NHS: When local isn’t always best

I seem to be turning into a bit of a one woman mystery shopping organisation for the NHS. This time the on-call ENT service was put to the test.

My ear condition flared up yesterday afternoon and I needed to see a specialist - pronto. As always, my fantastic GP saw me immediately after I described the symptoms on the phone. I have decided that I must have been very good when I was little and have been rewarded by the gods with a GP practice with excellent access and quick response times. I am fully aware that this isn’t the same throughout the UK.

Then it started to get tricky. One of the problems with the current state of flux in the NHS is that it’s constantly changing. So practitioners at all stages of the patient pathway aren’t actually clear on how to access some services. My GP phoned four (yes four) local NHS Trusts before he found one that provided an on-call ENT service. And we’re not talking midnight here, this was 2 pm.

My first reaction was – how awful that someone who is supposed to be at the hub of primary care services hasn’t been informed of each change in those services.  My next reaction was annoyance that I would have to travel half an hour to see a specialist, when there are at least five hospitals geographically nearer. This is the stuff of great political fuel – ‘patient drives past two hospitals before she can find the treatment she needs’.

But fast forward half an hour (and let’s face it –what’s half an hour if it means you’re going to get better quicker?) I was in front of an ENT specialist. And the clue is in the name - specialist. He immediately assessed my poor ear in the emergency department and then walked with me to the specialist ENT department where he undertook a specialist procedure requiring specialist skills and specialist equipment.

It would not be cost effective for this service to be available in every hospital.

So, as the NHS reforms are re-formed (more of that later when I’ve had a chance to digest all reports) there are two vital areas of communication that must be addressed.

Patients must be informed of the reasons of moving treatments to specialist centres. They need to understand the rationale. And GP’s – commissioning or not – need to understand how to access care for their patients. Which brings me to a final point. I believe that a Communications Director in each NHS Hospital Trust will be almost as important as the Chief Executive.

Yes – local isn’t always best – but everyone associated with delivering and receiving care need to understand what is available, where and why.