What’s changed since May 6th?
The new coalition government's plans for the NHS may not be dramatically different, but the devil's in the detail. Here we highlight some of the differences that the NHS will have to deal with under the new administration.
Serious funding challenges
The Conservatives' promise to protect overall NHS funding "in real terms" was an essential part of their election policy. It effectively neutralised the NHS as an issue during the election. But, as any economist will have noticed, the promise to protect funding was never going to be a promise to leave the NHS alone. Given the increasing demands on the NHS from an ageing population and the rising costs of drugs, merely keeping the overall budget constant in real terms will require some serious cuts in parts of the NHS budget. One of the most surprising pledges by the new Government is to pay for all new cancer drugs - a commitment which is likely to require deep cuts elsewhere.
Bureaucracy will be challenged more than it's ever been
The last Government claimed to see "bureaucracy" as getting in the way of delivering an efficient health service, and the new Government is no different. However the Conservatives characterise Labour's administration as "top-down, bureaucratic mismanagement", and they are promising to cut administrative costs much more deeply than Labour dared to promise. The Conservative manifesto speaks of "a culture where ticking boxes is more important than giving patients the treatment they need".
The coalition's Programme for Government says, "We will cut the cost of NHS administration by a third and transfer resources to support doctors and nurses on the front line". This is a terrifically ambitious pledge and will be painful to achieve.
Targets will be abandoned
Many staff will be happy that targets are being abandoned by the new Government, who plan to focus on results "which really matter" such as survival rates and infection rates, rather than what patients moan about most such as waiting times. These health outcomes should be easier to measure and monitor, and this in turn will reduce paperwork and save some costs.
GP contracts will be renegotiated
Some are forecasting a "long and bloody battle" with GPs as the new Government intends to force GPs to take back responsibility for providing care at weekends and in evenings, which in effect means refusing to honour Labour's 2004 contract with GPs that allowed them to opt out of out-of-hours care. The intention is good - to improve standards of out-of-hours care so that it is not provided by medics who are unfamiliar with the patient, and of course to improve patient satisfaction in the process. But to provide such care GPs will need to co-operate more as part of local groups, losing some autonomy, and making lifestyle compromises in the process, something they may not do happily.
Patient satisfaction will be improved by the carrot not the stick
Reading between the lines of previous years of policy statements, Andrew Lansley seems to be just as committed to patient satisfaction as Andy Burnham has been over the last few years. And in keeping with this, the Con-Lib Programme for Government contains a pledge to "enable patients to rate hospitals and doctors according to the quality of care they received", as well as a commitment to transparency about performance and mistakes.
However the emphasis is likely to be less on meeting patient satisfaction targets, and more on allowing patient satisfaction to speak for itself by allowing competition to reward those who deliver higher satisfaction levels. Promises include "the right to choose your GP, hospital and even the consultant responsible for your care", something that will make patient satisfaction important but without imposing targets.
What it means for us
At PatientPulse we can see continuing opportunities for our service to meet the needs of the new NHS. Our service allows GP practices and PCTs to save administrative time and money by automating their collection of patient satisfaction data and getting rid of time-consuming and fiddly paper surveys. And PatientPulse works out an awful lot cheaper than paying for the administrative time to run a paper survey, whilst offering the easy-to-use reports which keep practices on the right track to grow patient satisfaction, and ultimately to grow patient numbers in the more competitive world where resources will be spread more thinly. Published May 31, 2010 by Helen under Homepage, NHS news, Opinion, Patient Pulse.
