Should the NHS be more like the phone industry?

 
Mobile phones

The pace of change in the telecommunications industry has been phenomenal.

From telephone exchanges to landlines in every home and - in the past 20 years or so - the advent of mobile phones and now smartphones, the way we communicate with each other has come a long way.

But what, you may ask, has that got to do with health care? Well, perhaps more than you think.

While medical science has revolutionised the treatments available, the same cannot be said for where the care is given. Hospitals - and the district general hospital in particular - still dominate.

There is, it seems, a fear of change.

Too conservative

It is a point not lost on NHS England's Prof Keith Willett. He is the national director of acute care and is leading the review of how services are organised in the NHS.

He says the comparison with the telecommunications industry is an interesting one. He believes society as a whole is too "conservative" when it comes to embracing change to the NHS.

He believes we remain too fixated on the "bricks and mortar" than what works best. To illustrate the point, NHS England has released figures today showing that since the reorganisation of trauma care into regional networks in 2012, 600 lives have been saved.

The analysis - by the Trauma Audit and Research Network - has calculated that survival rates have increased by 30% for the 16,000 patients brought to hospital each year with major trauma from road accidents, falls and assaults.

But this is not a success story.

The case for changing the way trauma care was organised - it is now centred around 25 major hospitals - was put as long ago as 1988 by a report for the Royal College of Surgeons, by Sir Miles Irving.

NHS England calculates 6,000 lives could have been saved by introducing the reform earlier.

Why delay?
Old mobile phone

So why did it take so long? Many theories have been put forward over the years from politicians being too quick to put their names to campaigns to save local hospitals to NHS leaders - both doctors and managers - being too timid to put the case for change.

Recently, there has been some confusion over the direction the NHS is heading.

Much was made of the comments by Simon Stevens, the new chief executive of NHS England, about the role smaller hospitals have to play.

Some interpreted this as rejection of the desire for these specialist centres.

But the case being made today - Mr Stevens is making a speech to an Age UK conference in London when he will reference the data on trauma care - will make it clear.

Bigger when it comes to specialist care from stroke services to heart surgery is definitely better.

That is not to say there isn't a role for smaller hospitals, there is.

Even after the trauma care reorganisation, district general hospitals are still responsible for rehabilitation and carry out follow up appointments. But as the phone industry has shown, embracing change holds the key to progress.

 
Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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The NHS across the UK is already struggling to meet its A&E targets, and winter - the busiest time of year - has only just begun. Nick Triggle looks at why hospitals are under the cosh.

Read full article

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  • rate this
    0

    Comment number 145.

    134.Disabled Dave
    "..I was pointing out that you are wrong in claiming only the clinically depressed prefer death to life, and there are many sane people who logically seek death.."
    -
    Was Socrates clinically depressed? Probably - he was certainly a bit psychopathic.

  • rate this
    0

    Comment number 144.

    Pinotmoir said: “Incorrect. There are almost as many managers as nurses.”

    Wrong. Read this: http://flipchartfairytales.wordpress.com/2014/01/15/is-the-nhs-really-over-managed/

  • rate this
    0

    Comment number 143.

    Fetch an Economist!

    Ever in need of a headline, our PM highlights the problem of 'news abuse', moving-on from hollow address of GP diagnostic failure, reprising with variation the scare-story of 'antibiotic abuse'. Cameron makes fun of our gullibility, the treacherous top-downer waving the red-flag of 'market-failure', for all to charge-at, to miss the author of our misfortune: democratic deficit

  • rate this
    0

    Comment number 142.

    Voters & patients empowered as customers, unequal?

    In tabloid health & care journalism, daily a £-scandal. Behind scenes GPs lobby more money AND more access to back-up;
    consultants for more centralisation, near private centres. Govt semantics, all 'efficiency-cuts' welcome; self-funding why not?

    FAILING to ensure employ / benefit / pension for ALL, we are ever tempted to CUT, to dismantle more.

  • rate this
    +1

    Comment number 141.

    The NHS can't be run like BT. Phones aren't a matter of life & death, phone companies can fail, phones are disposable & you can always buy another one if you don't like the one you've got. People aren't disposable, if hospitals fail because they lose out in the market patients die, & you can't shop around for the best hospital when you are being rushed to A&E. A stupid comparison.

  • rate this
    +3

    Comment number 140.

    @113. Davey Trasker
    The NHS is not "overburdened with immigrants and health tourists". The total cost of treating them is estimated to be about 0.06% of the NHS budget. Many of those immigrants are eligible for NHS care because they pay tax into the system. Please stop spouting false claims by the Daily Mail as fact.

