Hospitals are often seen as an impediment to integrated care. The concern frequently voiced is that their dominant role in the health system makes it harder for commissioners to shift resources into the community, and to develop more coordinated services that cross organisational boundaries. It is certainly true that an over-reliance on hospital based care—and […]
Category: NHS
Tony Kelly: Is being confident to speak up enough?
Last month we saw two key messages come through regarding patient safety. The first was the publication of Sir Robert Francis’s “Freedom to Speak Up report.” The second was a report by the Parliamentary and Health Service Ombudsman (PHSO), which found significant variation in the quality of NHS investigations into complaints of avoidable death and avoidable […]
Samir Dawlatly: Do I obsess too much about the NHS?
When I was a teenager, I was obsessed with playing guitar. I taught myself to play on my sister’s guitar, taking it off her when she came back from lessons. For my GCSE music performance I sang and played an Eric Clapton song. While I was at medical school, I became obsessed with climbing after […]
David Wrigley: Manchester—the birth and death of the NHS
On 5 July 1948, in Manchester, Labour Secretary of State for Health, Aneurin Bevan announced the birth of the NHS. On 27 February 2015, in Manchester, Conservative Chancellor of the Exchequer, George Osborne signed a piece of paper that would bring about the end of a National Health Service. There is no longer an NHS in […]
Playing the percentage game: the arts of playing football and practising medicine
I’m proud to be working among a group of GPs in east London who, against all the odds, are delivering a remarkable level of clinical performance. Ninety two per cent of our patients with cardiovascular disease have their blood pressure controlled, despite our practice serving one of the most socio-economically and ethnically diverse communities in […]
Samir Dawlatly: Sabre-toothed tigers and the lottery
The other day an older gentleman* was brought to the GP surgery where I used to work. He was feeling nauseous, and his concerned family had initially taken him to the local pharmacy to see if there was anything they could buy over the counter to ease his symptoms. As he was on a number of […]
Saffron Cordery: Enhanced tariff offer—what’s left for mental health?
The big national health “system” story of the past week has been the surprise announcement of a voluntary tariff. This is one part of a solution put forward by NHS England and Monitor to resolve the current impasse, which arose from an objection mechanism to the proposals being triggered by those it affects—providers of NHS […]
Samir Dawlatly: Burnt out or boiled alive
The cleaner popped his head round the door, “You nearly finished, doc? Or are you happy to lock up?” The GP glanced at the bottom right corner of the glowing monitor that he had been looking at for the last two hours since the last patient left. “No, I’m fine thanks,” he answered, “I’m happy […]
David Zigmond: The extinction of care by treatment—our healthcare’s heart failure
At the end of last year, the media had a brief frisson over another dark story from our NHS: seven recent suicides and one homicide involving people who were acutely mentally ill. The transient newsworthiness came from the probability that the deaths were preventable: psychiatric beds were sought for these patients, but none were available. […]
Samir Dawlatly: Can we have our (political) football back please?
With the budget of the NHS being over £100 billion, coming from taxpayers’ money, it is inevitable that health is overtly political. How such a large chunk of the nation’s budget is spent is the interest of those in government, as well as those who are governed. One of the consequences of this is that […]