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My 8 reforms for the Health Service
Laurence Wood, February 2013

The National Health Service (NHS) was created out of the ideal that good healthcare should be available to all, regardless of wealth.
Our NHS now directly employs 1.7 million workers and it is rumoured that the only bigger employer is the Chinese Army!

I have been a volunteer in the NHS for nearly twelve years and I have every admiration for the staff and services delivered. Based on my observations and experiences I have developed my own plan for how the NHS can be improved and I share these ideas with you below. It would be interesting to have your opinion about them.

1. It seems to me that one of the key issues for such a large employer is leadership. There are many excellent leaders in the NHS but very often their talents are suppressed. My first recommendation would be to identify and encourage proven leaders who can motivate and make things happen at all levels. Pick those who are also prepared to pick up loose balls.

2. Encourage innovation and don’t force top down ill considered plans that change frequently. We all talk about hospital matrons and I regularly witness excellent and dedicated leaders in this group who manage a variety of units within our hospitals. There is a huge depth of talent here.

3. Provide the tools and allow leaders to encourage and prove 100% performance, attendance and professional standards from their teams. There will be then no need for separate “quality” initiatives and monitoring programs if everyone does their job properly.

4. Manage waste at a local level by providing the means for local departmental initiatives. The quickest way to save money is to stop losing it.

5. Get into the real world with regard to pay and conditions. At this time when we are all feeling the chill of austerity it is not unreasonable to review the vast benefits enjoyed in the NHS.

6. Our GP’s should retain responsibility for their patients as they pass through the many complex systems within the NHS, particularly when patients are transferred from primary care (their doctor) to secondary care (hospitals) or specialist services. Too often patients disappear into a black hole and nobody is monitoring their medical health or safety. No doubt this will be resisted but I am certain the monitoring of their patients health should be undertaken on a continuous basis by our GP’s.

7. Our Accident and Emergency (A&E) departments are always extremely busy. I think this is because we see them as convenient, a “one stop shop” and will see the experts. It seems therefore that this model is popular and we should try to copy it in primary care. How convenient it would be if we could get all the same tests and expertise provided by A&E at our own doctors surgery.

8. Finally, perhaps most controversial, at this time of extreme financial stress in the NHS what about each direct employee sacrificing one days pay or doing a voluntary extra project, demonstrating their commitment to the service. Based on 1.7 million employees this would produce many millions of pounds of savings the NHS. This gesture could also be suggested to the many subcontractors and suppliers working for our health service.