Health Minister Simon Burns explains how better care and listening to patients can result in the NHS having to spend less money
Later today, I will be speaking at the NHS Institute’s Patient Feedback Challenge event.
The Challenge is setting up a series of demonstration sites across the NHS to see how the NHS can get better at listening to patients – particularly to what they say about their experience of care, as well as their clinical care.
Did the doctors and nurses they saw listen to them and explain the treatment they needed clearly to them? Did they get the right information and support to help them when they return home? Did they get the help they needed with eating and drinking, or going to the toilet? In other words, were they treated like a decent human being – with dignity and respect?
It’s been too easy in the past to see such things as extras – clinical care comes first, and if people are decent to you then that’s a bonus.
But the two are certainly not unconnected. In the rare event of something going wrong with NHS care, the two often go hand in hand, with one greatly exacerbating the latter.
People have voiced concerns that the NHS’s efficiency drive will in some areas reduce the quality of care. I understand those concerns.
The NHS’s funding is, of course, protected. But because demand is increasing, it is in the middle of a major mission to find up to £20 billion of efficiency savings that it will then put back into frontline care. Back into frontline care, note – not back into Treasury coffers.
It is doing this not by cutting good services, but by discovering better models of caring for people. For example, making sure the 15 million people with long term conditions – on whom nearly three quarters of the NHS’s budget is spent – spend less time in A&E, and get more of the support they need to stay in good health.
People are understandably sceptical. The idea that you can improve quality while making savings sounds unlikely, particularly, I suspect, if it comes from the mouth of the politician.
But if you are a sceptic, consider this example.
One of the issues highlighted in the NHS Atlas of Variation is how the quality of care can differ so markedly from one area to another. And where standards are poor, costs are often much higher.
Two children with asthma who live in different towns, perhaps just a few miles from each other, could have radically different experiences.
For one child their condition is not properly controlled, their life is dominated by the illness and their time is spent coping with emergencies. Waking up in the middle of the night, struggling to breathe. Frequent trips to A&E. Missed school days. A complicated calendar of appointments with different doctors or at different clinics that is practically impossible to follow.
For the other, life is a lot simpler. Their condition is under control – they have the right medication, they know how to take it and they know what they need to do if they are feeling unwell. They don’t miss weeks of school every year. They have lots of friends. One night a week, they might play football for their local under-11s team, or take part in a local theatre group.
If you are a parent, and it was your child, which would you prefer?
Perhaps surprisingly, the scenario where your child gets better care and is happier and has a better quality of life, the NHS usually spends a lot less.
Improving asthma care is one of the issues being explored by South East Essex Community Healthcare. They are piloting a home nursing service for children whose asthma is difficult to manage. Among the children they worked with, they have reduced the number of A&E visits by half and hospital admissions by nearly a third. Their example of how they are improving quality and saving money is one of many happening all over the country.
And, to come back to the point of today’s Patient Feedback Challenge Event, satisfaction levels among South East Essex’s young patients are incredibly high. And even more importantly, they feel confident and safe about managing their own condition. That, of course, is priceless.