The doom-mongers would have us believe the NHS is a failing institution. That it's in the abyss of financial ruin, unravelling at the seams and unable to cope with the demands of patients.
Yes, our health service is facing difficult times but we need to ditch the hyperbole, focus on the facts and look to solutions. The challenges should be used as energy for change, rather than excuses for where we currently are.
Finding solutions will be top of the 'to-do' list for Simon Stevens, the new NHS chief who in his first speech in the job said the guiding principle of the NHS will be to 'walk in the shoes of the people we serve.'
To stand by this principle, he must ensure all those bodies in charge of running and shaping our health service are on the same page. Unless these 'constellations' including NHS England, Monitor and the Care Quality Commission share a common orientation, we're in trouble.
As well as the ongoing challenge to make £30bn efficiency savings by 2015, much has also been made about the overwhelming demand placed on services as a result of our ageing population. We talk about this as though it's a recent discovery when in fact we've known for at least two decades that people are living longer and therefore will require services to support their needs. Presenting this as 'new' is like revealing that winter exists.
And the truth is that much of the demand people perceive as catastrophic does not actually stem from additional pressure on the NHS created by patient need. No, it's actually a result of something known as 'failure demand,' a phrase first coined by the occupational psychologist Professor John Seddon to describe how service organisations fail to do something or do something right for the customer. In the NHS, this failure can occur when a patient visits their GP, the GP doesn't treat them properly so they resort to visiting A and E, a situation which wouldn't have happened if the problem had been treated efficiently first time round.
What Simon Stevens needs to do is to tackle this inefficiency within the NHS, this inability to deal with patients effectively. There's much to be gained in how we look at the causes of inefficiency in our health service rather than making the assumption that population trends are to blame.
Some NHS hospitals serve highly challenging populations yet they still manage to be hugely efficient. The reason for their success is they can identify processes that add value, not those which add demand. Instead of regarding the patient as a problem we should be valuing them as a partner in what needs to be created. NHS England must see itself through the eyes of the 'consumer'- and Simon Stevens must champion that as he's promised to do.
Then there is the challenge of redesigning our approach to mental health. Mental ill health is seen by some in the NHS as a single disease to be treated in a single way which isn't helpful if you're suffering from severe bipolar, a personality disorder that needs highly specialist care or have mental health issues linked to another long term condition or substance misuse. There are also very separate approaches to child and young people's mental health and adult support, which is again an unhelpful distinction when we know that the majority of severe and enduring mental health issues start early.
In the US, patients are offered mental health support alongside treatment for their physical health problems as part of their recovery plan. There's a recognition that looking after the mind is just as important as caring for the body, that it has to be integral to patient care and has to inform everything we do. But we're not quite there yet in the UK- we're locked into an 'either/or' mindset. What needs to happen for example is a life course approach to service design and family focused interventions so that when a parent visits the doctor, the GP takes into account not only their health and wellbeing but also their child's mental and physical health.
It's not just me who believes this. The message which comes through loud and clear whenever I meet with patients is that mental health is one of the key issues which they are concerned about. The government has made parity of esteem between physical and mental health a legal obligation in the NHS, it is one of the biggest challenges facing Simon Stevens, but as Nick Clegg has admitted, getting true equality between the two will take time.
Simon Stevens is right when he says the NHS needs to think like a patient, act like a taxpayer. That means it has to be prepared not only to change its culture but also ensure that everyone involved is thinking the same way.Suggest a correction