UK - Top clinicians argue case for NHS reform

Citation

(2007), "UK - Top clinicians argue case for NHS reform", International Journal of Health Care Quality Assurance, Vol. 20 No. 2. https://doi.org/10.1108/ijhcqa.2007.06220bab.005

UK - Top clinicians argue case for NHS reform

Keywords: Healthcare improvement, Quality outcome indicators, National service framework

Two of the top clinicians in the country have published reports on the need to change how emergency care and heart and stroke services are delivered to ensure that patients get the best care in the right place.

Sir George Alberti, National Clinical Director for Emergency Care and Professor Roger Boyle, National Clinical Director for Heart Disease and Stroke, both argue that traditional A&E departments are not the only option when dealing with life and death situations. The reports also include personal accounts of the recent service changes and improvements to patient care that they have seen in their own areas of expertise and that are already making a difference for patients.

Presenting his report to leading health experts, Professor Roger Boyle said:

There have been vast improvements in the treatment of heart disease since the National Service Framework was published in 2000. We have seen an increase in the number of heart attack patients treated within 30 minutes of arrival at hospital from 38 per cent to an impressive 83 per cent. Paramedics are now trained to assess, diagnose and provide thrombolysis treatment at the scene and 11 pilot schemes are in place to test the feasibility of providing angioplasty as the first treatments for heart attack patients.

Looking to the future, I expect to see 500 fewer deaths, 1,000 fewer recurrent heart attacks and 250 fewer serious complications such as stroke, every year as a result of developments in the speed and effectiveness of treatment for heart attacks. A further 1,000 stroke victims a year would regain independence rather than die or be left dependent on others if they were given clot-busting treatment in specialist centers. By giving life-saving drugs to heart attack victims on their doorstep and using clinical judgments to by-pass A&E to deliver heart attack and stroke patients directly to specialists, we are acting only in the best interest of the patient. This is not driven by saving money but by the aim of saving lives.

Outlining details of his report, National Clinical Director Sir George Alberti said:

Care for emergencies is good, and indeed there has been a transformation in A&E departments over the last five years. But there is increasing specialization and we need to ensure that people are seen quickly by an experienced doctor or health professional.

We have to be upfront and tell the public that, in terms of modern medicine, some of the A&E departments that they cherish are not able to provide this type of care and cannot and will not be able to provide the degree of specialist services that modern medicine dictates and the public deserves. That means we have to change services so we can deliver safe, high-quality care to everyone who needs it, when they need it.

Every service cannot be offered by every A&E department – it never has been, and never can be – so it makes sense to create networks of care with regional specialist centers to give the best possible treatment to the sickest people. For the majority of people, care is still going to be as local as it ever was. Major emergencies affect a relatively small number of people. For most people, care will continue to be as local – or indeed more local – than ever.

Speaking at a breakfast event, Health Secretary Patricia Hewitt said:

The NHS is at a crucial stage in a ten year process of investment and reform, and as part of this process, a number of service changes are being proposed across the NHS. The prompts for these changes are not only financial, as many would have us believe.

The NHS is changing because medicine and patients needs are changing. As both National Clinical Directors have highlighted, the NHS in the future will save more peoples lives by taking the most seriously ill patients to the right specialist centre. But it will also give many people with less serious conditions more convenient care by taking A&E to the patient rather than expecting every patient who wants urgent care to go to A&E.

For further information: www.gnn.gov.uk/