The NHS is like a very dear elderly relative – you don’t choose them, you love them dearly but you are also frustrated by their old fashioned ways and inability to change. It is however really time to have that talk with them because this time something really has to give.
I recently moved back to the UK and despite having experienced excellent healthcare in Switzerland it came at a steep price and sometimes lacked the empathy and compassion that makes me love the NHS (except my Swiss GP who was phenomenal). I have also had the misfortune of experiencing the Spanish (private) healthcare system which not only lacked the compassion and empathy but was downright terrible, unprofessional and borderline dangerous. Having moved back to the UK and the NHS I soon had my first experiences – and run ins – with our venerable old system of healthcare. I have been left in shock at what I have experienced and has led me to say “we need to talk”.
The NHS is our sacred cow that we defend to the hilt and which we love but it has come to a point where the system is so clearly broken that it is time that we moved our sacred cow into newer pastures and gave her a good clean. The problem with sacred cows is that no one wants to touch them and there is the hope that just throwing money at the problems will make them magically disappear. From my experience however there are many small fixes that could be implemented that could start to help resolve some of the issues, and the very least save some much needed cash.
My first experience upon returning home was the lack of digitisation. When I asked my local GP how to get 6 years worth of blood results to them from my Swiss records I was told to print it out and bring it in! I looked at the receptionist aghast and asked if she was joking – she in turn looked at me perplexed, clearly unaware of what a ridiculous thing she had just asked. My response was categorical – if they wanted my blood results they could have them either via email, USB stick or from a location in the cloud. After much consultation I was given an email address to send my data to.
My next experience came a few days later when we had to call am ambulance for my mother in the middle of the night as she could no longer breath. We were told there were no ambulances available but that an emergency medic would call. This took over two hours – by which time my mother might have already died. Fortunately she actually got better and so we followed the medics advice and took her to our local GP first thing … only to be told there were no appointments available and that we would have to take her to A&E ourselves! By this time my mother was feeling perfectly normal again but spent the day on a ward waiting to see a cardiologist (her ECG was slightly off). By end of day still no sign of the cardiologist and not wanted to bed block when she felt fine we asked if we could take her home for the night and come back the next day to see the cardiologist. We were told however that this would mean she would be treated as an outpatient and would have to wait weeks to see a cardiologist. Eventually she spent two nights in hospital, entertaining the ward, feeling totally healthy, and ended up discharging herself on the 3rd day as they still had no idea what was wrong with her.
And here comes my third moment of “WTF” – during her entire stay and during her discharge everything was done on paper! Not a tablet in sight! The nurses station was totally submerged in a mound of paper and even a simple questionnaire was done on paper. Now the NHS has apparently spent millions on upgrading their IT systems … where exactly did that money vanish to?!
So as I look at this sacred cow I realise that it is clearly very sick and needs help. Firstly we should not be having to bed block simply so that someone can see a doctor – the cost of that alone is an astronomical waste of money that could probably fund additional doctors to deal with the increased number of outpatients. Secondly in this day an age there is no excuse for using paper anymore (and let’s not get started on the fact that the NHS still uses fax machines!) – which also costs more. There is more than enough research showing the financial and safety benefits of going digital. There are also now plenty of off-the-shelf products out there that could be used for at least the basics (like that questionnaire). The cost savings of going digital would probably fund the tablets needed (or more doctors and ambulances).
The other thing that annoys me about the use of paper is the amount of waste it generates – both in terms of time (think of that poor sod who has to type up all that paper) but also in terms of environmental impact. Which brings me on to my final “GRRRR” moment with my NHS experience – the excessive waste and use of disposable plastic. Again this would be a quick fix and would surely save the NHS yet more precious pennies. The wards seem to cope fine with re-usable plastic jugs and cups – why not implement this throughout the hospital. And why on earth have we moved to using disposable plastic aprons for the staff serving food? We seemed to cope fine in the recent past with traditional aprons that got cleaned after each use – which have the added benefit that they absorb spills rather than letting the spill drip down off the plastic apron onto the floor.
Despite all these issues, just like that elderly relative, I still love my NHS. Whilst I am in shock at how antiquated it now is and the amount of wastage, the thing that still makes the NHS a world leader is the level of care its staff deliver – regardless of who you are. The dedication and care of its doctors, nurses and support staff is world class and at the end of the day this is one of the most critical parts to healthcare. If only though we could help those amazing people do their job better by supporting them with the use of technology and chipping away at the waste. Our sacred cow deserves more and we should not be afraid to overhaul her to place what she does best at the centre, namely the care of patients – because at that the NHS truly excels, despite all its flaws.