On Monday of this week the new coalition government released its white paper on the direction and general operating plan for the NHS. The paper outlined the emphasis that the NHS would now take - a much greater focus on patient outcome and satisfaction - with a step away from the target driven environment that has dominated the health service for the past decade or two.
That's all well and good, but just how will the government ensure that health care is focused upon patient satisfaction? How will it monitor and measure this without a target-led environment? The task of capturing patient satisfaction through measures that are in no way target related, or access and waiting times driven is significant. Anyone who has studied the current guidance on the make up and scoring means for the current 'patient satisfaction' measures in place will know that there is huge room for variance and distortion in the way that the results of surveys are scored. Just how well will patients' views be represented in this new monitoring regime?
In terms of access, the NHS has made significant improvement over the last ten years, with a much fast turnaround in A&E departments, the reduction in Hospital Acquired Infections, reducing rates of operation cancellations and of course, the introduction of the 18 weeks pathway which I for one think is fabulous. Removing these initiatives as 'targets' feels like a massive step backwards to me. And I can't believe that one thing that patients want is fast(er) access to treatment.
But aside from the changing focus of what will and won't be monitored, the White Paper announced some fairly hefty changes to the NHS structure. PCTS and SHAs will go, budget holding moves to the GPs, and potentially a new regulatory body will be brought in...again.
All in all, not the most positive document any of us have read. Except for GPs of course...What next? Surgeries in the Bahamas?!
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