Intended for healthcare professionals

Feature NHS at 70

Back to the future: aspects of the NHS that should never change—an essay by Iona Heath

BMJ 2018; 362 doi: (Published 25 July 2018) Cite this as: BMJ 2018;362:k3187

Effective and efficient use of NHS services

Dear editor,

I congratulate the NHS for its outstanding success and agree that the values on which the NHS is based should not change. I had the opportunity to work in the health systems in other parts of the world. Joining the NHS two years ago gave me mixed feelings. I appreciated the quality of services that the NHS is providing to the general population, which is at par or even better than the care patients receive even after paying huge sums of money in other parts of the world. At the same time, some patients fail to appreciate the worth of this invaluable healthcare available free of cost in the NHS. On many occasions patients don’t turn up for their clinic appointments or operations without informing the hospital beforehand. These wasted slots cost the hospitals a considerable amount of money and also take away the opportunity for other patients on the waiting list to have timely treatment.

A few measures should be taken to make patients aware of their responsibility so as we can use these scarce resources more efficiently. For example, if a negligible fee is applied for booking an appointment and the same is refunded when the patient attends the clinic, it will probably make people more inclined to attend the appointment.

Many of the patients requiring urgent tertiary care treatment (for example, cardiac or neurosurgery) are brought by ambulance to district general hospital emergency departments, requiring further transfer to tertiary care hospitals. If these patients are taken directly to the places where they can have the required treatment, not only would the patients receive timely treatment but a the wastage of time and resources would be reduced in district general hospitals with limited manpower. More education for the ambulance crew to choose the appropriate hospital for patients may help to ameliorate this problem.

Some unnecessary investigations can be avoided by stressing the need for appropriate application of clinical knowledge during the induction of junior doctors.

The NHS is a world class health care system. I truly wish and hope that it would maintain the high standards in the future by efficient and effective use of limited resources.

Competing interests: No competing interests

31 July 2018
Dr Nisha Saini
Speciality Doctor anaesthetics
Dr Ashish Rajkumar, Consultant Anaesthetics, South Tyneside district Hospital
South Tyneside District Hospital
Dept of Anaesthesia and Critical Care , South Tyneside District Hospital