Is the NHS delivering enough of the right things?

Hugh Alderwick writes for the King’s Fund – a blog about the problem of overuse in the NHS: where people get services they don’t want or need, which can lead to unnecessary harm and wasted resources. But this is only part of the story. The flipside is that the NHS faces the problem of underuse too.

Underuse happens when effective care isn’t delivered when it’s needed. It can lead to people needing more complex care as their conditions get worse – for example, if they end up in hospital because their condition isn’t managed properly at home. This means that tackling underuse can sometimes save money for the NHS, by keeping people well and reducing use of costly services. In other cases, reversing the problem of underuse is more likely to increase costs – particularly in the short term – as a result of investment in new services or improved access. In either case, tackling underuse is fundamentally about improving care for people who need it.

National Helth Service

So, where might the NHS not be delivering enough of the right things?

One example is diabetes care. While the National Institute for Health and Care Excellence (NICE) sets out clear guidelines for what good diabetes care looks like, data from 2012/13 tells us that only around 60 per cent of people with diabetes treated by the NHS receive eight of the nine recommended care processes that could improve their health. Even fewer – only 36 per cent – achieve all three of NICE’s recommended treatment targets. Failure to provide people with the right care can make their health worse – and around 24,000 people die from avoidable causes related to their diabetes every year. It also costs money: estimates suggest that around £170 million a year could be saved through better management of diabetes in primary care, reducing the need for people to go into hospital.

Another example is when people become ill but their conditions aren’t diagnosed, leading to missed opportunities to intervene early and stop them getting worse. Take chronic obstructive pulmonary disease (COPD), where Department of Health guidance suggests that around one in eight people over the age of 35 has COPD but doesn’t know about it – and more than 15 per cent are only diagnosed after turning up to hospital in an emergency. It’s thought that many opportunities to diagnose COPD are missed, and that better diagnosis and treatment could improve people’s health while saving the NHS money.

More and useful links at:  King’s Fund Blog

Our NHS can’t afford to treat the world!

The Daily Mail comments – On day two of our investigation into abuses of the health service, it emerges that ministers have known for nine months about foreigners charging the NHS for treatment in their home countries. Yet so far, they’ve done nothing about it.

Meanwhile, we reveal how doctors and hospital managers turn a blind eye to health tourism estimated to cost taxpayers up to £3billion a year.

NHS TouristAs a whistleblower admits: ‘Abusing the NHS is the easiest thing in the world.’

While other countries impose rigorous checks, visitors to Britain are routinely granted ‘free’ treatment to which they are blatantly unentitled – with managers only too happy to charge the NHS, so as to avoid having to chase up money from foreigners who can’t or won’t pay.

Indeed, only a quarter of those who abuse the service are flagged up; of these, just 15 per cent pay.

No wonder patients in need of expensive operations flock to Britain, while pregnant women fly in from around the world to have their babies on the NHS.

With unthinking self-righteousness, many doctors who dish out NHS numbers to all-comers say it is not their job to check patients’ entitlements, but merely to heal the sick. Others, disgracefully, accuse whistleblowers of racism.

Yet they’re colluding in a massive fraud against taxpayers, while placing an intolerable burden on an NHS so short of funds that it denies life-prolonging drugs to British cancer victims.

After the launch of our investigation, ministers have at last vowed to close the loophole that allows EU citizens who have never lived or work worked here to charge us for treatment they have at home.

But this can only be the start of the long-promised crackdown on every aspect of health tourism. The job won’t be done until the world gets the message that the ‘N’ in NHS stands for National.

“The scale of this is astounding and it’s a disgrace when UK ‘nationals’ are already seeing major problems with social and health care broadcast day by day”