More importantly, perhaps, the art of communication.
If that is true, in a country of 60m, why would a politician only want to share their thoughts with 1.08% of us?
That’s what No19 did last weekend. In an interview with the £walled Sunday Times, he told a rather gullible journalist;
‘Patients whose operations have been delayed will be able to shop-online for hospitals with the shortest waiting-times in the public and private sector, under plans being announced by the health secretary this week…’
This is part of a three point plan that he might tell the rest of us about... sometime.
The other two points; stopping us getting sick in the first place and reorganising hospitals into Academies.
Public health measures begin with the environment, work, family life, housing, education and all starts a million miles from the front-door of a GP’s practice. So, good luck with that, it'll take 20 years.
Reorganising hospitals… in the middle of a recovery plan, in the middle of legislation passing through the Westminister gas-works, to reorganise the system and the fag end of a pandemic… genius.
On-line shopping?
Patients already have the right to chose, enshrined in the NHS Constitution.
‘… you've the right to choose which hospital in England to go to. This will include many private and NHS hospitals that provide services to the NHS.’
That’s all gone by the board as demand on the system has outstretched capacity.
Shopping on-line for treatment depends on getting a website organised that can collect real-time data from all Trusts, for every specialty, that can take into account staffing, rota-gaps and clinical priorities.
US software group Palantir probably does have the know-how, to do this but I doubt most Trusts have the capacity to provide the inputs.
‘Palantir’s technology works by bringing together disparate data, such as number of patients waiting per clinician, operating theatre schedules, staff rosters and patient-specific pre-surgical tests, into a single system that surgeons and other clinical staff … rather than just admin and scheduling staff … could also use.
The dashboard allows clinicians to see which patients needed to be prioritised at a glance, allowing them to make real-time decisions on scheduling surgeries.’
The software prioritises treatments.
There are only two ways to get people off the lists. Treat them or cheat them.
Treat them… we all get that.
Cheat them? There are lots of cunning ways.
Validate waiting lists, weekly. Look for defective addresses, post-code errors and claim they’ve ‘gone’.
Give people impossible response times, particularly the elderly, to say they still want to be treated.
Claim they are overweight and move them to a non-live-list, whilst they lose weight.
The same for smokers and drinkers… give up or yer-off-the-list, mate.
The latest wheeze; for GPs to talk to a consultant about a patient and claim treatment has started.
Parking people on zombie lists
Another route; keep people off the lists.
Persuade people for ‘risks’ or other reasons, that an operation isn’t in their best interests and pain-killers and physio is just what the doctor ordered.
As for shopping around… software might be able to cope but has the potential to throw the NHS into chaos.
People arriving from ‘out of area’ will need video-out-patient consultations, some way of doing blood, imaging and other tests.
And post-op? The same again for out-patients and physio, OT, aids, adaptations, pharmacy and social care support.
... to say nothing of the stress on patients and their families.
In an area with long lists, there will be pressure on social and post-op' care. Accelerating treatment, for patients, out of area, threatens to put more pressure on services when they return.
None of this is impossible but the NHS is nowhere near geared up for it.
Treatment options using the private sector?
Sixty percent of private provision is in London and is staffed, mainly, by NHS surgeons and anaesthetists.
In the year before Covid nearly 600 patients had to be transferredfrom private operating theatres, to the NHS, when something ‘went wrong’.
And…
… the private sector don’t want our business. They are full of patients, impatient with NHS waits, paying a premium for treatment. NHS customers only pay tariff.
The Sunday Times swallowed the story, hook-line-and-sinker. Whoever put No19 up to this is naive and probably reads the Sunday Times.
Cut waiting?
Three things to do, now:
focus on the whole patient pathway like it was a supply-chain;
organise providers around cold-sites and emergencies, pool similar work;
>> I'm hearing - ambulance wait times are as long as a day in Hong Kong, struggling with CV-19.
>> I'm hearing - Nurse vacancies across England are up 9% in a year, with every region across the country recording an increase. Mental health nurse shortages have worsened by a 35% over the course of 12 months.
