As part of our ‘What If’ series on change in the NHS, we spoke to Operational Leader, Andrew Kent and asked him: “Putting all politics aside, if you could change one thing about the NHS, what would it be?”
If I could change one thing…
As an operational leader in the NHS, I would want to change the number of opposing constitutional standards. To deliver the service to the patient, we need to re-align the standards to be meaningful to the patient’s journey and not be in conflict with each other. The foundations are there, for example cancer standards have shown a significant improvement in care but maybe we have not got the early detection and prevention right.
The changes in the 18 week RTT standard were an opportunity to improve pathways for patients with benign conditions, but it has led to confusion and longer wait times. The diagnostic standard does not include reporting times and therefore is misleading and causes bottlenecks in the system. The emergency care standard gives an indicator of the pressure within the system but does not help to alleviate it, in fact it has the potential to be a catalyst for investment such as A&E departments but the reality is funding may be required elsewhere. We should now move towards social care, delayed discharges and medically fit for discharge, this could be more welcome, thus allowing flow to improve through the health economy. I guess what I am saying is that the amount of standards has caused bottlenecks and conflicts in the system, “we are what we measure.”
A full review needs to be undertaken and more meaningful standards should be put in place that allow the goal – which is flow with improved outcomes for the patient. Let’s be serious then about tackling variation and bottlenecks, by changing this element, this would give us significant improvement.
Andrew Kent is an operational leader, his last role was Managing Director of a Care Group in the North West. He has specialist expertise in operational leadership, flow and service improvement.
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