The media, and social media, is full of views and comments about the NHS. This is my first attempt to add to them from the distinctive position I have in working for the NHS and with patients for 36 years, in almost all aspects of the service.
The thing that characterises the views and comments for me is the lack of balance. For example, this time last year, in the wake of the Olympic Opening Ceremony, there was an outpouring of praise for the NHS. It was almost as if support for it had become close to being a religion. Read the newspapers over the last few weeks and it appears the NHS has become one of the worst health care systems in the world. In truth, neither of these two things are true, and this is the dilemma.
Over the last few years hospital mortality has fallen significantly. At the same time the NHS has continued to fall short in the care of some of our patients, indeed for a small minority it actually causes them harm. Both of these statements are true, and if you chose to ignore either than we are in trouble.
This is compounded by the nature of the statements and the hooks they use to draw people in. Hospital Mortality is a system wide issue, only commented on by individuals with system wide responsibilities, people like me. Harm to patients on the other hand, is an individual issue, the pain and suffering of individuals and their loved ones, something we can all relate to.
We need to find a better way of having a conversation about what is happening in the NHS that recognises both.
At the heart of this debate must be openness and transparency and how it can improve services for individual patients, as well as the overall performance of the NHS. Although some pioneers can predate their commitment to it, in practice, the NHS began its difficult transition to openness and transparency during the development of ‘High Quality Care for All’ in 2008.
The explosion of data available through NHS Choices, the definition of quality, the focus on outcomes, evidence based standards, ‘giving patients more clout’, together with Freedom of Information legislation, started to transform the environment we all worked in. Add to that the increasing availability of data, and the use of social media, there is an enormous opportunity, but also an enormous challenge to public sector leaders. The question is are we up to it?