A time for change?

So, as the results of the NHS Listening Exercise have come to pass and the Government seeks to make what certainly appear to be major concessions on some of their flagship reforms – I find myself reflecting on what these changes actually mean.

As someone who worked in the NHS for many years, I am pleased to see that GPs will not stand alone in commissioning services, but will be supported by other healthcare professionals including hospital doctors and nurses, as well as involving patients. GPs need the space and time to be good doctors and this means they cannot and should not be the sole source of commissioning expertise across the whole system. I am also pleased to see that cancer networks will continue to have an active role as experts guiding local cancer care. Choice can be an important aspect of this, particularly in prostate cancer diagnosis and treatment. A genuine compact between a man and his GP or clinician is essential if he is to choose and receive the right care for him. However, we need a system that provides an equal choice to all, in all parts of the country. The idea of introducing choice into the NHS is certainly not new. It was a key driver in the battle to reduce waiting times ten years ago. That experience showed that choice only works when patients have access to high quality information to support them making decisions through every step of their journey through the system.

Research is one area where swift developments need to be made to ensure new treatments reach those they can help. I am pleased to see it will be a core aspect of the NHS, but hope it does not get bogged down in a focus on short term solutions to short term problems.. I was on BBC Radio Four’s Woman’s Hour on Monday talking about a prospective new urine test for prostate cancer – there is a real opportunity to explore its potential for men. Innovations that may improve a man’s experience and treatment of prostate cancer could be missed if the NHS obsesses on how to assemble its component parts for too long.

Whatever the system that is adopted, a key to success is going to be leadership and that will need to come from across all of the NHS. I have been lucky enough to work with some of the highest quality leaders who were primarily doctors, nurses and other healthcare professionals. These are the individuals who have inspired their clinical colleagues to change the way that they work in order to improve services to patients. I also know that NHS managers will be critical to making the reforms working – they are an easy target for politicians and media but without them change in the NHS will not happen. I was as proud of my work as a manager in the NHS as I was pumping people’s chests as an A&E nurse, and on the good days I knew that in my role as a manger I had made as significant a difference to the lives of patients even if they were not directly in front of me.

Although political scrutiny and debate is necessary to keep the wheels of this change moving in the right direction, we can only hope that politicians channel it effectively to keep this on track. The last few months have made the NHS an even hotter political potato and I am sure there will be a temptation to keep the debate going as it is a pretty effective weapon with which to score political points. However, if the NHS is paralysed for much longer by the debate about reforms there is a very real chance that it will will not save the additional lives it committed to less than six months ago.

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