The demonstration #ournhs a few weeks back caught the attention of many; but poor media coverage limits the time memories stay or even who is reached. Complacency and lack of awareness are dangerous and should be feared – in a similar vein to the warning in Dickens ‘A Christmas Carol’
This boy is Ignorance. This girl is Want. Beware them both,
and all of their degree, but most of all beware this boy,
for on his brow I see that written which is Doom, unless the
writing be erased.
But the complacency and lack of awareness welcomed by some; in particular the current government; as this allows them to conduct their activities largely undetected. In particular I am referring to the silent attempt to dismantle the NHS.
Lack of awareness is the a key to the current conservative government pushing ahead with the Sustainability & Transformation Plans (STP’s). This has already broken the NHS in to 44 independent units. The STP’s are been purported as improving access to health care for many and lots of glossy broachers have been prepared, but when you look beyond the smiles and the infographics and start to digest the ideas they are suggesting the foretold doom appears more immanent.
The STP for Mid and South Essex area can be accessed: Mid and South Essex – NHS England but a simple google search will reveal those for other areas. Everyone should read the STP and be aware of the plans.
One of the key elements that has drawn attention some attention is the plan to downgrade the A&E departments at 2 hospitals in the area resulting in blue light ambulances for an area of 1.2million residents only being accepted at 1 hospital (Basildon) resulting in longer journeys for many patients on already over congested road in one of the most densely populated areas of the UK. This alone raises many concerns that have been put to the success regime, local council and MP’s extract of concerns letter
Previous research (Nicholl et al., 2007) has shown a 1% decrease in patient survival outcomes from every 10km travelled to hospital; increasing to 2% for respiratory cases. This is a risk factor that local government, council leaders and the NHS success regime have currently chosen to ignore – this is just one of the reasons the fight must go on. In fact they claim the opposite and that the distance will not effect patient outcomes; a request has been made to the success regime for data to substantiate these claims; however to date this has not been forthcoming.
Complacency amongst many is being created by poor media attention and unsubstantiated reports of ‘everything being ok’ or ‘it wont be happening’ and other such claims. While some are easily appeased there are others who are not so easily hoodwinked into believing, what they want us to.
Recently a member of the public, a EU national who has lived and worked in the UK for many years; having worked for one of the hospitals effected and only learnt of the plans on a leaflet and petition day in the local high street; was stunned at the plans and could not see how they would worked and also remarked
it is dreadful what is being allowed to happen to the NHS, as other countries such as where he comes from have to pay to access health services and that what the UK once had was the envy of many other countries.
While the A&E downgrades have been the subject of campaigning there are other elements of the STP that concern me and must be addressed by those that are key participants in the consultation process.
Technology and innovation – the suggesting being that ‘advice and treatment’ is obtained remotely via laptops, tablets and smartphones – aside from the risks of a proper diagnosis not being obtained or the consequences of unsuitable medication being subscribed – the wider concern is accessibility. With an increasing elderly population many may not have access to such technology or even where there is access not all may have the competency to use to device to access such facilities.
Prevention and telephone advice – one of the key elements of the plan would appear to be to deter patients from attending appointments by encouraging telephone advice – again there are serious concerns over risk of misdiagnosis and the impression of deterring personal attendance could have serious consequences. Also, where will all the suitably trained staff be sourced to field these calls as such a service could not be run as a regular call centre – it has to hopped these calls will not be diverted to a foreign call centre with staff reading from a series of set answer screen prompts.
There is also many references to working with GP’s and social care teams; again these are both areas already under pressure and understaffed as shown in a recent article Record number of GP closures so how are theses services going to be able to cope with the extra demand.
The whole STP situation appears be a cost cutting exercise that is not living up to its claims on focusing on patient outcomes, those in positions of authority in the consultation process need to be challenged and pressured and ultimately held to account for decisions they make.
While there is still something to fight for there, there a number of people doing a large amount of good work to #savesouthend the fight will go on.
Nicholl et al., 2007 The relationship between distance to hospital and patient mortality in emergencies: an observational study.