Steven West, Chair of the West of England AHSN and Vice-Chancellor of the University of the West of England, explores how we can come together to create solutions that are sustainable, affordable and acceptable to all NHS stakeholders?
Our NHS and social care system are one of the country’s greatest assets. They are a fantastic gift that we give to each other and one that is envied across the globe.
However, the world is changing and the need for us to continue to review, reset and reinvent our health and social care system has never been greater. The demands we are placing on it are huge and it is beginning to fail.
Whilst this is, in part, a reflection of us all living longer and increased potential through new technologies and new drugs to diagnose and treat more and more conditions and diseases, we have to face up to the challenges that this brings. More people are accessing services and there is often greater demand than we are currently able to meet.
The creation of Academic Health Science Networks by NHS England back in 2013 was an attempt to create partnerships to help us to better collaborate, innovate, disseminate and spread learning and best practice. It was done at a critical time as much of the infrastructure that had formerly been in place to facilitate this kind of learning and sharing had been dismantled in successive reorganisations. The uncomfortable truth was that the system had become fragmented, staff and expertise had been lost, resulting in us facing significant financial, social and staffing challenges.
Recent media reports have highlighted yet again just how fragile our health and social care eco-system is. It is difficult to ignore the reports when so many dedicated staff who have committed their whole lives to the service are signalling we have a problem. For those of us in the system it is heart-breaking to watch. We are working hard yet no matter how hard we try we are not gaining enough ground.
This is made worse when you listen to reports that seek to apportion blame in one direction or another. We are one NHS. The problems we face are not just about the funding – it is also about the structures, the interfaces, the mechanisms for collaboration, and the relationship between the government, the professionals and importantly the citizens. We all have a stake in this and it is important that we seek a collective solution to create the integrated and joined-up services that are required 365 days a year, 24 hours a day.
So how can we help, how can we get beyond the current ‘blame, denial and shouting’ culture that is so evident at the moment? How do we come together to really create solutions that are sustainable, affordable and acceptable to all the stakeholders? One of the answers is to look at what currently works. Where have we cracked some of this and can learn and spread this knowledge?
The West of England Academic Health Science Network (AHSN) is one of 15 AHSNs across England that has been innovating and spreading best practice. Each AHSN will have examples of best practice and innovation that have improved services locally. Our challenge now is spreading these beyond our local geography and partnerships.
Recently I read with sadness and frustration reports of critically ill patients dying on trolleys in over-crowded Emergency Departments. Sadly this is not new. But there are things we can, and have done, that is reducing the risks and has even eliminated the problem in some of our hospitals.
I want to shout about the National Early Warning Score (NEWS), which the West of England AHSN is supporting all our healthcare providers in the region to adopt and spread.
I urge our political and clinical leaders to stop arguing and blaming each other, and to wake up and work with us to spread this approach to every Emergency Department, every Ambulance Service, and every Community and Primary Care setting across the country. No more ‘lost’ critically ill patients need to die on trolleys for lack of basic care.
In the Emergency Departments in the West of England we now use NEWS alongside an Emergency Department safety checklist which should be universally adopted too.
This means care can be monitored across every handover throughout the system. This will ensure time is not wasted, and instead we are saving lives.
We have saved lives! We have a sound evidence base, training materials, toolkits and are happy to share and spread. Let’s not waste time and see more patients die needlessly. We can and we should adopt this approach and show we can spread best practice quickly, efficiently and safely.
Yes we can, yes we should, yes we have!