Dear Editor
I read with great sadness your opinion piece (1) where the author shares shocking inside clinicians view that they do not believe and have lost trust in the NHS and its ability to take care of them and their loved ones. The health of the NHS has been raised before with the Guardian publishing letters under the title “Tory underfunding has put the NHS on death row” (2). It has been well articulated in the pages of the BMJ how the COVID pandemic pushed the NHS to its death bed (3). There has been suggestion on the imminent demise of the NHS (4) and the possible reasons for it. The BMA has argued that it is imperative to reform the NHS pay review body to solve the staffing crisis (5).
To address the ongoing crisis the government recently announced two key interventions. The first one is to address system’s inability to discharge clinically optimised patients into the community through the £500 million “Adult Social Care Discharge Fund” (6). Furthermore, in January this year the government came up with its delivery plan for recovering urgent and emergency care services (7). This was an attempt to shore up struggling care sector and solve the crisis in emergency care. According to health leaders discharge fund initiative is too little and too late (8) and I questioned (9) whether splashing the cash is the right answer to solve the NHS and Social Care permacrisis. There appears to be green shoots on the horizon with ambulance handover times improving (10).
With doom and gloom all around (11) I want to reflect on an uplifting story using a case study approach from your own pages. You recently reported on the findings from the Care Quality Commission (CQC) inspection of Norfolk and Norwich University Hospital (12). I felt your coverage was very balanced and as it presented both negative and positive results of the inspection. The CQC report (13) make sombre reading. An unannounced inspection was carried out on 23rd of November 2022 when the NHS was in crisis in response to the concerns about safety and quality of services. Under the heading is the service caring CQC reports “Conversations with staff demonstrated that they put patients at the heart of everything they did. Staff were focused on providing the highest quality care possible, despite the challenges that they were facing. This was confirmed through our observations of care”. The report added “Staff were doing their best to provide the highest quality care possible”. CQC report on Colchester General Hospital published yesterday reported “Staff were discreet and responsive when caring for patients. We saw staff took time to interact with patients and those close to them in a respectful and considerate way. Patients said staff treated them well and with kindness. All patients we spoke with told us they had been treated well” (14). I salute and applaud colleagues in Norfolk and Colchester hospitals and across the wider NHS who look after their patients with great care and compassion under very testing circumstances. An organisation is only as good as its staff and we are very lucky to have such caring and committed staff.
Despite all the pressures facing the NHS, the compassion and care shown by NHS colleagues lives on and it is premature to write off the NHS. With commitment and dedication shown by its staff the NHS will survive and thrive for the next hundred years. We may lose confidence in it, but we should not underestimate the public’s support to it and the NHS’s ability to respond and rise to the occasion.
Dr Padmanabhan Badrinath, Retired Consultant in Public Health Medicine
Disclaimer: The views expressed here are the professional views of the author and in no way represent the views of any organisation the author has been associated with at present or in the past.
References:
1. Mathew R. Rammya Mathew: This NHS crisis is unlike any we’ve known BMJ 2023; 380 :p210 doi:10.1136/bmj.p210.
Available from https://www.bmj.com/content/380/bmj.p210
2. Letters. Tory underfunding has put the NHS on death row. The Guardian [Internet]. [cited 2021 Dec 30]. Available from:
https://www.theguardian.com/society/2021/dec/30/tory-underfunding-has-pu…
3. McLellan A, Abbasi K. The NHS is not living with covid, it’s dying from it BMJ 2022; 378 :o1779 doi:10.1136/bmj.o1779.
Available from https://www.bmj.com/content/378/bmj.o1779
4. Kennedy I. The NHS dream is dying. Can Britain have a grown-up conversation about its national health service? The New
European [Internet]. [cited 2022 Dec 8]. Available from https://www.theneweuropean.co.uk/the-nhs-dream-is-dying/
5. Sharma V. The NHS staffing crisis cannot be resolved without reform of the doctors’ pay review body BMJ 2023; 380 :p151
doi:10.1136/bmj.p151. Available from https://www.bmj.com/content/380/bmj.p151
6. GOV.UK. Guidance Adult Social Care Discharge Fund. Department of Health and Social Care [Internet]. [Updated 2023 Jan
5] Available from https://www.gov.uk/government/publications/adult-social-care-discharge-fund
7. NHS England. Delivery plan for recovering urgent and emergency care services. Department of Health and Social Care
[Internet]. [cited 2023 Jan ] Available from https://www.england.nhs.uk/wp-content/uploads/2023/01/B2034-delivery-
plan-for-recovering-urgent-and-emergency-care-services.pdf
8. Iacobucci G. Funding to ease discharge delays is “too little, too late,” say health leaders BMJ 2023; 380 :p60
doi:10.1136/bmj.p60. Available from https://www.bmj.com/content/380/bmj.p60/rapid-responses
9. Badrinath P. The NHS and Social care Permacrisis – Is splashing the cash the right answer? BMJ [Internet]. [cited 2023 Jan
11] Available from https://www.bmj.com/content/380/bmj.p60/rr
10. Badrinath P. Christmas 2022 – A Christmas of doom and gloom or a Christmas of Hope and Joy. BMJ [Internet]. [cited
2022 Nov 17] Available from https://www.bmj.com/content/379/bmj.o2740/rr
11. NHS England. NHS weekly winter operational update for the week ending 29 January 2023. [Internet]. [cited 2023 Feb 2]
Available from https://www.england.nhs.uk/2023/02/nhs-weekly-winter-operational-update-…
january-2023/
12. Wise J. Staff shortages are blamed for Norfolk hospital’s poor rating from regulator BMJ 2023; 380 :p261
doi:10.1136/bmj.p261. Available from https://www.bmj.com/content/380/bmj.p261
13. Care Quality Commission. Norfolk and Norwich University Hospital. [Internet]. [cited 2023 Feb 1] Available from
https://api.cqc.org.uk/public/v1/reports/45262b72-ea90-43be-8b7d-d856e7e…
14. Care Quality Commission. Norfolk and Norwich University Hospital. [Internet]. [cited 2023 Feb 2 ]
https://api.cqc.org.uk/public/v1/reports/6ebaba9b-335b-4df1-be67-09564c3…
NHS may be in the ICU, but the care and compassion of its valiant warriors lives on