Should the NHS be more like the phone industry?

  • 1 July 2014
  • From the section Health
  • comments
Mobile phones

The pace of change in the telecommunications industry has been phenomenal.

From telephone exchanges to landlines in every home and - in the past 20 years or so - the advent of mobile phones and now smartphones, the way we communicate with each other has come a long way.

But what, you may ask, has that got to do with health care? Well, perhaps more than you think.

While medical science has revolutionised the treatments available, the same cannot be said for where the care is given. Hospitals - and the district general hospital in particular - still dominate.

There is, it seems, a fear of change.

Too conservative

It is a point not lost on NHS England's Prof Keith Willett. He is the national director of acute care and is leading the review of how services are organised in the NHS.

He says the comparison with the telecommunications industry is an interesting one. He believes society as a whole is too "conservative" when it comes to embracing change to the NHS.

He believes we remain too fixated on the "bricks and mortar" than what works best. To illustrate the point, NHS England has released figures today showing that since the reorganisation of trauma care into regional networks in 2012, 600 lives have been saved.

The analysis - by the Trauma Audit and Research Network - has calculated that survival rates have increased by 30% for the 16,000 patients brought to hospital each year with major trauma from road accidents, falls and assaults.

But this is not a success story.

The case for changing the way trauma care was organised - it is now centred around 25 major hospitals - was put as long ago as 1988 by a report for the Royal College of Surgeons, by Sir Miles Irving.

NHS England calculates 6,000 lives could have been saved by introducing the reform earlier.

Why delay?

So why did it take so long? Many theories have been put forward over the years from politicians being too quick to put their names to campaigns to save local hospitals to NHS leaders - both doctors and managers - being too timid to put the case for change.

Recently, there has been some confusion over the direction the NHS is heading.

Much was made of the comments by Simon Stevens, the new chief executive of NHS England, about the role smaller hospitals have to play.

Some interpreted this as rejection of the desire for these specialist centres.

But the case being made today - Mr Stevens is making a speech to an Age UK conference in London when he will reference the data on trauma care - will make it clear.

Bigger when it comes to specialist care from stroke services to heart surgery is definitely better.

That is not to say there isn't a role for smaller hospitals, there is.

Even after the trauma care reorganisation, district general hospitals are still responsible for rehabilitation and carry out follow up appointments. But as the phone industry has shown, embracing change holds the key to progress.