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Friday, 12 April 2013

Over to you

Next week the Department of Health will write to patients reminding them that the new NHS is more patient centred, outcomes focused and transformational than ever before and that patients and the public are, in a very real sense, at the heart of things. NHS Networks has obtained a copy of the letter, which is reproduced here in full.

Dear Citizen-patient

As you know, you are now in charge of the NHS. This is partly because the people who used to run it weren’t up to the job but, more importantly, because we think the NHS is too important to be left to politicians, civil servants or managers. 

You may feel you lack the clinical and managerial expertise to take on a public service with a budget in excess of £100bn a year. Don’t worry, we’ve thought of that. You will be working in partnership with your GP, someone who knows all about medical matters and running their own business, admittedly on a slightly smaller scale. 

The new arrangements, which took effect earlier this month, mean that you will be making all the important decisions that affect your care. You and your GP will be able to decide exactly how the NHS budget is spent and where. You will have the power to close underperforming hospitals, commission new services, redesign care pathways and hold local providers to account – all of which you’ve told us you can’t wait to do.

You can find everything you need to run the NHS by following the links at the end of this letter. They give you access to lots of regulations, guidance, directions, policies, procedures, contractual frameworks, procurement rules, commissioning guides, toolkits, clinical guidelines, spend and outcomes data and more. Don’t worry if it all seems a bit daunting at first – if you follow the instructions carefully, you’ll soon get the hang of it. 

Of course not everyone will have the time to get involved on a day to day basis. If your GP is in the driving seat, think of yourself as in the passenger seat telling him where to go or in the back of the car quietly watching a DVD or listening to music on your iPod. It’s up to you.

But whatever your level of participation in running the NHS, we know you will want to be involved in your own care. “No decision about me without me” is our way of saying that nobody knows more about heart disease, diabetes or rare tropical diseases than you. So if you think that the digoxin is interfering with your renal functions or the amlodipine is giving you headaches and causing your ankles to swell up, make sure you let your doctor know. Because she will be busy getting to grips with funding flows or renegotiating the contract for outpatient dermatology services with the local hospital, she may not have noticed. 

The best thing you can do to help the NHS is not get ill or injured in the first place. Looking after yourself, eating the right food, cutting out alcohol and cigarettes, giving up dangerous sports and taking lots of long walks are just some of the ways you can save yourself and the NHS money.

If you must use the NHS, please do so in moderation and remember that by making just one less trip to A&E or thinking twice before asking for expensive cancer drugs you will be saving resources that may be put to better use somewhere else. Reorganising the NHS for your benefit has already cost upwards of £1.5bn. Inevitably that has meant cutting back in less essential frontline areas, but you can do your bit too.

You kept saying it was your NHS. Well now it is. Over to you.

