A new NAO report concludes:
'We are concerned that the NHS may be working at the limits of a system which might break before it is again able to provide patients with care that meets standards for timeliness & accessibility';
So, the NAO suggests either the Govt. ramps up funding quicker/higher than planned, or ways must be found to reduce demand!
The humane (but long-term) way is via preventive medicine, but the short-term 'solution' will likely be explicit rationing!
h/t FT
Yes, the NHS has been 'run hot' with little spare capacity for some time, and we are now seeing the inefficiencies this actually causes.....
@ChrisMayLA6 ah, but prevention is often a non-medical public health concern, and therefore a totally separate budget from regular NHS activities.
It doesn't matter that every pound spent on public health saves orders of magnitude more on healthcare. We don't have joined up accounting, therefore we don't have joined up thinking.
excellent point, thanks (& boosted)
@JetlagJen @ChrisMayLA6 We did have "joined up government" once.
But, like "big society" and "levelling up", it was only a slogan, nothing ever actually happened.
@ChrisMayLA6 rationing in the NHS is already widespread.
For example, shared a pilot plan to ration A&E in England :
#NHS isn't "broken". Its been short-changed, starved, and shrunken. When all of primary and secondary care capacity was starved of funds and shrunk, A&E was forced to pick up the slack. Eventually, even they would give up. Behold, #NHSEngland now considering implementing "appointment only" admissions to A&E. https://www.pulsetoday.co.uk/news/integrated-care-systems/ae-by-appointment-only-as-icb-reveals-radical-plans-for-acute-care/ #UK #England #Health #Healthcare #Labour 1/2
Both. Reduce demand and increase spending. But thatโs a bigger issue than the health budget alone. Goes back to the notion of joined up government which sounds, well, just a little too unpalatably central planning socialist for the current regime.
It already, implicitly, is. Waiting lists; qualifying criteria; restricted treatment duration (eg immunotherapy). All of which can be bypassed if you can afford it (most canโt).
@GreenerFutures @ChrisMayLA6 exactly!
Criteria for testing for instance are so much more stricter now than what I learned in med school.
You can call it "efficiency", I consider it rationing. Its extremely bad for patients.
If you need to be at an advanced state of the disease to qualify for a test, whats the point of the test then?
I learned in school it was to catch it early and preserve health.
In practice, the criteria barely allow for "early" anymore.
Emeritus Prof Christopher May
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