The NHS at 70 years old
I have worked in and for the NHS for the best part of 14 years now. Some of it has been on the front line being there for patients and relatives during the Out Of Hours period of evenings, nights and weekends. Some of it has also been working behind the scenes and not me personally delivering direct patient care and support but driving change that enables the service as a whole to keep patients and direct care as its focus. It is about this side that I would like to write about here.
Out of Hours GP service
When I worked for the Out of Hours GP service in Wolverhampton, part of my role was to produce performance figures against national quality standards. These weren’t just figures produced for a group of people to talk over in a meeting over tea and biscuits. They were produced with the aim of improving the level of care to patients in the area, and to work out ways of implementing service change so that our organisation could deliver care more efficiently, with greater productivity – i.e. having the right amount of clinicians on at the expected peaks and falls of the service. This meant working with GPs, nurses, call handlers and also justifying changes to commissioners that any savings to the delivery of the service were being put back into front line care. It also meant talking and spending time with patients and finding out about their real life experience in normal words, rather than health service lingo. It was through listening that we keep the focus on the patient and their relatives.
Working for NHS Digital in Leeds, part of my role when I worked for the General Practice Extraction Service team was ensuring that GP practice system suppliers were working to the correct criteria in providing extracted data to the NHS. This was in order to provide the correct information for GPs to be paid appropriately for the services they provided for their patients on behalf of the NHS. Other examples of data extractions was relating to data collections to help provide commissioners such as NHS England with the numbers required to help tackle different medical conditions and get accurate information as to how prevalent different conditions, medications and treatments are across different parts of the country. Extracting data from 7500 GP surgeries that use four different GP system suppliers in their practices is not an easy task. Patient consent, GP consent and contractual talks with GP system suppliers are all crucial and are very important factors involved with getting hold of data legally and ethically to help provide informed decisions on how money is spent in the health service.
Working for a large national organisation like NHS Digital enables a big opportunity to work in many different areas of work. I am currently working on a service where we are liaising with data providers such as hospital trusts to see if the burden can be reduced for them. Burden can be anything such as time or money or duplication of requested data. We then investigate the concerns of data providers and look to improve the impact on their organisation by possibly reducing the amount of data requested if it is duplicated, or getting a collection owner to access the data from a different published dataset if it is available, or get the provider organisations to work to best practice to minimise the impact on them. By looking at how the system of data collections works, we are able to identify exemplar sites where they get the best outputs from their informatics team and are willing to share their success stories with other trusts who may be struggling or are in need of pointers. We are also able to reduce burden by removing the need for duplicated collections freeing up the providers to use their staff and resources elsewhere or on other projects.
Saving money as well as spending money
Throughout all my roles in these organisations, I know that just throwing money at the NHS doesn’t solve everything. There is a lot of work done behind the scenes to reduce burden, waste, and extraneous costs. There is a lot of work that IS being done to provide a service that has better value for money, is more efficient, and puts the patient first by improving services and keeping this at the forefront of what we want to achieve. The NHS is a wonderful organisation. It doesn’t get things right every time, but it does its very best to ensure that patients and their relatives are treated in the best way possible with the information they have. There is a lot of work still to be done to bring together so many different local systems and working practices, but behind the scenes there are people who are just as passionate about delivery change and improvements knowing that patients will the benefactors of this work upon implementation.
Happy 70th birthday to the NHS. Here’s to lot’s more innovative improvements in healthcare for this country.