NHS Future

Name: Marion Judd
Comments:

My vision for the NHS The whole system needs review. The following principles should be adopted or strengthened:

1. It is essential that the NHS is clinically led and patient-focused

2. Cost rationalisation: the following should be considered:

• Creating a separate funding source to cover high cost/low volume procedures, high cost drugs as provide real benefit to patients, innovative expensive surgical care packages/pioneering interventions - consider possibilities such as charity funding or lottery money with doctors applying for funds on behalf of individual patients

• Introduce policy that stops post code lottery anomalies in treatment provision

•Remove provision of very cheap drugs such as aspirin and paracetamol from NHS funding ? Introduce policy that reduces clinical

• flogging dead horses?, i.e. reduce NHS provision of futile treatments (may need the medical profession to develop futility guidelines) ? Stop NHS provision of alternative therapies with no evidence base

• Review current procurement practices - can the system be changed so that savings can be made? ? Review formula for funding allocation per capita

• Cease all catering services within the NHS. Let private free enterprise provide food for patients and staff - no contracts - let customer preferences/market forces determine which provider is successful

• Review all quangos - discontinue as many as possible

3. Remove the NHS from direct control by Whitehall. Control should be city/county based in line with needs of local populations. Centres providing specialist care for patients from other regions as well should be funded accordingly

4. Reduce management structures throughout. Minimise monitoring data required by Whitehall. Provide adequate extra funding for all centrally-required monitoring activity

5. Retain audit commission and NICE

6. Encourage and sustain development of academic departments, research and training facilities for clinical professions - make Britain a world player again in research and development of new and effective treatments. Encourage rather than stifle development of new technologies and treatments.

7. Remove current internal market practices - too costly. Rather seek to improve efficiency in use of NHS funding through root and branch review of current system with the aim of a radical reduction in current levels of bureaucracy. Divert funding released toward clinical care of patients and specialist equipment

8. Cease PFI initiatives. See alternative cheaper ways to fund new buildings.

9. Commission review of how nursing care is currently delivered. Review minimum ratio of staff/patient. Review ward management systems and cleaning systems. Use checklists to ensure that essential daily care for each patient is fully delivered.

10. Review the provision of therapy and rehabilitation services to provide 7 days per week (aiming to reduce hospital stays)

11. Let Mental Health specialists and patients decide on how best to improve current systems of treatment and management of Mental Health patients: make provision to allow removal of everyone with severe mental illnesses from the prison system