Back in the 1990s politicians dreamt up a way of funding new hospitals, prisons, and schools and keeping the borrowing away from national debt. It was John Major’s government that began the private finance initiative (PFI) scheme, which was much loved by Gordon Brown who expanded on it, and which we still see being used now. […]
“The rationing process in the NHS is messy,” said the King’s Fund. On this I think we can agree. Just look at what is happening with IVF services to understand the messiness with commissioning and the rationing of health services. Croydon’s clinical commissioning group (CCG) has decided to save over £800 000 a year by […]
As an intensive care consultant, the risk of “burnout” is ever present. Everyday, I will deliver devastating news to families when they least expect it. I will often make life changing decisions with limited information in a time critical manner. I will have passionate debates with other medical specialties over what is best for patients. […]
“Art washes from the soul the dust of everyday life.” ~ Pablo Picasso Working within the NHS it is easy to find oneself questioning whether our clinical work spaces reflect their vital therapeutic role. Too often our working environments are cold, harsh, and uninspiring. Nowhere more so was this the case than the junior doctor […]
Last week we heard the devastating news that another junior doctor has taken their own life. Another remains missing. Cases like this are not new in medicine and are reported the world over. We cannot speculate about the causes, and the exact circumstances are, and should be, private. However, these cases have been widely discussed […]
Medicine used to be fun. I could spend time chatting to patients and listening to their ideas, concerns, and expectations. Hopefully, despite their predicament I could bring them hope that we, the “medical profession,” could make a real difference. Has the digital age shattered this ethos? William Olser taught us that the key to a diagnosis […]
It is no secret that the UK healthcare system is under strain. The percentage of GDP spent on healthcare is projected to fall to 6.6% by 2020/21, back to the same levels as the 1990s. For comparison, the OECD average (excluding the US) is 9.1%. Reminiscent of the 1990s, waiting times are rising and the system […]
As the good book notes “Without a vision the people perish.” While not on a biblical scale, the Five Year Forward View published in 2014 set out what was a broad road for the NHS in England. Last week saw the latest report on its progress. The Five Year Forward View pithily summarised a common view […]
Everybody wants world peace; everybody wants an end to poverty. And we all want the NHS to have a safe, efficient and cost-effective emergency service. The trouble is that nobody agrees how to bring it about. In January, A&E’s in England hitting the four-hour performance target was just 85.1%—the lowest figure since monthly reporting began […]
This week we expect NHS England to publish a “delivery plan” setting out priorities for the sector over the next two years. No one is quite clear on the detail of this plan yet, but Simon Stevens has indicated that we should expect further detail on the future role of sustainability and transformation plans (STPs). […]