The NHIS Update

If New Labour had transformed the NHS it would probably sail through the coming election. But it hasn’t because, even for Tony, miracles take time. Last month, we quoted the statistic that some two-thirds of us now think that we personally are getting a good service from the NHS – but, irrationally, fewer than half of us think that applies nationally. Perhaps that is because NHS professionals working hard at the coalface provide the local view, while the politicians generate the national view. If that is so, the politicians are doing a lousy public relations job. As the modernised and competitive NHS develops, hospitals are likely to be forced to set up advertising departments to sell their wares. How else are they going to beat the competition? If the consumers don’t choose them, they’ll be out of business with no safety net. So will we see radio jingles and incentives? Alder Hey, Alder Hey, we ain’t got MRSA! Or Convalesce with a free holiday for two in the Bahamas after your Addenbrooke’s hip replacement. And so on. It conjures up what would be, to many, a distasteful and tacky way of organising healthcare. But what would happen if such a system were to deliver real benefits at patient level? Then the local/ national split in perception would be even more skewed. So it would appear that the NHS needs to get much better at selling the Brand. To do this it has to be clear and honest about what the Brand stands for and where it is going, so that the customers (and voters) can understand what is happening and why. The pharmaceutical industry has the same kind of problem. Ask anyone in the street what they think of pharmaceutical companies and the chances are there will be hints of evil, over-charging, over-selling, preventing the poor in developing nations from getting the medicines they need, and paying their executives obscene amounts of money. Ask someone who has just found relief, if not a cure, by using a product from one of these dreadful companies, and they are very, very grateful for the expertise and experience that allowed the product to be developed. In both cases – microscopic and personal good, macroscopic bad. In March, a King’s Fund Audit of NHS performance under New Labour said what must be obvious to most people: a lot has been achieved, but there was no guarantee that the reforms would deliver. Clearly we are in for a long haul. But if I were Mr. Reid, although Aneurin Bevan would turn in his grave, I would start spending an odd few quid on Brand Awareness.

. . . even for Tony, miracles take time

So what else happened in March?

• Delivering the NHS Improvement Plan was published to help in delivering the NHS Improvement Plan
• MRSA was down and a statutory code was published on cleanliness in hospitals – but blood clots are said to be 25 times more lethal than MRSA
• it was announced that prescription changes will rise by 10p
• Delivering Choosing Health was published – which was about how to deliver the Public Health White Paper Choosing Health
• substance abuse in the young was reported to be down, and the EU launched a 72 million anti-smoking campaign
• the EU also launched a platform for action on diet, physical activity and health
• a new consultation was launched on extending supplementary prescribing; and the DoH published Medicine Matters, a guide to prescribing and medicine delivery
• a breakdown of NHS costs was published, as were data on the increase in the number of critical care beds
• there was an initiative to improve mental health services for ethnic minorities
• there were 48,000 more people working in the NHS than in 2003
• the National Programme for Information Technology became Connecting for Health
• a social care Green Paper proposed individual budgets
• £150 million has already been saved by eliminating Arm’s Length Bodies, and more will follow
• £1.2 million was allocated for inequality pilots, and PCTs were urged to address vaccination inequalities
• the Healthcare Commission is to merge with the Commission for Social Care Inspection
• surgery choice was widened
• recommended standards were published for sexual health
• Patient and Public Involvement Forums are to be boosted
• more details were published on the new NILSI
• a report on the Pharmaceutical Price regulation scheme was presented to Parliament

National Service Frameworks were also in the news:

• there were progress reports on the NSFs for coronary heart disease and diabetes the Long-Term Conditions NFS was launched
• there was a pregnancy exemplar as an extension to the Children’s NSF
• a chapter on arrhythmias and sudden cardiac death was added to the Coronary Heart Disease NSF . . . and they even fitted in an Easter holiday! Is that hyperactive or what?

Another triumph for the NHIS! Having moaned about the language used by the DoH, we were delighted to see that they had taken on board our constructive criticism, and have begun to talk to the common man with a press release entitled “More Support for ’em.” Although we were not quite sure what it meant, it does seem a move in the right direction.

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Hospitals are likely to be forced to set up advertising departments to sell their wares More elderly people are now living independently in their own homes, but that’s basically because there are more elderly people. The DoH published a compendium of practical examples of self-care support. But the benefits of self-care will not be evident unless more money and thought are invested in the necessary infrastructure. Telemedicine was reported to be on the wane. Therefore, it is interesting to see that Telecare, which is a vital part of that infrastructure, seems to be moving forwards. The technology is not exactly advanced, but it is very appropriate. Systems at Newham are concentrating on COPD and CHD, while Kent County Council has introduced technology to enable patients to self-assess with a range of conditions.

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