I’m trying hard here to come up with one, and the only example that I would draw attention to is within the flawed Lansely H&SC act of 2012 which did at least put the NHS at arms length from direct political control and interference and which I predict we will value in hindsight when it is taken away by the proposed reforms.
The general issue with these so called reforms is that they are always top down in delivery and too wholescale and grand in scope and therefore take too long to realise and embed to make much of an objective assessment of their effectiveness, by which time they are either out of step or too rigid in their application with little room for tweaking etc in practice.
They also tend to be the brainchild of some highly overpaid consultancy or other which intrinsically means that they come from the mind set of strategists rather than from people with any kind of appreciation of how services are commissioned and delivered in an operational sense, and therefore they are big on things like governance etc but when it comes to the crunch of the ‘how’ rather than the ‘why’ this is much less thought through and consequently this where any reform will tend to fall over/ stall in real world application.
When you overlay irrelevant and illogical political ideology on top then you really do create a toxic cocktail of half baked ideas combined with bizarrre and disproprtionate priorities - for example this is the kind of twisted dogma that led to the fuss and nonsense over ‘health tourism’ and clawing back relatively insignificant sums which is just pure politics that suits the facile ‘Britain First’ agenda that lurks underneath Brexit etc and bears no relation to actual situation and needs of the current health and social care service at scale. When health and clinical leaders are surveyed on their priorities this wouldn’t even make the top 50.
I can’t think of a single Health Secretary who I’d consider as competent in either approach or results. Some of the advice that they solicit and follow is consistent in being shockingly poor.
I think that one change at the NHS that would help is around database interoperability. When my GP does my blood tests, my consultant’s nurse specialists need to phone them up, get the blood test results faxed to them, then they input them manually onto their system.
The NHS Programme for IT was designed to overcome this, but I think that got bogged down in top-down installation of specific systems, which are easy to specify but could actually be done much better at a local level. They didn’t spend enough time/resource on managing the interfaces between the systems, which is the one thing that should have been done at national level.
when wife has her tests in hospital, all the results are pinged electronically to the GP. The reverse happens when she goes to her GP for interim tests.
My neighbour had to attend A&E yesterday, and they could instantly see all the GP based blood test results prescribed medicines etc…
I think your GP needs to get into the 21st Century with the practice IT.
Mine work the same as described by Simon.
When I moved house and signed up with my new GP they had access to all my records including consultants reports and hospital tests etc within 3 days and I was set up on an app to order repeat precriptions within a week.
This really isn’t the biggest issue or the one that would have or enable the greatest impact.
And after the last fiasco it’s completely off limits to even suggest a large scale IT programme as anything other than a colossal waste of public money (that could right now be better served by going straight to front line care given the pent up demand for planned care referrals).
Depite its newly rejuvenated sovereignty there’s no way the UK will be admitted to trading blocs such as CPTPP if it won’t stick to the terms of trade deals it’s already signed. At least not according to Jacinda Ardern who’d happily veto it. Someone needs to tell Liz Truss before she over promises.
