Healthcare delivery
make improvements – management time and the investment of staff time in new ways of working is finite and is increasingly committed to efforts to improve performance and quality of care in the face of a relentless growth in demand.12
Digital challenge Improving facilities and digital capabilities would make some of the productivity and efficiency challenges much easier, enabling staff to focus on key operational and clinical tasks. Electronic patient records can transform services to improve outcomes and contribute to enhanced productivity. However, the costs of the IT required to upgrade all the ancient hardware in the NHS is substantial and the capital funding is not available. There needs to be a recognition of the funding that is required to achieve this transformation, which would undoubtedly deliver huge gains. Technology can improve productivity by providing data analysis and enabling communication at a speedier rate. Nurses and junior doctors constantly complain about the volume of administrative tasks they have to do, reducing clinical hands-on care time. There are many administrative tasks which could be simplified or done quicker by some use of technology.
Conclusion As ever, in healthcare, the problem at present is far from simple and requires fixing. My
personal view is that the bed capacity and flow is the one huge problem which needs to be resolved. Countless governments have ignored social care, whose chickens have now come home to roost. Some of the bed capacity could be released if resources were put into social care and community support to patient care at home. It would certainly not solve the issues set out, but it would start to unstick the apparently insoluble problems. Of course, staffing and the huge vacancy
rate is a problem, which is completely out of the hands of any Trust manager – although making the NHS a more person-friendly place to work would go a long way to help with retention. But it will take the efforts of many leaders at different levels to ensure that all their staff feel valued and rewarded for what they do. The financial issues are beyond this author to resolve or even to suggest any options, as so many of the issues can only be managed at the top level by NHS England and the Treasury. The new Chief Executive, Amanda Pritchard has certainly got a perfect storm and is accountable to parliament for all of the £150 billion annually which the NHS swallows. However, every individual can have an impact on Accident and Emergency visits and GP services, by attending only when necessary and ensuring they attend the right place. Many minor issues can be managed by using Urgent Treatment Centres in daylight hours or getting advice from 111 services to self-care.
Individuals have lost sight of the many ways in which they can help themselves, thus taking responsibility for their own health and leaving the facilities to those who really need them. That would be a good place to start.
References 1. Stretched to the limit: tackling the NHS productivity challenge,
nhsproviders.org
2. Neville S, Cocco F (2023). ‘NHS productivity lags as recruitment fails to keep pace with demand’. The Financial Times, 23 May.
https://www.ft.com/content/69ffd8e2- eb4a-4c01-98cb-436dbc8ddc5b.
3. NHS England, ‘2022/23 priorities and operational planning guidance’, Accessed at:
https://www.england.nhs.uk/ publication/2022-23-priorities-and- operational-planning-guidance/
4. NHS Providers, ‘Stretched to the limit: tackling the NHS productivity challenge’, Accessed at:
https://nhsproviders.org/ stretched-to-the-limit
5. Figures show growing number of staff leaving the NHS in England, ITV News, 1 July 2023, Accessed at:
https://www.itv.com/ news/2023-07-01/record-number-of-staff- leaving-nhs-in-england-figures-show
6. NHS Staff Survey 2022: analysis of the results, NHS Employers, Accessed at:
https://www.nhsemployers.org/articles/ nhs-staff-survey-2022-analysis-results
7. NHS priorities and operational 2022/23 planning guidance, NHS Confederation, Accessed at:
https://www.nhsconfed.org/ publications/202223-nhs-priorities-and- operational-planning-guidance
8. NHS staff sickness hits record high in England, BBC News, Accessed at: https://
www.bbc.co.uk/news/health-66047270
9. NHS England, ‘Delivery plan for recovering urgent and emergency care services’, 30 January 2023, Accessed at: https://www.
england.nhs.uk/publication/delivery-plan- for-recovering-urgent-and-emergency- care-services/
10. NHS discharges: Reasons for hospital departure delays revealed, BBC News, Accessed at:
https://www.bbc.co.uk/news/ uk-england-66284404
11. Stretched to the limit: tackling the NHS productivity challenge, NHS Providers, Accessed at:
https://nhsproviders.org/ stretched-to-the-limit
12. Making the most of the money: Efficiency and the long-term plan, NHS Providers, Accessed at:
https://nhsproviders.org/ making-the-most-of-the-money-efficiency- and-the-long-term-plan/1-the-efficiency- challenge
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