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Current State And Future Of The NHS

CURRENT STATE AND FUTURE OF THE NHS – Report from the Parliamentary Group for Integrated Health

Advances in medical technology have meant longer life spans, and LIFELONG CONDITIONS are now the problem faced, and what is costing the NHS – Arthritis Mutagens, Cystic Fibrosis… just to name a few. The vast majority of the elderly are healthy, only the minority are ill. What GPs are seeing mostly, now, are people living with multiple conditions. The NHS is now beginning to see an insight into Mental Health and what effects lifelong and longstanding conditions has on it. It is now accepted and acknowledged in mainstream medicine that Mindfulness and other CAM based therapies can have positive effects on Mental Health in these and other situations, and the focus that loosely floated around was how CAM could be the saviour to the NHS, if only it was used by GPs. Speaking was a gentleman who trained originally as a vascular surgeon, then a GP. I apologise that I never caught his name. The meetings are incredibly fast paced, and if I miss something, I must carry on! I really enjoyed his definition of a 100% healthy person: Someone who has been investigated insufficiently. This has a double edged sword meaning, though, and he jumps straight into a surgeons role in today’s NHS. “Skills to address disease and to actually be ABLE to address Dis-ease are very different.” Reminding that most surgeons think along the lines of ‘let me find a reason to operate. A Great surgeon knows when NOT to operate.’ “The structure to actually address problems has not changed for years, and we are seeing a gap between the roles of general surgeons.” “Today we are seeing surgeries like Elective Knee surgeries, Shoulder and Back surgeries, and other areas of Hyper-specialisation. General Surgeons are now a thing of the past. Conventional Medicine is now showing an inability to treat people, and an Explosion of Complex Care.”

Did you know?

  • There are 325,000 care and residential homes in the UK.
  • 50% of people report they don’t adequately get the care they hoped for.
  • In a recent review of 71 people, 140 medications prescribed by GPs were stopped by specialists who deemed them unnecessary.

“Many GPs were happy with this result because they aren’t happy about it either. They are forced to prescribe on rules and Guidelines (Including the NICE Guidelines). Society expectations have changed, though. Access of what people want, how they want it, and when they want it. Internet has changed everything because of Dr. Google. People are coming in knowing what they want and the approach they would like to take. They are not given the freedom of that option though.” The system and communication is rigid. “I can email my bank, and even a prisoner; but not my GP. Health care system needs to embrace technology to give people control (if they want it) and better communication. This would reduce urgent care unit need by a significant amount! This will provide continuity of care; the public will have access to their own records; all of their care will be built around them and their needs and they would have a trusted advisor.” “Evidence-based medicine is currently being used to conform practices by Guidelines.” As a complementary therapist myself who has worked within the NHS Privately, this sentence really sums up my personal reservations as to why I would never accept privatised work again. I can tell you first hand that everything is incredibly black and white. You are expected to treat everyone in the exact same manner, focusing on the “diagnosis” and not the person. Communication is poor, and everything is very impersonal. Of course, this method of practice does not resonate with me, nor do I wish to be restricted in my work that way. This is a very important fact to consider for all practitioners of CAM when considering wanting to work within the NHS, as well as wanting to be a part of its Guidelines. As was stated above “GPs aren’t even happy.” “These are supposed to be guides, not god; Guidelines, not tramlines.” We move on from Primary care, into Emergency. “Over 75’s fill 46% of hospital beds, and every (un)emergency call is considered a failure of the system. We CAN have a great Health System, but without a continuous chain of information, it just doesn’t work.”

A recent survey asked: What kind of care do you want?

  • I want people who understand me and put ME in control of my own health
  • Person Centred Care
  • Not Condition Based

“To move forward, we need to think about the components of Health, because Health is Political. An important driver is politics because policy emerges from it.” This includes:

  • Measurement around individuals
  • Personal Commissioning Agenda

“We all know what is WRONG with the NHS, but not what is right. We only measure activity by 5 years. Little of this is from communities but recorded daily in hospitals. Primary care is only 8% of the Budget.” “How do we make changes? Technology is the key! NHS needs to offer more incentives for wellbeing! Use technologies to reduce in-clinic time. Empower Patients and use Professionals as a guide. NHS needs to see Specific Professionals, Generalists, and Specialists working together.” “Change Patient Behaviour, Change GP Behaviour.” “What needs to be understood, is that GP surgeries are run like a business. Money goes into their primary care pot, and to offer anything outside of that pot affects their paycheque.” He then told a story of how he offered PREVENTATIVE Asthma tests for free to the public and on his OWN TIME at the weekends. He was asked by the other GPs in the surgery to stop because it was costing them money. “Commissioning should always be about Quality Improvement.” Margaret Coats from CNHC points out that: “The challenge is to get funding. Funding is at a National Hospital Focus, and we would have to close hospitals for that funding. We would have to show there is no activity. The NHS cannot invest in areas of care that do not have the evidence, so why isn’t there more evidence being produced by Primary Care? In CAM, we should be using CNHC for Commissioning to create that evidence.” “Modern Medicine should be about people working together to benefit an individual. The current policy is driven by a strict set of rules. It is also currently driven by the very wild stresses of people thinking they are immortal. The question should be ‘What Matters Most to you? What if we CAN’T get you better?’” Again, this always goes back to putting help back into the hands of the people. Empowering them to maintain their own health because it is their responsibility above all else. “GPs plain and simply don’t have time for consults like CAM Therapists do. It is in these consults, though, that builds a lasting foundation for patient empowerment. This should be about accountability of care, not a business transaction.” “At the moment, Western Culture is too far left brained with hardly any care for people. A Good Physician treats disease, and great physician treats the person.” If you have any questions or comments regarding this report please put them on our Facebook page or email Brittany at [email protected]

