It wasn’t 5 minutes ago that I was writing just before Christmas – that’s been ‘n’ gone in the blink of an eye and here we are now on the verge of a brand new year. There was a lot on the news this morning about New Year’s Resolutions… the only resolution I ever made was to never make resolutions – I won’t lose any weight, I will continue to eat the same amount of chocolate, I won’t drink any less and I haven’t ever smoked, so that’s a non-starter! People always start the year with the best of intentions, but l don’t know anyone who has ever kept a resolution (at least beyond January!).
So, it got me thinking about New Year’s Resolutions for the NHS… what would we change and what could we change? Well, shed loads if you ask me (although no-one ever does, which is quite strange given that I have lots to say on the subject!) but I’ll name just my top three if that’s OK?
Let’s start with CQC – my current bête noire – I’d like to say no to CQC for 2016 please, let’s get rid of it, let’s remove all that paperwork and bureaucracy. You don’t need to ask doctors and managers if they are doing a good job – we know we are, we shouldn’t have to prove it!
How about we ask NHS England to sort out their Shared Business Services department… specifically, the one called ‘Finance’? Wouldn’t it be great if their New Year’s Resolution was to ensure they paid everyone on time, and not only that, but let’s start sending out remittance notices when payments are made, so I don’t need to be psychic to work out that the money they’ve sent me is for three different invoices, sent on three different days, for three different streams of work.
And finally, IT. Many, many years ago ‘Connecting for Health’ were the words bandied around with ideas about electronic referrals systems and sharing medical records and wouldn’t that be great?! And here we are with a system that I think is running about five years behind schedule, has cost us millions and millions of pounds and got us where exactly? As it stands, Choose and Book was created at a cost of over £130 million and it’s now defunct and ‘not fit for purpose’ apparently, although the newer electronic referral system isn’t that different. We’ve got some clinical computer systems managing to talk to other clinical computer systems (GP to community and vice versa) but perhaps not all the time – this may of course depend on that robust N3 connection or whether you’re out in the sticks and you’ve got no dial up broadband… you can forget wifi! The NHS IT programme seems to be as stale as it ever was – will we ever get where we need to be to provide joined up electronic medical records?!
Speaking from experience, years and years of experience, I doubt that any of the above will be resolved. I would even go so far as to say, I would bet my life that NONE of the above will be achieved – IT might just get there by 2025 but by then, we won’t have an NHS as we know it, so what difference will it make?
Perhaps we could have credit-card sized records that get updated each time we visit the doctor/dentist/hospital etc. Patients could be responsible for their own records, and it would be their responsibility to take that little card to the doctor each time they go, so that it is updated properly with medication, medical history etc… oh, hang on a minute, I’ve just suggested that “patients would be responsible”… now I’m just being completely ridiculous!
And on that note, I might just start drinking more… at least in an alcoholic haze I might not be so grumpy! Roll on 2016…
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January 6, 2016 at 5:15 pm
Nicola…I enjoyed your rant and could add oodles to it but my energies are needed elsewhere.
However, you did just spark an interest and an idea that I’d take a closer look at CQC as an organisation. This’ll make your blood boil.
During 15/16 the staff bill increased by 10.5% to £179m, the non-pay spending by 14.75% to £70m and it is going to take £113m out of health care to pay itself in 2015/16 which is 10% more than the year before. All in all CQC has direct costs taken from the health econony pushing £500m….or £10m a week!
The vast majority of CQC performance indicators are soft when it comes to what it calls achieving its “Purpose”. That is about 80% of its performance is measured on what people say….so anecdotes. Not generally accepted as reliable data on which to justify diverting £500m from health care. I couldn’t see anything about what has happened to improve the health of the nation as a result of its work.
Curiously the ‘Business Plan 15/16’ talks about achieving its ‘purpose’ but this purpose isn’t obviously defined in the document. If it is to put undue mental, financial and operational pressure on services which face uncertain futures with exponential increase in patient demand and an equivalent exponential reduction in resourses then ok it probably is doing what it set out to do.
But if you asked the man in the street or the ubiquitous (reasonable) man on the Clapham Omnibus what improvements to the health and social care services in the UK are resultant from CQC activity I think that most would view its relevance as being very different to how it sees itself. Which is more important….that we have lids on our general office waste bins and that our staff wear name badges, or that the elderly woman was prescribed antibiotics early for a chest infection just getting hold and she recovered quickly?
Cheers 🙂