Simon's thoughts are a good challenge to orthodoxy in the English NHS,
and orthodoxy in our recent culture is always over-zealously followed
in any case.
One thing though: the press has picked up his 'reversal of policy' in
a misleading way. Simon is not, I assume, suggesting that
small-to-middle-size hospitals stay open as acute/A and E
providers....but is urging that very small (cottage) hospitals be used
for post-acute care and indeed to help avoid acute admissions?
This may be a reversal of policy in some areas, but builds on what
North Staffordshire, for example, has been aiming for (yet failing to
implement!)
It is not the reversal of policy which would reverse centralisation of
specialist care and A and E......or is it? Over to you, Simon!
Best to all, Calum
On 02/06/2014, Adam Oliver <[log in to unmask]> wrote:
> Hi,
>
> Simon Stevens, the new head of the NHS and a fellow AAHPN-er, has started to
> outline his vision for the NHS, and has been in the news quite a bit over
> the last week:
>
> http://www.telegraph.co.uk/health/healthnews/10864015/NHS-chief-Simon-Stevens-We-need-cottage-hospitals.html
>
> There's a lot here to comment on, if you wish. Simon seems quite critical of
> the targets introduced by Labour. I guess some of his criticisms might be
> valid, but, in terms of reducing waiting times, they worked. I think it's a
> bit misleading to group all target initiatives together as a single
> initiative. It always seemed a mistake to me that the Labour Party didn't
> highlight their success in reducing waiting times at the last election -
> possibly the most successful NHS initiative of the last 25 years.
>
> Also, Simon seems to like the idea of financial incentives to motivate, for
> example, weight loss. Strictly speaking, these are not nudges, but aside
> from that, they don't seem to work in a sustained sense. They've worked for
> Simon himself. But we should weigh him again in a couple of years.
>
> Anyway, his main call is for a greater focus to treat people, particularly
> the elderly, in local community hospitals. I guess, aside this, it might be
> good if local governments, pressurised by central government, ceased the
> unprecedented slashing a community social care spending.
>
> Best,
> Adam
>
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