It’s easy to say that the NHS should do better, not more – but what does that actually mean? Well, it means investing resources (money, people, buildings…) in healthcare which delivers outcomes that people both want and need. Unlike many private organisations whose objectives may be a little simpler (e.g. maximising shareholder value, obeying the law, and promoting reputation), the NHS has mutiple (and often conflicting) objectives, whilst it is constantly exhorted to improve quality and minimise cost. Cost is easier to measure, but there are just a few challenges with “quality.” First, there is not a widespread agreement on what it means and secondly, we rarely have the information systems (or even the culture) to know exactly how money and other resources translate into high quality outcomes (valued by both patient and professional).

Let’s be positive, opportunistic, and ensure we do not waste the current crisis. Let’s throw brains and application at the issues facing the NHS, not just money. Charlie Tomson, a distinguished renal physician from Bristol, England has put it better than most by reminding us that more is not necessarily better (in the same way as we have it, think of prosperity without growth) “Sustainability is the seventh dimension of quality of care, alongside safety, timeliness, effectiveness, efficiency, equity, and patient experience. It is important to realise that working to improve sustainability will seldom be in conflict with the other dimensions; in particular, low carbon healthcare is likely to improve cost efficiency and patient empowerment.” Let’s get measuring and delivering…