Prof Parag Singhal, MD, MPhil, FRCP, FACP
Founder Director Our NHS Our Concern
Former Divisional Director Emergency Care
Specialist Advisor CQC
"NHS needs to be made sustainable and it is not about how much money but how we spend our money. Ournhsourconcern, a truly independent think tank offers a different narrative."
‘’Our NHS Our Concern’’ is a think tank which offers a new narrative for the NHS by embracing practical, innovative and cost-neutral solutions to the current crisis in morale, healthcare provision and the dominant ethos. Our values are the founding principles of the NHS: care free at the point of need, available to all, and a great duty of state, where the measure of success is health or living well with a long-term condition.
Our mission is to reduce the "unnecessary practices" and develop and promote efficiencies in the organisation and delivery of UK healthcare.
Our vision is an efficient, effective, equitable NHS.
The budget allocated to the NHS has seen a significant increase since it was founded. Last year the NHS spent £156 billion, 12 times more than 70 years ago. It means today about 30p in £1 spent on public services goes on Health. It was inevitable that spending has slowed down due to the national austerity policy and the global financial crash. We therefore, have to acknowledge that resources are always going to be finite.
There have been increases in the number of doctors and nurses but the NHS is still facing huge staff shortages; 40,000 nurse vacancies and 9,000 medical vacancies which are not just due to a lack of funding. The situation is made worse with rising demand on existing services and staff. For example, the impact of an ageing population where the average 65-year-old costs the NHS 2.5 times more than the average 30 year old. The key standards are not being met. The 4-hr target for emergency care, Referral to Treatment Time target for elective care and Cancer treatment targets across the whole of the United Kingdom are being missed.
The current state of the NHS is attributed to underfunding and lack of staff and various minds and authorities are trying to grapple with these challenges by exploring integrated systems, acquisitions, mergers and transformation projects costing millions and billions across different regions to improve the efficiency.
The problem of increasing financial deficit, worsening quality and workforce crisis is compounded by low morale of the staff which is the most precious resource in the NHS but largely ignored. Public and staff are led to believe that more funding and more and more staff will solve the crisis the NHS is facing. There is no doubt that NHS will continue to need increased funding year on year but the real question is whether the current funding is being used wisely and effectively.
Our NHS Our Concern is offering a different narrative based on proposing solutions involving front line staff and aimed at avoiding wastage which remains a huge problem in the NHS. Front line staff have the ideas and it is imperative that these ideas are captured, fine-tuned and provide the basis of health care delivery. Our aim is to provide quality care within finite resources, minimising the need for more staff. We are promoting a new narrative towards a change in culture, which promotes the role of frontline staff in generating ideas and driving actions.
We believe that there is a need to focus on key areas including: low staff morale and growing sense of not being valued; loss of effective team functioning; lack of accountability; low productivity of key staff; and ineffective engagement with the public. There are common sense proposals, mostly cost neutral, to tackle low morale and a growing sense of not being valued. We also believe that there is a need to transform the current model of A&E care and to create more space and capacity to effectively care for the frail elderly. We plan to draw attention to the continued waste of NHS funds, such as the excessive and ineffective use of external consultancy companies.
We have a range of solutions that have been developed in collaboration with front line staff. The following practical solutions are either cost neutral or require minimal extra resources. These are summarised below, but more detailed descriptions are available for the interested reader.
1. A new model of care in the A&E departments changes the pattern of working resulting in the removal of duplication of work, faster triaging of patients and improved training of junior staff and better patient experience.
2. Establishing ward-based teams; this will immediately create a sense of belonging, significantly reduce low morale, promote local accountability and meaningful sense of a team.
3. Practical ways of creating more spaces for the care of the frail elderly in a short time are described in a detailed paper.
4. Campaigning for all NHS Boards to be accountable. This change alone will dramatically bring about more efficient, transparent and accountable governance. Trusts will become patient and staff centre and will bring about the culture change.
5. To promote assessment of productivity of all key NHS staff as a mandatory practice; an activity currently missing.
6. To involve the public in an understandable manner by providing important information of how money is spent and how different activities cost as part of public information. This will help us to inform public expectations and reduce waste.
7. We will campaign against the continued use of management consultants as part of waste reduction. As a matter of priority, we will be working with other organisations to identify sources of waste and how to correct them.
We have received considerable support from several organisations and individuals. It is our intention to continue to work with these organisations to further our aims, in addition to lobbying MPs. Organisations to date are BMA, BAPIO, BIDA, Doctors for NHS and Policy Exchange.
We firmly believe that the media will play a crucial role in making our solutions known to the public and public leaders.
We continue to attract members from all sections of society, and we welcome as members anyone who wishes to work with us to further our aims.
To campaign for a better patient and staff orientated NHS funded Healthcare service.
To campaign for a transparent and prudent use of NHS funds at all levels.
To campaign for unification of primary and secondary care system
To campaign for closer collaboration between the NHS, social services and public health
To seek the support of and collaborate with other organisations who are promoting the effectiveness, efficiency and preservation of the NHS
To propose, support and collaborate on practical solutions to the problems identified
To promote awareness of how NHS money is spent including the cost and value of services provided.
To listen to and act as a conduit of the vision and experiences of the users and staff of NHS.
This organisation will not seek to belong to any political party