Doctors must help explain need for NHS changes, says NHS Confederation

BMJ 2012; 345 doi: (Published 31 December 2012) Cite this as: BMJ 2012;345:e8712
  1. Zosia Kmietowicz
  1. 1BMJ

Doctors should take a lead in explaining to patients why major changes are needed to the health service in England to make it truly modern and sustainable, the head of the body that represents NHS organisations has said.

Those changes included the closure of some hospital units, not necessarily to save money but to improve the quality of care by concentrating specialist services in fewer centres, said Mike Farrar, chief executive of the NHS Confederation, the membership body for organisations that provide or commission NHS services. Another major change was to boost primary, community, and social services to enable more people to be treated at or near their homes, he added.

Patients needed to be given clear examples of where change had improved services, in a language they could understand, not “abstract concepts,” he said.

In his New Year message Farrar said, “At the moment the public are fearful that the changes mean depriving them of really good services. All of us in the health service have got to be more transparent and explain to the public about how the changes can work in their interest and that that means a new deal with them about how the NHS is run, how we fund it, and how we provide the care that they need.”

A larger share of the NHS budget should be spent on primary, community, mental health, and social care services to keep people out of hospital and living independently, said Farrar. Currently 70% of bed days in hospitals were accounted for by elderly people, many of whom could have left hospital sooner, or not have been there at all, if the right services were in place.

He also had a message for MPs to put the health of their constituents above their own electoral health by not opposing the closure or merging of local emergency or other services where the evidence showed that such action would improve the quality of care.

“Politicians have a responsibility to inform their constituents about how changes to services can benefit them, not just lead marches to oppose them,” Farrar said. “Politicians can’t vote to limit the resources of the health service with one hand and then resist change on the other when the service looks to make the most of the money it relies on from taxpayers.

As well as demanding better services in the community, Farrar called on patients to get involved in their health service by asking about local performance and giving feedback. Patients should also take more responsibility for their health and take drugs as prescribed. “The NHS spends £300m [€370m; $480m] annually on unused prescription medication. And we could save over £500m every year if we used our medicines in the best way,” he said.

In response to the message Clare Gerada, chair of the Royal College of General Practitioners, said, “While the NHS Confederation raises the right issues, their comments allow politicians to abdicate their responsibility to determine what should be provided by a publicly funded health service. I feel that politicians should lead on these issues as the ‘public’ representatives, supported and informed by policy makers, professionals, and patients.”


Cite this as: BMJ 2012;345:e8712