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What will 2013 have in store for healthcare?

Stephen Thornton
Stephen Thornton
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I am always amazed when I read new year predictions of the so-called ‘experts’ in the City as to where the FTSE will be at the end of the year. They vary so dramatically. It means that most of them will be wrong, some of them wildly wrong. It is the same with estate agents and their predictions of house prices.

Then I look back at the blog of my own predictions for the NHS, made this time last year. While I might have got some things right I was clearly some way off the mark in suggesting that the Francis Report would hit the streets in 2012. So it is with some trepidation that I offer my thoughts for 2013.

Surely, 2013 will at last see publication of this long awaited report? Leaks in last weekend’s Sunday papers make me feel the government is expecting it imminently. No doubt when it does come it will generate huge media and public interest. For a week or so it will be on everyone’s lips. But will it have any lasting impact?

There is the danger that the events it concerns happened such a long time ago now that all those individuals and institutions criticised will be able to say ‘that was then and this is now – we have all moved on and things are so much better already’.

Another danger is that, however nuanced the report itself may be, the media will just look to pin blame, no doubt choosing ‘managers’ as their scapegoats. I hope that once the noise has died down there will be lasting impact. Perhaps a statutory duty of candour will be a result? Perhaps the training and education of clinical staff, especially nurses, will change to re-emphasise the value of caring? Perhaps there will be a more realistic appreciation of what regulators can and can’t do? Perhaps there will be a renewed emphasis placed on patient safety and on giving patients and carers voice in the system?

Clinical Commissioning Groups will go live in April. I said this time last year that it would be anyone’s guess which model of commissioning we would end up with. I believe it still is. Will the CCGs assert themselves and be prepared to take some tough local decisions on priorities or about service reconfiguration? Or will they be born looking over their shoulders to the myriad tiers above them?

My fear is that only a small proportion will have the resource, experience and will to do the former and may find themselves picked off by an increasingly anxious Commissioning Board, mindful that an election will be a mere two years away. Meanwhile, who is going to keep their eye on the quality of out of hospital services, especially primary care? Will there be any desire on the part of the Commissioning Board’s Local Area Teams to bear down on poor GP performance, let alone consider how to transform out of hospital care?

All that said, just as always, I can confidently predict that the rest of the NHS will muddle through. It’s what it does. Some hospitals, be they foundation trusts or not, will experience severe financial difficulties. I predict the ones most likely to do so will be small to medium sized district general hospitals. Even if the numbers remain small in 2013, this will be a trend we will see intensify in later years. However, addressing which pattern of hospital services we want for the country will be the big question that will go unanswered as the government, in England at least, has ensured that there is enough money ‘put by’ to avoid a financial meltdown.

Meanwhile, what will the Health Foundation be up to in 2013?

We will continue to play our role in developing leaders at the forefront of improving healthcare quality, launching further rounds of GenerationQ, improvement science PhD Scholars and clinician scientists.

We will continue to be a major funder of improvement work in the service by launching further rounds of our ‘Shine’ and ‘Closing the Gap’ programmes. We will place emphasis on selecting teams that can demonstrate a track record in successful improvement projects and who can generate publishable results.

The importance of understanding the economic case for improving quality will continue to run through our work – we’ll be commissioning primary research to examine the cost benefit of improving patient safety and person centredness. Economic evaluation will continue to feature in our award programmes. We will also develop our capacity to act as a conduit for the transfer of international evidence and practice in service innovation.

Based on our track record and where we think an independent voice can make a significant contribution, we will advocate for greater focus by the healthcare systems of the UK on patient safety and person-centred care. On safety, our emphasis will building a consensus on how best to measure it. On person-centred care, we want to spread approaches to equipping patients and professionals to work in partnership beyond the innovators we have supported in the past.

Stephen is Chief Executive of the Health Foundation, www.twitter.com/THFstephen





 
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Comments
Thanks for a useful blog Stephen.

It's great to see the Health Foundation focus on patient safety and effective, good quality care...a necessary response from the Francis report.

If I could add a personal view, Id like to see more of a focus in 2013 on all the health professionals who work in localities - from the NHS to providers such as acupuncturists. There is a wealth of talent in each locality that is not being harnessed to improve the health of the whole population. Perhaps this is something health and wellbeing boards will do?

I'm also excited by the opportunites in personal health budgets - for people and patients to really choose the care they want.

Self care is an issue that the Health Foundation has championed and I hope will do so in the future - again, Id like to see the Health Foundation leading research in this area e.g. we know from small scale studies that people who attend acupuncture sessions improve their attititude to their overall care.

Finally, I wonder if the Health Foundation may put its head above the public and media parapet more ? The election is 2.5 years away and a focused piece of work such as a health foudnation "commission" e.g into good care to influence political party manifestos on health may be worthwhile? - just an idea though!
I feel that the changes that are about to be imposed upon us by the Department of Health will have unforseen consequences - some of them will be tragic. This seems to me to be an uncontrolled, even an uncontrollable social experiment on unsuspecting patients as no one seems to be considering how patient safety is to be monitored or policed. I want to see a Patient Safety Officer (with a very small team) on every acute and intermediate site so that unacceptable incidents can be addressed immediately.
With the emphasis on GPs keeping patients out of the acute, I hope it is not to be at the cost of the patient's life.
And worryingly, splattergunning patients into elderly care homes with inadequate monitoring to ensure that their care needs are being met, means that they will be hidden from view. Who is to ensure that care home staff are trained, have time and are willing to ensure that mobility is maintained so that the patients are able to return home.
I could go on. . . and on. . . .
Dear Barbara

Thanks for your comment. We agree that monitoring patient safety is critical and we have a major project this year to review how we monitor and measure safety. We will be publishing a report on a new framewrok for doing this around Easter time and will be holding a number of roundtables to discuss the implications.
We will be posting details of the project on our website so please keep reading
I believe you have to be client centred and the safety of the patient and quality of care is important.
I can see the benefits of clients choice.

Starting from when we first visit the doctor.

Included in the consultation, the client should be do we be able to choose natural holistic ways as an option to perhaps a life time of taking tablets. (Then if we do need them later on in our
lives, our body has not got immune to them or overloaded with them.)

As a child when having a cold, cough or sore throat, home remedies where given. After a few days i was up and running.
Did not go to the doctors unless it was serious.

The focus has change in modern times. Habits have changed.
Of course doctors will have to make some decisions, as they are the first port of call.
Thanks for taking the time to discuss this, I feel strongly about it and love learning more on this topic. If possible, as you gain expertise, would you mind updating your blog with more information? It is extremely helpful for me.
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