Like asking accountants to practise medicine
The primary job of General Practitioners is to see and treat patients. That is what they spend years at medical school learning. That is what the general public and patients expect them to be expert in and do. Of all the arguments over the government’s proposed reforms of the NHS, there is one argument that [...]
NHS information – local decisions
On the 18th May The King’s Fund published a report entitled “The future of leadership and management in the NHS – No more heroes”. It is the result of nine months of research, seminars and consultation into the state of management in the NHS. Broadly, it is supportive of NHS managers and it is against [...]
Why do NHS managers want to keep targets?
The Public Service web site reports on a survey where 59% of NHS managers say they want to keep the targets that are being dropped by the new government. Andrew Lansley has said that the 48 hour GP target, the 4 hour A&E target and the 18 week GP to treatment target are to be [...]
The alternative to ring-fencing
Age UK has called for the social care budget to be ring-fenced like the money for the NHS has been. They claim that social care has an effect on the NHS and cutting its budget will drive demand into the NHS. They are no doubt right, but they are using a classic silo-thinking trick. They [...]
Surgery targets endanger patient safety
The BBC reports that About one in five of the nearly 600 surgeons questioned by Bournemouth University reported being involved in incidents, during a two-week period, where patients were harmed. Using the figures further on in the article of 549 surgeons questioned and 19% seeing harm, that means that in two weeks, 104 surgeons saw [...]
NHS four-hour A&E target to be cut
From the Press Association, NHS four-hour A&E target to be cut This is good news, but it remains to be seen what the alternative will be. It is hoped there will be some sort of method behind it this time. By method I mean a practical way of improving that is not ideological or dogmatic, [...]
Perverse process is caused by policy
In The Guardian: Dr Lansley’s prescription can only induce more perversity, comes: No business is immune from the perverse incentive. People will always find a way to work around financial incentives, and processes will evolve that look, well, perverse, until they’re traced back to the policy that created them. This goes further because it is [...]
NHS readmission policy is sticking plaster on a bad system
The Health Secretary Andrew Lansley, announced yesterday that hospital trusts will not be paid for the second visit if they discharge a patient who returns within 30 days. This is to discourage trusts from discharging patients too early to try and save money. There are problems with this. Firstly, there is a report from the [...]
Welsh Ambulance Response Rates Show No Improvement
It is reported by the BBC that the Welsh Ambulance Service has improved its response times for Category A emergency calls. These calls are targeted to have an ambulance arrive within 8 minutes 65% of the time. The BBC article states that the percentage has been above 65% for the last three months and that [...]
Ambulances no longer sent to all seriously ill patients
The obvious angle for comment on the recent Daily Telegraph story, ‘Ambulances no longer sent to all seriously ill patients’ is that targets are damaging patient care and causing ambulance services to cut corners by sending paramedic cars to patients who really need an ambulance. But this has been covered in previous posts and actually the more interesting point is hidden near the end of the article.
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