 
rob.thornburn@nhs.net
rob.thornburn@nhs.net says:
Apr 12, 2013 07:52 AM
At last a clear statement of the reality of health care delivery. It will only get worse and the best service will be destroyed by this silliness.
ruhi.siddiqui@hpa.org.uk
ruhi.siddiqui@hpa.org.uk says:
Apr 12, 2013 09:18 AM
Thank you for these regular updates - always brings a smile to my face. Keep up the good work.
sharon.levack@nhs.net
sharon.levack@nhs.net says:
Apr 12, 2013 09:36 AM
How sweet. Sending a letter to the Citizen/patient. If only it worked in the real world like that. It's all still run by politicians, civil servants and managers. When GPs are giving placebos to patients, won't refer you to Consultants for ailments they themselves cannot resolve to "Save NHS Money". Where in all of this does the Citizen/patient have a choice? They may insist on seeking further consultation, but they still have to get past their GP for referal. Reorganising the NHS for their benefit has already cost upwards of £1.5bn.With so may different NHS bodies now created there won't be the continuity of working and planning together for the future as before when all divisions were under one "roof". Let's see what the future holds for the sick citizen/patient who just wants someone to help him/her get better and receive outstanding care during this process.
dwdeborahwainwright@gmail.com
dwdeborahwainwright@gmail.com says:
Apr 12, 2013 11:04 AM
It should be noted, not to telephone DH or senior NHS managers for advice and guidance since they are all busy moving furniture, changing email addresses and moving into each others jobs. An NHS where everybody is equal ... Right up until some become more equal than others ...
sarah.j.lea@uhl-tr.nhs.uk
sarah.j.lea@uhl-tr.nhs.uk says:
Apr 12, 2013 12:37 PM
After 34 years in the HNS I have yet to meet any patient who is an expert in tropical diseases and as for thinking twice before asking for an expensive cancer drug it's obvious the people responsible for this letter have never been seriously ill themselves.
GP should concentrate on being first line clinicans and looking after their patients, like fund-holding they will employ others to do this work .
stevie.pattison-dick@nclondon.nhs.uk
stevie.pattison-dick@nclondon.nhs.uk says:
Apr 12, 2013 02:19 PM
Post 5. Oh dear.
les@wilki023.fsnet.co.uk
les@wilki023.fsnet.co.uk says:
Apr 12, 2013 05:03 PM
Regret this reads like a trial for a board room ad campaign, its patronizing and negative about the NHS management generally lumping the poor in with the good. Patients are not in charge of the NHS, although there is now some involvement and input from patients in some areas here and there. This might help to influence the way forward in places but it does not make the patients the ultimate decision or policy makers. Trained, qualified and experienced individuals are being paid, highly paid in places, to do this on our behalf. Between us we must be sure the job is being done well. Masses of documentation, such as those shown as related sites are written too often as papers in flowery NHS speak and do not help. Papers must be shorter, clearer, written in simpler terms and to the point. This information is to be passed on to and understood by the public, many of whom are very busy people and will just not have the time or inclination to read such long convoluted documents.
kate.robinson@srft.nhs.uk
kate.robinson@srft.nhs.uk says:
Apr 15, 2013 08:42 AM
I was really shocked by this statement, it seems to imply that people should chose to suffer rather than cost the NHS any money, surely its just very badly written though?
jpatterson
jpatterson says:
Apr 15, 2013 10:24 AM
Following publication of this letter, the DH has announced that extra supplies of irony enhancing medicines are to be made available on the NHS. A spokesman said: "We are concerned but not terribly surprised that some people are unable to tell the difference between broad satire and genuine DH communications. Emergency supplies of irony supplements will be delivered with next week's NHS Networks editor's blog."
The DH confirmed that supplies of cancer drugs would be unaffected.
robin.cameron@nhs.net
robin.cameron@nhs.net says:
Apr 16, 2013 10:53 AM
Wholeheartedly agree with the earlier comment. Please keep up the good work. These perceptive blogs have the added benefit of helping us to retain something of a sense of humour through all of it.
Tghis time, I am especially pleased to see someone picking up on the nonsense of some of the soubndbites introduced to underscore recent NHS reforms "no decision about me without me" or the even more ridiculous "Patient knows best". Did nobody question how a person with absolutely no medical training or qualifications whatsoever - or even a person with no trainiong or qualifications in anything at all - could possibly "know best" when it comes to medical diagnosis and treatment decisions. Very much more of that nonsense and I fear we could risk seeing lengthy queues of parents in South Wales anxious to get their teenage children inolculated for MMR, only since those parents aboslutely "knew best" in the late '90s and equated that the MMR vaccination was the social equivalent of breaking wind in a crowed lift.
Healthcare policy by soundbite is probably the least effective a country can devise.
sketch.chris01@googlemail.com
sketch.chris01@googlemail.com says:
Apr 16, 2013 01:29 PM
And when it fails they will blame the system and say its better put in Private sector hands - USA insurance Co.s are i'm sure are waiting in the wings

(PS: The public don't understand GP's are businesses they see them as part of the NHS/public sector the same as the hospitals)

What happens when a GP / Practice is lobbied to change funded treatment policy by a influential patient that has connections to offer(give) treatment - e.g. free botox if depressed with looks! Free IVF for the 6th time - Can they as a small fish resits such direct and possibly personal demands which were previously controlled by PCTs/SHA Policies and GP's could say I would love too but the PCT won't allow me too fund this Tx! [the examples may not be right but I hope you get the drift]