Waiting lists, social care, and NHS in crisis

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Waiting lists, social care, and NHS in crisis

There are weekly stories in the press of the NHS at breaking point, waiting lists climbing, morale low, and examples of patient safety being under threat. I can only imagine how disheartening it is for patients waiting for elective procedures and having to live with conditions that impede their quality of life, whilst they work their way up the queue.

 Let me start however by giving due credit to those who work in the NHS. They are working in the most pressured environment, under the most stressful conditions, where resources are finite. The quality of working conditions was an issue raised by many clinicians in the long running disputes on pay; something which certain sections of the media focussed very little on, preferring to demonise doctors for wanting to work in an environment where there are sufficiently skilled colleagues to assist them, with fair remuneration for the skills they provide each and every one of us in society.  

 We are told that the government has invested “record” sums direct into the NHS and can’t afford to pay the wage increases the doctors are demanding. Firstly, you would expect “record sums” to be investigated – things generally increase in price and as such budgetary contributions will, and should, increase not decease. We are an ageing population and if we all are living longer, then there are more people to treat, for longer periods of time. That “record funding” therefore, is nothing more than a statement of fact, and shouldn’t be seen as something to be celebrated. It should be record funding every year.

 What doesn’t seem to be appreciated are the hidden costs to both health and social care where those waiting for treatment are concerned. Statistics available from the BBC website provide information of how many patients are waiting above the “target time” of 18 weeks. These are reproduced below for Manchester University Hospitals NHS Foundation Trust, the trust local to me.  There are other examples, where performance is “better” and some are “worse”, and Manchester isn’t highlighted for any other reason than to illustrate, it shows that 54% of patients waiting for “routine treatment” are waiting beyond 18 weeks.  Think about the implications of that.

The condition may not be life threatening, but it may be life limiting. They may not be able to work or perform all aspects of their job, which has implications for productivity and their well-being. They may have no one to look after them if they have mobility problems – that may result in care being provided by the local authority or benefits paid by the DWP.  

 We may have record sums invested, but it is self-evident it isn’t enough.

 Last week I spoke on BBC Radio Manchester on Martha’s Law and this welcomed initiative for patient safety to enable those concerned about a patient’s deteriorating condition to request a second opinion from a dedicated clinical team at the same hospital. I stated that it can only work if it’s given the resource with which to do so. It’s a simple point, which to my mind, seems to frequently be overlooked. The sticking plaster mentality to try and patch up the NHS isn’t working, and it deserves better. Investing more at the front end will enable patients to

1)    Get treatment faster

2)    Recover faster

3)    Became independent faster

 All of which surely mean they are less likely to

1)    Deteriorate

2)    Suffer worsening mental health

3)    Require additional NHS or social care.

 Prevention has to be a better goal than cure.

 We have seen the concern that the BMA and others have expressed with the introduction of Physician Associates and the potential dilution in the quality care that may follow. I have seen this from my clients who had no idea there weren’t being seen by “a doctor” and were in fact assessed by an “advanced practitioner”. I fear with these “quick fix”, short term “solutions” are little more than soundbites and will do little to improve the situation. Recruitment is suffering and it is common knowledge we are failing to attract the numbers and quality of people needed to work in the NHS. I have to say that sadly I am not surprised.

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