I've visited eight adult social care departments this year, and talked with front line staff in all of them.
At the Conservative Party Conference earlier this month I attended an event on whether efficiency and patient expectations mutually exclusive. The discussion featured sensible yet well-trodden arguments that yes, you can be more efficient and improve outcomes. Examples included:
- Patients using Pharmacies as the first point of call, rather than the GP or A&E
- More preventative services, especially around mental health
- Investment in public health to prevent demand
The rhetoric was right, but the ‘how’ part of the discussion was missing. Listening to Jeremy Hunt talk about NHS efficiencies on the Today Programme this morning reminded me of this: One of biggest challenges the health service faces is getting everyone to change their behaviours.
- How do you get patients, who for all of their lives have called their GP when they feel ill and attend A&E if they can’t get an appointment, to visit the pharmacy instead?
- How do you get carers to, instead of having conversations about what patients need and what can be provided, have conversations about how a care provider can support them to be independent?
It is difficult to change behaviours. Especially, I would argue, when it comes to health because of the expectations and fondness that citizens have for our National Health Service.
Furthermore, it’s behaviour change at scale. Patients, health providers, health workers – everyone across the health system needs to change if the health service is going to be sustainable. Some councils understand this, and are working with iMPOWER to do that. As an answer to the ‘how?’ question at the Conference fringe event, the discussion only got as far as ‘educating people’ which is nowhere near where we need to be in terms of tackling this.
If the sector wants patients to use pharmacies, take more responsibility for their own health etc. then not only does it needs to start a wider and deeper discussion about changing behaviours at all levels of the health economy, but it needs to happen pretty soon.