accuracy and effectiveness of the treatment available was incredible to understand. But what really stuck in my mind was the mortuary tour and not for the reasons you might imagine. 

One of the staff who did the tour still referred to the bodies they receive as "patients" and how what they do is still part of the treatment, the last thing they can do for that patient in their journey, compassion was evident in abundance. The person who really impressed was Brett (Lockyer, I think) the Pathologist, he explained in detail what his job was and how long he had been in training to do that job - 16 years training in fact! He had been through doctor training and then a doctor in various departments including A&E leading up to the job he is doing now (classing all this as 'training') and his ambition to become a forensic Pathologist. How lucky are we that there are people like Brett who are prepared to do the job they do, and spend so much of their lives dedicated to doing it, to wanting to do that job. I can never imagine doing the job Brett does, but spending some time listening to his passion could even persuade someone like me to want to go into the medical profession (not now, I'm too long in the tooth). It strikes me that if the NHS really is struggling to recruit GP's, then the NHS needs to talk to young people at the right age, spread that passion that I witnessed to impressionable young minds. If that passion was infectious to me, it surely would have been to a 14 year old me. As with any organisation, its strength lies in its people and they will be the saviours of the NHS.

Yes, that is a simplistic view, politics and money have to come into play. But I don't think it will matter which political party sticks its oar in, I don't think any of them have a true grasp of how to fix a problem like the NHS. In reality it is a complex myriad of things. With the population generally living longer maybe we should all be prepared to pay just that little bit more out of our salaries each month, I'd willingly do this if there was a robust plan in place to spend it wisely. 

So here's my plan for the NHS:

Make good models standard
Identify models/practices from across the NHS (across the world!) that work well, hell that work perfectly, save money and use those models as a basis for care in every hospital, GP surgery etc. If you have a process that is helping patients, saving money, creating efficiency etc. then it should be adopted as a standard, no arguments. I know not every patient has a standard 'need', but if a model for (say) excellent Diabetes care exists, why wouldn't every hospital/CCG area implement it? Should they even be told they HAVE to implement best practice?

Pay more
We should be prepared to stump up a bit more from our salaries to help fund the NHS. There are about 30 million people working, if they all paid an extra £1 per month or £12 per year, that is an extra £360m into the coffers....£3 a month would make £1bn. My simple sums probably don't stack up, but it is surely a rough guide? Could the NHS use an extra 1% budget, I'd have thought so.

Spread the love
Get those passionate experts out into the community, let them tell the world about the job they do and get recruiting, persuading and educating the potential next generation of NHS heroes what a great and exciting place to work the NHS could be for them.

Finally, us, the patients

Where possible, we do have to look after ourselves. Health is a fickle beast and it isn't always within our grasp to be healthy all the time, but eating correctly, not smoking and generally not doing things can land us in hospital is our responsibility. Lifestyles have changed even from when I was young, not that long ago! My cycle & walk for miles as fun is today's Xbox/PS4 fun. Probably a subject for a different blog right there......

I feel like perhaps I have rambled on a bit, but the summary of all that is....I've got no faith in any political party to fix the problem, I think we all need to be prepared to pay a bit extra to support the NHS and that the best chance of the NHS being 'fixed' is for the NHS to promote its most excellent models and make them standard. And finally let some of that NHS passion out into the wider world, help persuade new talent into the NHS and make sure that the NHS continues to be the envy of the world for years to come.

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