Editorial
| Date | 01 November 2007 |
| Published date | 01 November 2007 |
| DOI | https://doi.org/10.1108/17556228200700014 |
| Pages | 2-3 |
| Author | Ian Baguley |
| Subject Matter | Health & social care |
2
Editorial
October has seen the publication of a number of key
reports, two of the most interesting are Our NHS, Our Future:
NHS next stage review byLord Darzi (2007) and the second,
AClinical Vision of a Reformed NHS jointly produced by the
Joint Medical Consultative Council (JMCC) and The NHS
Confederation (2007). Both of these reports focus on
health care in the round in the UK, not just mental health.
However, both have some important things to say that
have implications for mental health, education and
training, and workforce planning and development.
The Darzi (2007) interim review reports on the results
of a series of interviews with NHS organisations and
professionals, and service users and members of the public
as part of a consultation exercise. Darzi highlights some
interesting challenges for the current health care system:
health and social care needs to be better integrated and
despite the growth in the numbers of general
practitioners, there is poor distribution leading to
increased health inequalities. Patients complain of feeling
neglected, not being respected, not being listened to and
feeling unsafe on mixed sex wards.
Darzi (2007) goes on to suggest some major structural
changes to the current health care system. First that
health and social care, along with housing, local planning
organisations etc. need to work more closely together to
deliver a system that will address health inequalities.
Second, that government departments work more closely
together to ensure that policy between departments is
consistent and designed to support change rather than
confound it. Third, that primary care services (GP
practices) should operate more flexible services that are
available in the evenings and at weekends, and suggests
that primary care centres should open from 8am until
8pm and be available on Saturdays and Sundays.
The NHS Confederation/JMCC report (2007) presents
the results of a comprehensive survey of NHS consultants’
views on the current state of the NHS and their vision of
what the NHS could look like. Although this is verymuch
an aspirational report it does emphasise the gap between
where we are now, and I refer you back to the service user
views, and how consultants would like the health care
system to operate. This is best summed up through the
‘Design rules’ that the report recommends as the
foundations to good service delivery.
The values that underpin the system
Doctors have very strong personal values and see
medicine as having a moral purpose to care, heal and
make a difference. In their everyday work they are
committed to integrity, compassion, altruism, continuous
improvement, excellence and working in partnership
with the wider health team.
Getting the basics right
Seeing the system from the patient’s perspective and
providing care in a high-quality, clean, quiet and
comfortable environment.
The design of the system doctors work in
Doctors want to work in a system rather than a
disorganised, poorly co-ordinated and disparate set of
services that do not connect.
The nature of relationships with patients
The wish to create services that are timely and highly
responsive to patients’ needs and the importance of
patient feedback.
Interactions with colleagues and the organisation
Working in a system of teams and one that promotes
professional interaction and high-quality interpersonal
relationships.
Learning, measurement and feedback
The system needs to be based on continuous learning and
the analysis of empirical data, using evidence where
possible. More data about performance is required.
The way change is managed
Goals and targets for change need to talk about patients.
Leaders of change need support and it is important to
establish a culture of working together.
One doctor talks about respecting patients’ time and
treating it as valuable. He asks what is the point of asking
apatient to put aside a day of their life, time to get to an
appointment and get home, plus time waiting at an
outpatients clinic, to be seen for a few minutes by an SHO
and told everything’s OK?
Ian Baguley
Editor, The Journal of Mental Health Training, Education and Practice
The Journal of Mental Health Training, Education and Practice Volume 2 Issue 3 November 2007 © Pavilion Journals (Brighton) Ltd
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