Monday, 19 December 2011

Tales of NHS Waste

I'd be more sympathetic to 'Save the NHS' calls if I knew exactly what we were trying to save. A couple of recent experiences highlight the problem.

First, we had an occupational therapist (OT) and physiotherapist arrive together to visit my elderly mother-in-law. Good coordination you might think, but no. These were two therapists from two different teams, and only by a miracle of coincidence had they arranged their visits for exactly the same time on the same day! The two didn't even know each other. We expected the OT, but knew nothing about the physio and have yet to figure out how he was referred to mum-in-law. Not surprisingly, his visit was of little value.

Then my (even older) father told me that for many weeks an ambulance has been calling to provide him with clinic transport on days when he has no clinic appointment! Every week he tells them he doesn't have an appointment on that day, but the following week they're back again. The clinic isn't contactable by phone, he has tried his GP without success, so in desperation he has made a formal complaint in an attempt to stop these wasted calls. He has yet to receive an acknowledgement.

Both instances show a lack of coordination. Different NHS services or teams, even when their work is closely related, do not know what others are doing and cannot seem to communicate. Such confusion and waste would be infuriating at the best of times, but with the NHS experiencing a funding crisis it makes one despair.

It's tempting to say that better IT systems could solve this – a single patient record system of the type that is just about to be abandoned (at a cost of billions to the taxpayer). But I'm not convinced. Focusing services around the patient rather than around the NHS itself is as much to do with attitudes as with IT. I realise that a lot has been done on NHS modernisation in this area, but it's clearly patchy when failures of this kind leap out and slap you in the face.

I remain impressed with the dedication and professionalism of the vast majority of NHS people I meet. But in too many cases their focus is on the service they deliver, rather than starting with the overall needs of patients. Until this changes, I remain doubtful whether the NHS – in its present form – is something worth saving.


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