Wednesday, 14 August 2013

NHS consultation - sustaining the secret society that is the NHS


NHS England is:

...seeking your views to help shape the future of general practice services in England.

On the face of it, this is brilliant. And they say that they wish to: stimulate debate in local communities...

Again fantastic.

Except they don't mean a word of it. This is who they mean by community:

...GP practices, area teams, CCGs, health and wellbeing boards and other community partners...

The patient? The taxpaying public? Nope, not included. Local doesn't mean you and me, oh no. it means:

A number of area teams and CCGs are already working collaboratively to develop shared strategies for primary and integrated care, and the questions in this ‘call to action’ are designed both to support these existing examples of local action and to stimulate similar approaches in all other parts of the country.

I'm sure it's wonderful stuff all this collaboration and so forth. But where in all this improving of General Practice is there any attempt to talk to the poor folk who actually use the service?

Maybe it's in the 'online' survey - perhaps that will provide ordinary patients with a chance to say what they want from their GP and local medical centre? You can have a go if you want! But it's not for the faint-hearted. I'm on a Health & Well-being Board, I'm informed, experienced and trained and this is just wibble - and bear in mind this is supposed to be something that "citizens" can "engage with":

How can we best mobilise existing improvement resource (e.g. NHS IQ) and facilitate access to other potential external support for primary care transformation?

How might we develop QOF so that that we preserve its essential features but create more flexibility for practices and reduce the feel of a tick-box culture?

How do we create synergy with the new system of CQC ratings and inspections to create a clearer sense of what patients can expect from good general practice?

What is the potential future role for PMS and APMS contracts in stimulating innovative approaches or helping address particular local challenges?

And there's loads more where that came from. The truth is that the NHS has no desire or intention to consult real people - the patients, the carers, the public - preferring instead to consult itself in some sort of mutual backscratching exercise. And the end result will be a little money bunged at GPs, a whole raft of meetings, strategies, pilots and boards all doing precisely nothing other than sustain the secret society that is the NHS.


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