The government wants the NHS to do more with less (or, if a member of the media is within earshot, to do more with about the same). To achieve this, if indeed it is achievable, everyone is going to have to work a lot smarter.
And so we’ve got the White Paper, which shakes up primary care and once again seeks to usher in the private sector in pursuit of competition and efficiency.
But, efficiency isn’t just about the big stuff. Torching all the SHAs, PCTs and quangos before lunch and then shooting a few managers in the afternoon might grab the headlines but large scale re-organisations are often slow, expensive and rarely deliver the intended results.
Real progress - in both efficiency and quality - will be found in improved working practices and how services are organised locally. And that’s why we surveyed hospital doctors on how things could be improved.
Shift handovers are clearly a serious problem. If we don’t have the balls to modify the working time regulations, then trusts have got to adopt best practice and bring uniformity to the process.
It’s all very well for Sir John Temple to say every handover should be a well-planned and supervised learning opportunity (hang on a minute, when was the last time you attended a post-take ward round Sir John?) but the reality for many consultants is very different.
It’s also concerning that, according to hospital doctors, a lack of staffing and training resources are already compromising care. This is only going to get worse. At least the government appears to be tackling targets, another highlighted problem.
Our survey also offers some clear pointers for IT development. Time is regularly wasted finding medical records. Clinicians want to be able to access real-time electronic patient records.
How much public money has been spent on the NHS IT programme and yet we still can’t deliver this? It’s starting to make the Millennium Dome look like a successful project.
The message is a difficult one for a government with no money to stomach: you’re going to have to invest a bit more before you can make long-term savings. Having said that, scrapping the 48-hour week wouldn’t cost a penny…
Tags: WTD
