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Milking the A&E brand is better than killing the cow


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Friday, 1 February 2013

Milking the A&E brand is better than killing the cow

The chief economist of the King’s Fund predicts that within 50 years the NHS will employ one in eight of the working population and account for nearly a fifth of GDP.

If this heartwarming vision of expansion is to be realised, the NHS will need to up its game. In particular, it must stop measuring success in terms of prevention, good health outcomes, self-care and other ludicrous concepts designed to put it out of business.

There are encouraging signs that the government is beginning to get this. But as usual its motives are misconstrued by leftists and troublemakers who fail to appreciate the subtleties of health policy.

Take A&E. Once upon a time there was only one kind. Soon people will have a choice of services ranging from A&E Lite, A&E Plus and A&E Extra Strength to A&E Total Protection, a version of the service that actually stops you having accidents or getting ill for days after you leave hospital.

Soon there will be more than one number to dial. Stopping to decide whether to call 111 or 999 will help patients feel more involved and enrich the overall helpline experience. Spend an empowering hour on the website working out which number is right for you and your nosebleed or serious head injury. It’s all about choice. Everything else is secondary.

Everyone was getting steamed up about the closure of Lewisham hospital’s A&E department, but it turns out it will just be rebranded and scaled down a bit with “up to 75%” of its existing capacity, according to Mr Hunt, the health secretary. He might have been better off describing it as a “25% off” deal, but such refinements of sales technique will come with experience.

The NHS doesn’t close things, it reconfigures them. There’s a big difference. If you close something, no one can use it anymore. If you reconfigure it, it simply ceases to exist in its current form. Others just like it, or quite like it, are still available. They may be a bit further away or not as good, but that’s not the point. Marketing is about getting the language right. “Reconfiguration” is consumer friendly. “Closed” is a bit of a turn off.

A&E isn’t failing. The problem is that it’s too successful. That’s why everyone wants to use it. It doesn’t matter how many times you tell people that there are perfectly competent GPs ready to treat their twisted ankle or their infant’s colic, they want what everyone else is getting, they want top of the range.

For too long we thought the answer was to come up with different products when it’s really to diversify the brand. Don’t confuse the punters with polyclinics, urgent care and walk-in centres, minor injury units and so on. That’s like Colgate trying to flog toothpaste as mouth polish or dental scrub. Toothpaste is toothpaste and healthcare is healthcare. A&E is a powerful brand, so milk it.

The local doctor’s surgery can occupy the bottom end of the market – the A&E Value range, good honest healthcare for people on a budget who are prepared to forgo the luxury of convenient opening hours and a state-funded taxi service.  It might need a few touches for the sake of authenticity:  get rid of the silly and unnecessary appointments system and bring in less comfortable furniture, car-park charges and perhaps a drunken thug to create the right atmosphere at peak times.

Somewhere in the middle of the range would be good old-fashioned traditional hospital based A&E in the new variety of sizes and flavours the government appears keen on, with all the usual “while stocks last” disclaimers. 

Then you get the fancy brands with names like Finest or Seriously with the same basic ingredients but lots of nice packaging for people with more money than sense.

Why cling to old-fashioned labels like outpatients and inpatients? It’s all Club A&E – pop in for a few hours or stay for weeks. It’s up to you.

A&E is the only serious player in the market, but instead of investing to protect a fine monopoly we’re hell-bent on ruining the brand with a risk-averse strategy based on cutting costs and reducing demand.

Tesco didn’t become the UK’s most successful supermarket chain by sending customers it couldn’t cope with to Asda or the nearest corner shop. Store too small?  Open a bigger one, cut prices, create more special offers, introduce loyalty cards, sell petrol, clothes, tellies, financial services. With similar bold thinking A&E could be just as big.

You can already buy coffee and Mars Bars in most A&E departments, why not petrol, clothes, tellies and health insurance? Don’t look at a four-hour wait as a problem; see it as a retail opportunity.

harry.longman@gmail.com says:
Feb 01, 2013 09:00 AM
Dear editor,
Why aren't you more serious? Because your stories and pictures and jests and puns are getting under my skin and making me think. This hurts.

So it would be much easier for all of us if you just got heavy and used the correct management terminology like the rest of them. Then we could safely ignore what you are writing.
johnmurphy says:
Feb 01, 2013 09:25 AM
Brilliant and on the mark as usual,
david.truswell@nhs.net says:
Feb 01, 2013 10:01 AM
It is unfortunate that you are unable to take the essentially visioning step towards understanding the potential of Tesco NHS bringing added value to the NHS brand through locating A&E in major branches of Tesco. This will allow the discerning consumer to buy the discounted washing powder they need to wash their blood stained clothing while waiting to get that serious head injury assessed at Tesco A&E. With bonus loyalty card points for major trauma, this is a marketing opportunity begging to be realised.
jpatterson says:
Feb 01, 2013 10:59 AM
It's funny you should bring that up:
stephanie.clarke@cht.nhs.uk says:
Feb 01, 2013 11:33 AM
This would be funny if it wasn't so terrifying.
gsharp says:
Feb 02, 2013 09:55 AM
Another brilliant editorial - I'm still chortling!
Keep them coming Julian - humour is in short supply at the coal face.
lauraruddy@yahoo.co.uk says:
Feb 02, 2013 02:31 PM
The NHS is being Milked by the Government the Pathetic the closures of A/E departments is Beyond recognition
 why not just close all the main services??
 where are the ambulances going to take patients Straight on to the wards with NO Beds some one needs to inform Mr Hunt that the lives that they are playing with are the very same ones that put the idiots into power>>>
Mrsou12507@gmail.com says:
Feb 04, 2013 12:50 PM
Simply brilliant and good to read. Please keep it up.