I am going to avoid the controversial issues such as Healthier Together and Greater Manchester devolution – for today, and instead link to one of the most ironic newspaper stories linked to the recent kerfuffle over a 7 day NHS.
One of the nation’s favourite cabinet ministers was recently inconvenienced and you would think by the reaction of his wife and the Daily Telegraph that this was a result of the lack of willingness of staff to work at weekends.
I see that the paper has now issued an apology – small and hidden away – but an apology none the less. It transpires that Mr Gove does not understand the difference between ‘Minor Injuries Unit’ and a full ‘Accident and Emergency Department’. Does this make our ex Secretary of State for Education stupid or is he a victim of a complicated system many do not understand?
Each year the NHS has to spend millions of pounds on communication but deciding which service is the right service for you at any given moment can be a challenge: last year whilst away from home I smugly hunted out a Walk-in-Centre for a minor ear problem for my daughter, only to end up in A&E twenty minutes later when told that was more suitable.
We bemoan people turning up at A&E when they need to see a GP, and then we put GP services into A&E. We give confused signals. A friend and I had to stop a young man ringing an ambulance for his dislocated finger recently: in his mind ‘I need A&E + I don’t have a car = I need an ambulance’, it seems to me making decisions about accessing the right services (and in the right way) is growing harder, which inevitably leads to people leaning on the bits they understand, GPs, Ambulances and A&E.
So what does this all tell us?
For me there has to be a message to those re-designing services to ensure the public are involved. We can design the clearest ‘pathways’ and put services in the most accessible places and create lots of specialities, but if people do not understand how and where to access the services, or their behaviour does not bend to how we want to deliver the service then we will fail. Designing health services in this country is not a straightforward scientific formula, it has to take account of our previous experiences, of our behaviour patterns and our future needs. It needs to take account of clinical evidence, patient safety and finances, but it must not be about what is politically expedient.