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Looking through my blog, a friend was surprised

May 1, 2013

Looking through my blog, a friend was surprised I hadn’t made any mention of my Young Fabians life on here. Well, that made the two of us. So before my next piece goes up or before I delete this blog (I genuinely don’t know which will come first), here’s a piece I wrote with one of our members:


Focus on Health & Society Series: Can the NHS become a successful business?

By  Richard Stebbing with additional comments by Adebusuyi Adeyemi.

In the latest installment of the Focus on Health and Society Series by the Health Network, Richard Stebbing looks at whether the NHS can become a successful business.

If the NHS were a normal business, then given its tumultuous performance so far in 2013, its share price would have probably fallen. Of course the NHS is a business, but given it is in the business of protecting the nation’s health, with its fortunes so closely woven to that of the Government it is a unique one. We know that the NHS is underachieving in terms of productivity and it is under pressure to be financially prudent in the face of ever increasing demand; whilst the recent findings of the Francis Report on Mid Staffs have underlined how factors of care and compassion cannot be discarded. Therefore we must consider how the NHS can be a more successful for its customers, employees and employers. Its shareholders, customers and investors, try figure out who’s who! Answers on the back of a postcard.


Making sure people are good at their jobs and doing jobs that are needed

So, considering the NHS is like a modern business. Considering it rewards key staff for good performance and it evolves, developing new areas of business. One glaring deficient area is in retraining or making redundant staff that are no longer required in their present roles. Now the premise of cutting necessary staff from the NHS is one that rightly fills many with dread. However cutting unnecessary staff – well that is something that makes good business sense – especially good business sense when it is us that is employing them, and that this is public money that can be used for ‘better’ things. Ask almost anyone that works in the NHS and they will tell you that administration is bloated and can be reduced. A solution is restructuring and reappraising NHS non-frontline teams and making staff reapply for these new roles if reductions in team numbered are deemed necessary. If we are serious about the NHS being a productive, successful business, then unnecessary staff is an opportunity cost that has to be considered.

Adapting GP surgeries for the 21st century

Most people now use the internet as the basis for all communication and arrangements in their social and professional life. Yet for most people the most advanced aspect of NHS services is receiving a text message reminder for that upcoming appointment or renewing their prescription online. Yes, yes, we know the more technologically savvy are messaging on other platforms like Whatsapp and Facebook. Still, there is significant inefficiency and wastage in not making adapting more services and logistics in the NHS to take advantage of internet technology.

For example, create a web-based GP booking as the default booking service. It is simply inefficient to have the default method of booking as phone-based when the technology for patients to complete web-based forms on their symptoms and select available appointment time slots exists online. Crucially this would mean that patients can book appointments 24/7 – i.e. when they fall ill – rather than when the GP surgery is open. This would reduce this burden for administrative and supporting staff in GP surgeries, especially in the 15 minute window when a GP surgery opens, and would mean that these staff are freed up to help the running of the surgery in other ways throughout the day.

Such a system could also be used to coordinate bookings with specialists and consultants, which if made more interactive, could help patients attend and cancel appointments they cannot make thus ideally meaning that these appointments could be allocated, say via email, to other patients in need at short notice.

Another simple idea is allowing patients to register with a GP online. When the process essentially involves proving one’s address via an official letter and completing a basic health questionnaire, why does this have to be done in the GP’s surgery? Doing this online would save time for the patient, who might otherwise have to take time out of the working day, and also GP surgery staff.

Using technology to aid patients in self-care

Another area where technology can be embraced is around patient self-care. In 2011 I (Richard) had the misfortune to contract Bell’s palsy for around 3 months. My GP at the time was helpful and gave me some printed information on the condition. However I received no information/advice around necessary items of self-care that I would need to undergo, such as taping one’s eye completely shut on a nightly basis.

I found useful information in this area, by a chance YouTube search after a few days, and research for this article demonstrates that similar information is also available for other conditions. Given that most patients do not master aspects of self-care on day one (for the record I was waking up each morning with my eye un-taped and open at first); technology here can help reduce patient follow-ups and can help them recover quicker and better. This also embraces technology; this form of advice needs to be more interactive than a piece of paper. So why not have health professionals email relevant self-care information to patients? I am not suggesting that patients are emailed arbitrary links, but why not have NHS-branded self-care videos either using actors or volunteering patients under supervision? It would be cheap and very useful to many patients. It would also save on GP printing costs! Isn’t the NHS in the business of being useful to its investors, shareholders and customers?

Richard Stebbing is a Young Fabians Member and Adebusuyi Adeyemi is Chair of the Health Network.

For more information on the Young Fabians’ Health Network email Adebusuyi:


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