The public must be more involved in how NHS services are run:
The service needs more transparency, honesty and openness, says the NHS Confederation chief executive
In recent weeks I have attended numerous meetings that used the NHS constitution as a means to describe the health service. For those less familiar with this excellent creed, it includes the statement: "The NHS belongs to the people."
While this principle is truly laudable, the daily reality for patients and the public can be very different. Just read about the poor practice on some wards, as reported at Stafford hospital, which its own board did not pick up on.
Or, how some NHS boards, faced with difficult decisions and large public attendances at board meetings, spend hours rehearsing so the public sees a smooth performance rather than the tensions and shades of grey that exist, while continuing to make decisions in the private part of their meeting. Take all this in to account and you sense the NHS is a "public service" with a long way to go.
The NHS provides a public service and is funded through taxpayers' money, so it must be accountable and transparent to the public. Yet too often the public is seen as part of the problem and not part of the solution. This is a situation that has to change – and rapidly, if the NHS is to survive its next decade of challenges.
I believe NHS organisations need to do more to involve patients and the public in how our services are run. There are three key areas where we can do this: involving the public more in key decisions about their health services, involving patients more in managing their care, and encouraging greater involvement from the public in how they improve their health and wellbeing.
There have been increased efforts by organisations to see patients as partners in their care. Evidence shows that being engaged as a partner, whether you are acutely or chronically ill, produces faster and more sustainable results. This is important for patients. But it is also business critical for the NHS if it is to provide better quality care and outcomes for less money as healthcare demands grow.
When Bupa declared in its famous campaign many years ago, "The patient will see you now, doctor", the NHS looked on in envy at the personalised choice it offered its patients. But the NHS is catching up. NHS Choices has since been introduced, allowing patients to provide feedback on standards of care which is routinely collected and used to make improvements. And the introduction of personal health budgets for patients could be another tool with the power to shift control from doctor to patient.
There is no doubt that healthcare issues are complex. But NHS managers and doctors do themselves no favours by their attitude of "arms around their work, no peeking". We have to change.
There is a huge need for more transparency, honesty and openness about why we need to modernise health services. There is an even bigger need for revealing to the public information about the economics, finances, and costs of health and social care.
With the NHS putting a greater emphasis on the health of local populations, there is a tension between tending to the needs of the individual patient versus the needs of the wider community. This brings with it issues about how local NHS organisations manage their resources from a finite pot of money.
For this reason, we need to start a dialogue with the public about the case for changing the scope, range and location of health services so that we can continue to fulfil the aims of the NHS constitution to "provide a comprehensive service, available to all ... based on clinical need, not an individual's ability to pay".
Taking a radically different approach to openness on these matters would not just engage the public in supporting change, it would also enable people to suggest more radical and sustainable solutions than healthcare managers often do.
Armed with better information about demand for and costs of healthcare, it should create the right platform for encouraging us to change to healthier lifestyle choices. There is the potential to move the public from "marching in opposition" to changes to local services, to "walking in support" of them. We could look forward to public board meetings, not fear them.
And when Robert Francis unleashes, in his own words, "a tsunami of anger" from patients about care standards at Mid-Staffordshire NHS foundation trust early next year, let us turn this into a "tsunami of opportunity" and move faster down this path of involving the public in improving the way we provide their care.
I believe the underlying culture in the NHS, if not in practice everywhere, is now ripe for that to happen. We just need to go that step further to make it systemic.
Mike Farrar is chief executive of the NHS Confederation. He is on the panel for our new partnerships in healthcare debate at the Labour party conference in Manchester this Tuesday. Guardian Professional.
In recent weeks I have attended numerous meetings that used the NHS constitution as a means to describe the health service. For those less familiar with this excellent creed, it includes the statement: "The NHS belongs to the people."
While this principle is truly laudable, the daily reality for patients and the public can be very different. Just read about the poor practice on some wards, as reported at Stafford hospital, which its own board did not pick up on.
Or, how some NHS boards, faced with difficult decisions and large public attendances at board meetings, spend hours rehearsing so the public sees a smooth performance rather than the tensions and shades of grey that exist, while continuing to make decisions in the private part of their meeting. Take all this in to account and you sense the NHS is a "public service" with a long way to go.
The NHS provides a public service and is funded through taxpayers' money, so it must be accountable and transparent to the public. Yet too often the public is seen as part of the problem and not part of the solution. This is a situation that has to change – and rapidly, if the NHS is to survive its next decade of challenges.
I believe NHS organisations need to do more to involve patients and the public in how our services are run. There are three key areas where we can do this: involving the public more in key decisions about their health services, involving patients more in managing their care, and encouraging greater involvement from the public in how they improve their health and wellbeing.
There have been increased efforts by organisations to see patients as partners in their care. Evidence shows that being engaged as a partner, whether you are acutely or chronically ill, produces faster and more sustainable results. This is important for patients. But it is also business critical for the NHS if it is to provide better quality care and outcomes for less money as healthcare demands grow.
When Bupa declared in its famous campaign many years ago, "The patient will see you now, doctor", the NHS looked on in envy at the personalised choice it offered its patients. But the NHS is catching up. NHS Choices has since been introduced, allowing patients to provide feedback on standards of care which is routinely collected and used to make improvements. And the introduction of personal health budgets for patients could be another tool with the power to shift control from doctor to patient.
There is no doubt that healthcare issues are complex. But NHS managers and doctors do themselves no favours by their attitude of "arms around their work, no peeking". We have to change.
There is a huge need for more transparency, honesty and openness about why we need to modernise health services. There is an even bigger need for revealing to the public information about the economics, finances, and costs of health and social care.
With the NHS putting a greater emphasis on the health of local populations, there is a tension between tending to the needs of the individual patient versus the needs of the wider community. This brings with it issues about how local NHS organisations manage their resources from a finite pot of money.
For this reason, we need to start a dialogue with the public about the case for changing the scope, range and location of health services so that we can continue to fulfil the aims of the NHS constitution to "provide a comprehensive service, available to all ... based on clinical need, not an individual's ability to pay".
Taking a radically different approach to openness on these matters would not just engage the public in supporting change, it would also enable people to suggest more radical and sustainable solutions than healthcare managers often do.
Armed with better information about demand for and costs of healthcare, it should create the right platform for encouraging us to change to healthier lifestyle choices. There is the potential to move the public from "marching in opposition" to changes to local services, to "walking in support" of them. We could look forward to public board meetings, not fear them.
And when Robert Francis unleashes, in his own words, "a tsunami of anger" from patients about care standards at Mid-Staffordshire NHS foundation trust early next year, let us turn this into a "tsunami of opportunity" and move faster down this path of involving the public in improving the way we provide their care.
I believe the underlying culture in the NHS, if not in practice everywhere, is now ripe for that to happen. We just need to go that step further to make it systemic.
Mike Farrar is chief executive of the NHS Confederation. He is on the panel for our new partnerships in healthcare debate at the Labour party conference in Manchester this Tuesday. Guardian Professional.
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