Tuesday, 3 January 2012

A year in the life of the NHS

Regular readers will know that I’m generally an optimistic soul but I must confess that I face 2012 and another year of observation on healthcare and the NHS with a heavy heart. Before I look forward, I thought I should review 2011 – through the eyes of my blog and its readers.

There is clearly an appetite for news and opinion on the NHS and Finchers Health blog is now followed in 75 countries – Kyrgyzstan, Albania and Vietnam are the most recent to come aboard. I shall continue to attempt to provide rational and fair commentary although I make no secret of my reservations regarding the content and application of the NHS reforms proposed by the Health and Social Care Bill.

How can I summarise the NHS in 2011? Turbulent. Upsetting. Disappointing. Shocking. Worrying. Exasperating. That pretty much covers the care scandals, job cuts, waste, political posturing, and worst of all back-biting a cross the medical disciplines. Has the NHS moved forward in the past year? I really don’t think so.

No-one can deny the need for a significant shake up of cost management and quality assurance, but a top down radical reform was never going to be the best way forward.

At the end of 2010 I wrote about the fear factor in the NHS as the Health and Social Care bill loomed. One post which struck a chord nationally was where I quoted a young NHS employee who had left a note saying ‘I’m worried that I’ll lose my job and I’m scared that I won’t find another’. Alas in 2011 a significant number of very able staff have left the NHS and the phrase ‘brain drain’ has been echoing in the corridors of many a strategic health authority and primary care trust. It is expected that over £1bn will be paid in redundancy settlements to over 20,000 staff in the next couple of years.

What were my most popular posts in 2011?
‘The list’ - 22nd March: I produced a (then) almost definitive list of organisations and influential individuals who had spoken out against the Health Bill. This proved to be one of my most popular posts of the year.
‘My dream team for the NHS future forum’ – 18th April: I listed the perfect combination of the great and the good, past and present who could help shape the new NHS. These included Florence Nightingale, Mother Theresa, Albert Einstein, Lord Robert Winston, Joseph Lister, NHS founder Aneurin Bevan, and - to ensure he hears everything first hand without the political spin - David Cameron
'What do patients really want?’ – 25th April: Concerned that patients were being forgotten in the political melee, I posted a simple list of ‘must haves’ for patients. This included information, choice, to be listened to, easy access to GPs, decent out of hours primary care cover, courtesy and kindness and continuity of care. This post was very popular in the USA.
‘Another view from the front line’ – 9th May: An impassioned plea from a GP who asked me to write about a colleague of hers who died suddenly– and she was convinced it was due to the stress of reform.
‘NHS Future Forum’ – 18th -21st May: I was fortunate to attend a future forum seminar and wrote in some detail about the varying views of consultants, GPs and politicians. A fascinating event which failed to reassure me that the ‘listening exercise’ involved much actual listening.
‘View from an inpatient bed’ – 10th -12th June: Finchers took research to the next level – as an inpatient! Grateful for emergency care and life-saving treatment, I still had to comment on the poor organisation, lack of ownership, waste and poor time management among the ward staff – shocking in some cases.  
‘My birthday wishes for the NHS’ - 5th July: My list of gifts for the old lady’s 63rd birthday included clarity (sadly lacking throughout 2011), rejuvenation (we could all do with a bit of that) communications training for all staff, tolerance, innovation and performance management.

'Who really has power in the NHS?’ – 4th August: A fascinating study outlining the disconnect between doctors and nurses.
‘Clinical commissioning groups – time to face reality’ – 21st September: I reported (admittedly a little smugly) that GPs are now facing the reality of their commissioning responsibilities as an advocate of extra GP powers, Dr Michael Dixon states that he doesn’t want to have to decommission services’. Tough.
'Ministers behaving badly must go’ – 14th October: This post enjoyed multiple re-tweets, possibly because I came right off the fence and stated that it was time for Andrew Lansley, UK Secretary of State for Health, to go. He sneered openly at a health worker during a BBC political discussion programme, showing his contempt for the very people for whom he has responsibility.
‘How to win a healthcare argument’ – 17th November: one of many posts outlining the challenge of educating and persuading the public on what’s best for them

And finally ..
‘The NHS – with a little help from Charles Dickens’ – 23rd December: The ghosts of NHS past present and future ponder on what has been, what is and what may be…

Which brings me nicely to 2012.

With my thanks to all my readers for your support, robust discussion and frank comments. I look forward to continued stimulating and enjoyable engagement for another 12 months and wish you all a happy, healthy and prosperous New Year.


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