  • rate this
    +1

    Comment number 139.

    Just another attempt by agent Triggle on behalf the City of London to - dehumanise -medicine and social care.

    For the old lady in the picture, give love and help from a person not a piece of plastic.
    For the sick, give treatment free at the point of delivery.

    Honour your father and your mother!

  • rate this
    +3

    Comment number 138.

    Just another BBC question to aid the sell off of the NHS me thinks!!!

  • rate this
    +1

    Comment number 137.

    135 I'm not convinced that centralisation of specialist care will save lives. If I've had an accident and need an operation within an hour I wouldn't want to face a two-hour journey by ambulance driving past 3 hospitals to get to the nearest centralised unit as I would be dead by the half-way point.

  • rate this
    +3

    Comment number 136.

    Ironic that the article cites the phone industry given the pathetic performance of '111' compared with NHS Direct. We have a government that (i) can't distinguish between 'cheap' and 'value for money';and (ii) is committed to dismantling the NHS for ideological and Party funding/payback reasons.The Service is too publicly valued to allow this self-interested Tory/corporate elite to profit.

  • rate this
    +1

    Comment number 135.

    I totally agree that the centralisation of specialist care will save lives; and that integrated care should move us on from the traditional 'bricks and mortar' model of treatment. Two points though - (i) in terms of patient safety, the aviation industry is a far better exemplar for the NHS;(ii) deliberate privatisation will render any strategy chaotic and benefit shareholders more than patients.

  • rate this
    +3

    Comment number 134.

    133 Griff-rhys said "I think that you are wrong in asserting that " we all prefer life over death", in fact there have been recent high profile court cases examining the right to die"
    You replied "Only relating to the clinically depressed."
    I was pointing out that you are wrong in claiming only the clinically depressed prefer death to life, and there are many sane people who logically seek death.

  • rate this
    -1

    Comment number 133.

    131.Disabled Dave
    "..And those in uncontrollable pain, and those with locked-in syndrome.."
    -
    Just what has this to do with privatising the NHS?

    Is your argument that a normal person prefers to die and thus hope of a quality life is not in itself a justification for having an NHS?

    Weird!

  • rate this
    0

    Comment number 132.

    12.Griff-rhys
    ..I take it from your response that you think that all treatment should be free irrespective of the cost/benefit to society generally and all paid for by the taxpayer?..
    -
    We have bodies like NICE to sort out cost benefit. Do you even think before mouthing off trying to grab what doesn't belong to you?

    So don't "..take it..". Go and dream up a more intelligent script.

  • rate this
    +2

    Comment number 131.

    130.
    BlackWednesday
    7 Minutes ago

    12.Griff-rhys
    ..I think that you are wrong in asserting that " we all prefer life over death", in fact there have been recent high profile court cases examining the right to die..
    -
    Only relating to the clinically depressed.

    =======================

    And those in uncontrollable pain, and those with locked-in syndrome. You want to make them suffer for longer?

  • rate this
    -1

    Comment number 130.

    12.Griff-rhys
    ..I think that you are wrong in asserting that " we all prefer life over death", in fact there have been recent high profile court cases examining the right to die..
    -
    Only relating to the clinically depressed.

  • rate this
    +5

    Comment number 129.

    A many faceted question. Your image of an old lady stuck with a mobile perhaps conveys more than we might at first realise, namely a loss of the common touch, a spreading of the gadget industry and a reliance upon technologies that lack a heart. The attitude in the charities industry today sums it up, namely, financial reward versus true philanthropy.

  • rate this
    +6

    Comment number 128.

    Privatised NHS like BT? Not a chance. It's more likely to be like G4S. A preferred service provider that is guaranteed to get contracts no matter how badly it performs. That's why private health care companies fund the Tory party. Running privatised public services is a license to print money with no competition, no investment, no risk, & no accountability just guaranteed profits.

  • rate this
    +1

    Comment number 127.

    The last time I had to accompany someone to A&E (a blues & twos event) it was a Friday night. Around half of the other people there had binge-drinking related injuries. Isn't it time that people with these sort of injuries were charged for their treatment? Nobody is forced to get so drunk they fall flat on their face, and why should sensible people's taxes be used on these idiots?

  • rate this
    +1

    Comment number 126.

    In reply to the comment to pay doctors less and employ more of them:
    Fewer people want to be doctors. There is a 12% vacancy rate in GP and 40% drop in applications to train. Huge uni fees, unsociable hours, constant criticism from politicians, press and the rest, dropping income. If you want the brightest and the best to be doctors not bankers, you have to make it a little more attractive.

 

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