Advances in medical technology have meant longer life spans, and LIFELONG CONDITIONS are now the problem faced, and what is costing the NHS – Arthritis Mutagens, Cystic Fibrosis… just to name a few. The vast majority of the elderly are healthy, only the minority are ill. What GPs are seeing mostly, now, are people living with multiple conditions. The NHS is now beginning to see an insight into Mental Health and what effects lifelong and longstanding conditions has on it. It is now accepted and acknowledged in mainstream medicine that Mindfulness and other CAM based therapies can have positive effects on Mental Health in these and other situations, and the focus that loosely floated around was how CAM could be the saviour to the NHS, if only it was used by GPs. Speaking was a gentleman who trained originally as a vascular surgeon, then a GP. I apologise that I never caught his name. The meetings are incredibly fast paced, and if I miss something, I must carry on! I really enjoyed his definition of a 100% healthy person: Someone who has been investigated insufficiently. This has a double-edged sword meaning, though, and he jumps straight into a surgeons role in today’s NHS. “Skills to address disease and to actually be ABLE to address Dis-ease are very different.” Reminding that most surgeons think along the lines of ‘let me find a reason to operate. A Great surgeon knows when NOT to operate.’ “The structure to actually address problems has not changed for years, and we are seeing a gap between the roles of general surgeons.” “Today we are seeing surgeries like Elective Knee surgeries, Shoulder and Back surgeries, and other areas of Hyper-specialisation. General Surgeons are now a thing of the past. Conventional Medicine is now showing an inability to treat people, and an Explosion of Complex Care.” Did you know?  There are 325,000 care and residential homes in the UK.  50% of people report they don’t adequately get the care they hoped for.  In a recent review of 71 people, 140 medications prescribed by GPs were stopped by specialists who deemed them unnecessary. “Many GPs were happy with this result, because they aren’t happy about it either. They are forced to prescribe on rules and Guidelines (Including the NICE Guidelines). Society expectations have changed, though. Access of what people want, how they want it, and when they want it. Internet has changed everything because of Dr. Google. People are coming in knowing what they want and the approach they would like to take. They are not given the freedom of that option though.” The system and communication is rigid. “I can email my bank, and even a prisoner; but not my GP. Health care system needs to embrace technology to give people control (if they want it) and better communication. This would reduce urgent care unit need by significant amount! This will provide continuity of care; the public will have access to their own records; all of their care will be built around them and their needs and they would have a trusted advisor.” “Evidence-based medicine is currently being used to conform practices by Guidelines.” As a complementary therapist myself who has worked within the NHS Privately, this sentence really sums up my personal reservations as to why I would never accept privatised work again. I can tell you first hand that everything is incredibly black and white. You are expected to treat everyone in the exact same manner, focusing on the “diagnosis” and not the person. Communication is poor, and everything is very impersonal. Of course, this method of practice does not resonate with me, nor do I wish to be restricted in my work that way. This is a very important fact to consider for all practitioners of CAM when considering wanting to work within the NHS, as well as wanting to be a part of its Guidelines. As was stated above “GPs aren’t even happy.” “These are supposed to be guides, not god; Guidelines, not tramlines.” We move on from Primary care, in to Emergency. “Over 75’s fill 46% of hospital beds, and every (un)emergency call is considered a failure of the system. We CAN have a great Health System, but without a continuous chain of information, it just doesn’t work.” A recent survey asked: What kind of care do you want?  I want people who understand me and put ME in control of my own health  Person Centred Care  Not Condition Based “To move forward, we need to think about the components of Health, because Health is Political. An important driver is politics because policy emerges from it.” This includes:  Measurement around individuals  Personal Commissioning Agenda “We all know what is WRONG with the NHS, but not what is right. We only measure activity by 5 years. Little of this is from communities, but recorded daily in hospitals. Primary care is only 8% of the Budget.” “How do we make changes? Technology is the key! NHS needs to offer more incentives for wellbeing! Use technologies to reduce in-clinic time. Empower Patients and use Professionals as a guide. NHS needs to see Specific Professionals, Generalists, and Specialists working together.” “Change Patient Behaviour, Change GP Behaviour.” “What needs to be understood, is that GP surgeries are run like a business. Money goes into their primary care pot, and to offer anything outside of that pot affects their paycheque.” He then told a story of how he offered PREVENTATIVE Asthma tests for free to the public and on his OWN TIME at the weekends. He was asked by the other GPs in the surgery to stop because it was costing them money. “Commissioning should always be about Quality Improvement.” Margaret Coats from CNHC points out that: “The challenge is to get funding. Funding is at a National Hospital Focus, and we would have to close hospitals for that funding. We would have to show there is no activity. The NHS cannot invest in areas of care that do not have the evidence, so why isn’t there more evidence being produced by Primary Care? In CAM, we should be using CNHC for Commissioning to create that evidence.” “Modern Medicine should be about people working together to benefit an individual. The current policy is driven by a strict set of rules. It is also currently driven by the very wild stresses of people thinking they are immortal. The question should be ‘What Matters Most to you? What if we CAN’T get you better?’” Again, this always goes back to putting help back into the hands of the people. Empowering them to maintain their own health because it is their responsibility above all else. “GPs plain and simply don’t have time for consults like CAM Therapists do. It is in these consults, though, that builds a lasting foundation for patient empowerment. This should be about accountability of care, not a business transaction.” “At the moment, Western Culture is too far left brained with hardly any care for people. A Good Physician treats disease, and great physician treats the person.” If you have any questions or comments regarding this report please put them on our Facebook page or email Brittany at [email protected]

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