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The NHS is broken. The NHS workforce know this. When will politicians accept it? Covid placed a significant stress on the NHS. But Covid didn’t break the NHS. It was the final straw that broke an already creaking NHS. Before Covid the NHS operated greater than full capacity with no resilience in the system. This was evident every winter. To continue treating Covid we create hospital capacity by cancelling elective work, increasing waiting times, and creating a “pandemic” of future elective care. This can’t be addressed unless the NHS changes its working practices. Emergency Medicine consultants face this problem daily. Departments are over capacity, patients face long waits at triage, for medical assessment and hospital beds. The Royal College of Emergency Medicine has shown these delays adversely affect patient outcome 1.
The NHS is chronically underfunded. No matter how much money you invest in a failing business, if the business model doesn’t change, the business fails. Throughout my 30 years working in the NHS I remain amazed that a hospital effectively “closes” at 5pm, leaving only “emergency” work. We operate a 1970’s model of health care provision in the 21st century. We need to become a minimum 08.00 – 20.00 service, six/seven days a week, with primary care synchronising working patterns with secondary care. Out-patient clinics, diagnostics services, elective operating lists, need to run in the evening and weekends. Throwing more money at the NHS will not provide this – money will inevitably go towards paying existing staff to reduce waiting lists at enhanced rates of pay, not changing the system.
We cannot change working practice with the current staffing levels. We need an increase in medical, nursing, and paramedical students at universities, investment in recruitment, good working conditions to retain existing staff and attract new staff. There is a job market and the NHS must compete. Politicians must acknowledge that change is needed, and accept this will take years to complete. The NHS should be apolitical, run by people with organisational and business skills, increasing efficiency, accountable to a cross party committee and not changing governments. If not, a two tier health service could emerge in this country, those with private health insurance paying for services in an expanding private sector, and those who can’t, waiting years in the lengthening NHS queue.
References
1. Jones S, Moulton C, et al. Association between delays to patient admission from the emergency department and all cause 30 day mortality. Emergency Medicine Journal 2022;33:168-173.
The NHS Is Broken – We need to change how our healthcare system works and join the 21st century
Dear Editor
The NHS is broken. The NHS workforce know this. When will politicians accept it? Covid placed a significant stress on the NHS. But Covid didn’t break the NHS. It was the final straw that broke an already creaking NHS. Before Covid the NHS operated greater than full capacity with no resilience in the system. This was evident every winter. To continue treating Covid we create hospital capacity by cancelling elective work, increasing waiting times, and creating a “pandemic” of future elective care. This can’t be addressed unless the NHS changes its working practices. Emergency Medicine consultants face this problem daily. Departments are over capacity, patients face long waits at triage, for medical assessment and hospital beds. The Royal College of Emergency Medicine has shown these delays adversely affect patient outcome 1.
The NHS is chronically underfunded. No matter how much money you invest in a failing business, if the business model doesn’t change, the business fails. Throughout my 30 years working in the NHS I remain amazed that a hospital effectively “closes” at 5pm, leaving only “emergency” work. We operate a 1970’s model of health care provision in the 21st century. We need to become a minimum 08.00 – 20.00 service, six/seven days a week, with primary care synchronising working patterns with secondary care. Out-patient clinics, diagnostics services, elective operating lists, need to run in the evening and weekends. Throwing more money at the NHS will not provide this – money will inevitably go towards paying existing staff to reduce waiting lists at enhanced rates of pay, not changing the system.
We cannot change working practice with the current staffing levels. We need an increase in medical, nursing, and paramedical students at universities, investment in recruitment, good working conditions to retain existing staff and attract new staff. There is a job market and the NHS must compete. Politicians must acknowledge that change is needed, and accept this will take years to complete. The NHS should be apolitical, run by people with organisational and business skills, increasing efficiency, accountable to a cross party committee and not changing governments. If not, a two tier health service could emerge in this country, those with private health insurance paying for services in an expanding private sector, and those who can’t, waiting years in the lengthening NHS queue.
References
1. Jones S, Moulton C, et al. Association between delays to patient admission from the emergency department and all cause 30 day mortality. Emergency Medicine Journal 2022;33:168-173.
Competing interests: No competing interests