At a time when the NHS has done so much during the COVID-19 crisis, it might seem unfair to point out the flaws in the system, but we think this is essential if we are to get improvements.
The NHS must resolve to re-organise to deal with the pandemic and treat the backlog of treatments, ` (estimated at 6m), many of them very serious, including cancer and heart defects. This will involve getting better at isolating patients from infections.
The problems can be solved by bringing together stakeholders from NHS Health Trusts, Clinicians, Nurses, Ancillary workers, GPs, Pharmacists, Care Workers and many more.
Scale and complexity
Hospitals in the United Kingdom already have problems associated with scale and complexity:
- They are difficult to manage.
- There is an infinite demand on their services, but finite resources to manage them.
- There are profound disagreements about how they are funded and managed. As a result, they are often seen as a “political football.”
The benefits of reform
The work done by the NHS is essential to the entire population, and it is perfectly positioned to achieve even more. But it can only do this if it:
- responds to the exciting new treatments that are developing because of the Genome and other scientific projects.
- benefits from the rapid development of technology and equipment, which is in full flow.
- harnesses the continued refinement of medical techniques and knowledge.
- connects to the wider health and care system.
The problems
The main problems are:
- The development of hospitals has not kept pace with the medical and technological advancements. This needs to be done to improve the nature and volume of treatments.
- Staff knowledge has not kept up with medical and technological advancements. The Trust should lead a development programme, which will be a long-term development. Priority should be given to quick wins.
- It takes too long to develop Hospitals – and most of that time is spent in design. Trusts should be given the freedom to develop hospitals as they see fit, without being beholden to the central NHS system. (Funding will be based on an appropriate business case.)
- Hospitals are not sufficiently flexible – and soon get out of date. Trust should ne permitted to develop hospital refurbishment programmes which are associated with change of use, associated with technological developments.
- There are too few critical care beds. Neither the Government nor the NHS has kept up with population growth over the past 30 years.
- The NHS does not do enough to diagnose and prevent disease. There is a huge gap between the science and the ability of hospitals to treat disease. The Trust should develop a development programme for staff with the accent on diagnosis.
The NHS is in desperate need of reform – there is disillusionment about the health system. There is too much money reserved for court cases (£83bn) and staff are frequently assaulted by patients and visitors. This demonstrates a level of dissatisfaction with the population that it serves.
The future approach
The NHS is especially important to the nation and cannot be allowed to fail, but the pandemic has exposed many of the faults in the system. For example, it has not been possible to isolate patients with Covid 19 – or any other infectious disease. MRSA, for example is an infection, which patients pick up whilst being in hospital for other reasons. It has dogged the NHS for years.
The collective minds of the Executives of the Trusts must surely be able to solve these problems if the resolve to de-politicise the NHS. It means that both politicians and NHS executives must produce practical solutions for dealing with the problems, have the courage to act and to be accountable for them.