Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Divide between expectation and service ‘threatens to unravel NHS’

  • 5 Comments

An emerging, “terrible” divide between what patients expect and the services nurses and doctors are able to provide threatens to “unravel the NHS from the bottom upwards”, an organisation representing primary care groups has warned.

Bureaucratic and financial pressures are beginning to cause a “serious” fracture between patient demands and what clinicians can do for them, claimed NHS Alliance chair Michael Dixon.

“We must learn once again to allow all our professionals to be professionals. Not zombies. Not chickens dancing to the latest target”

Mike Dixon

Speaking today at the NHS Alliance’s conference Breaking Boundaries and Beyond, Dr Dixon said he believed this “ever-present” danger had been partly addressed following chancellor George Osborne’s autumn statement yesterday, in which he announced an extra annual £2bn for the NHS from next year.

However, Dr Dixon warned delegates that the health sector must still “act quickly” to avoid this collapse of the NHS on the frontline.

He said: “The combined effect of bureaucratic and financial pressures is beginning to create a terrible divide between what frontline clinicians feel able to deliver and what patients have been led to expect.

“I do think we are very dangerously close to the brink. I’ve never seen this happen at the frontline before… It’s something we must avoid,” added Dr Dixon.

In his speech to delegates, he also called for an end to “heroics” in primary care, in which he claimed some clinicians were now working up to 14-hour days.

“It threatens our ability to provide safe and consistent patient care, it affects our family lives, it affects morale and job satisfaction. We became clinicians in order to provide care, to diagnose and heal – not to push paper around late into the night,” said Dr Dixon.

To address these problems, he pointed to NHS England’s Five Year Forward View and its focus on integration and creating additional resources for out of hospital care.

In addition, he called for earmarked funding for training practice nurses, community nurses and GPs “to get things moving at scale and at speed”.

NHS Alliance

Michael Dixon

“We must learn once again to allow all our professionals to be professionals. Not zombies. Not chickens dancing to the latest target or financial incentive,” he said. “Then we need to train a sufficient primary care workforce to meet the opportunities for extended primary care.”

New relationships between health professionals in primary and secondary settings and with their patients are also required, he said, adding that delegates should not focus entirely on budgets for the new models of care being proposed for the future.

“A love for what you do, time to deliver both care and compassion, time to listen, time to be kind, time to discover a new relationship with your patients. These are what matter most, what have always mattered most and which will continue to matter most in the kind of NHS that we will create,” said Dr Dixon.

  • 5 Comments

Readers' comments (5)

  • I couldn't agree more about the gap between public expectations and service reality, however, as the 'real reality' is that there will never be enough money to meet demand, we need to start managing expectations.

    Unsuitable or offensive? Report this comment

  • Being a retired practice nurse of 17yrs I now understand the worries of people. I now have aches and pains and think will the doctor be able to do anything about it. As an ex nurse I think what can be done-- nothing other than anti inflammatories and painkillers but the non medical minded person thinks the GP can work miracles. The fact is we must start thinking is it wise to try to keep people alive for ever.

    Unsuitable or offensive? Report this comment

  • There has for some considerable time been a vicious media campaign directed , in particular, against GP's.

    The GP service is now allocated approx 8% of NHS resource. GP's are almost impossible to recruit and young medics do not wish to train for a specialty which will expose them to impossible to meet demand and vicious criticism from the press and public alike.

    The population for various reasons has increased massively which has resulted in all public services being overwhelmed.

    Cut back immigration and do not (emergencies excepted) provide "free" health care to those who do not qualify . If this is done there may , once again be space in the schools and easily obtained GP appointmets.

    Unsuitable or offensive? Report this comment

  • michael stone

    'He said: “The combined effect of bureaucratic and financial pressures is beginning to create a terrible divide between what frontline clinicians feel able to deliver and what patients have been led to expect.'

    That is quite a lot of this problem - the 'patients have been led to expect' part.

    Policiticians will almost never admit it, if they have 'made the NHS worse' - so patients expect 'the NHS to do what it says on the tin' and the 'label on the tin', which is being printed by politicians, doesn't really reflect the conents. That isn't the same as some patients 'expecting too much'.

    I always thought, that the PCT to CCG change, was so that the politicians would be able to say, if the NHS got worse and increasingly cash-strapped', "That isn't our fault - patients and their GPs decided how to spend the money, not us".

    Unsuitable or offensive? Report this comment

  • It has nothing to do with immigration. I work in an area where there are very few immigrants, but the problems are exactly as Dr Dixon describes.

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.

Related Jobs