05.06.13
NHS reorganisation ‘must involve patients’
“More meaningful” engagement with the public and patients is vital to reform the NHS, a new report from the NHS Confederation, National Voices and the Academy of Medical Royal Colleges (AoMRC) urges.
The report, ‘Changing Care, Improving Quality’, states that the reorganisation of services is essential to provide sustainable care, but that service users must be involved from the beginning. The NHS must emphasise a whole-system approach to ensure change is not perceived as a loss.
The organisations set out five recommendations each for local health service leaders and their national counterparts, including coproducing any change with patients, making the case for value, providing a forum to consider access, providing more slack for change, letting change be driven locally and regionally and establishment of a political consensus on clinically-driven change.
Mike Farrar, chief executive of the NHS Confederation, which has the opening day of its annual conference and exhibition in Liverpool today, said: “More than two-thirds of NHS Confederation members have told us ‘political resistance’ is the biggest barrier they face in relation to successful service reconfiguration. But political courage by itself is not enough to deliver the kind of change that the NHS needs at this point in its life; the service itself must overcome its paralysis in relation to change, and it must bring the right people with it.
“It is not good enough to say that it is ‘difficult’ to communicate the need for change to the public. Local people who use and rely on NHS services, whether they are regular service users or just count on it being there if they need it, deserve to have safe, sustainable health services. ‘Tweaking’ bits of the system in isolation from each other or changing only in response to external pressures will not deliver the long-term change we need for the NHS's survival.
“The onus is on us in the NHS to build the case for change amongst the people we need support from, so that 'reconfiguration' stops being a dirty word and starts to represent the kind of planned, well-evidenced change programme which the NHS deserves.”
Jeremy Taylor, chief executive of National Voices, said: “Patients are not best served by the current pattern of services. For the safest, highest quality care, hospitals need to be organised differently and more services are needed closer to people’s homes. But the changes needed are often highly controversial.
“The NHS has often failed to make a good case; to involve patients and communities in ways that would build trust and to follow through to ensure that the new pattern of services is better than the old. And the public are rightly suspicious of closures and downgrades that seem to be more to do with money than quality of care. It is hardly surprising that local politicians often rush to defend the status quo – even if it is not in the longer term interests of patients.
“The NHS has always evolved to meet changing needs. We need a more honest debate and a better way of making the decisions. This should not be about the NHS getting smarter at public relations, but about working with patients and citizens to jointly shape the decisions.”
Professor Terence Stephenson, chairman of the AoMRC, said: “As clinicians, patients are at the centre of everything we do. Changes in how the NHS delivers care will need to happen to continually deliver high quality patient care in the future. These changes cannot be delivered by one group alone. We believe that bringing together clinicians, patients and managers is vital to ensure that everyone is working together for the same standards of care.
“We want to create a culture of joint working, where it is normal for patients to be involved in every stage of designing their healthcare. Leading positive change together will ensure that we are able to deliver the excellence in care people have a right to expect from the NHS.”
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