{"id":12634,"date":"2011-11-16T12:55:58","date_gmt":"2011-11-16T11:55:58","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=12634"},"modified":"2011-11-16T12:56:02","modified_gmt":"2011-11-16T11:56:02","slug":"chris-ham-commonwealth-fund-survey-if-the-nhs-is-doing-well-why-is-it-changing","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2011\/11\/16\/chris-ham-commonwealth-fund-survey-if-the-nhs-is-doing-well-why-is-it-changing\/","title":{"rendered":"Chris Ham: Commonwealth Fund survey: If the NHS is doing well, why is it changing?"},"content":{"rendered":"

\"\"<\/a>The Commonwealth Fund\u2019s survey of the experience of adults with complex care needs<\/a>, published last week, paints a remarkably positive picture of the NHS. The results show that, of the eleven countries surveyed, the number of patients reporting that they did not use services because of concerns about cost was lowest in the United Kingdom. And while the absence of user charges in the NHS (with the exception of some prescription charges) means that this finding is not surprising, other results are equally encouraging.<\/p>\n

For example, the United Kingdom performed best on the co-ordination of care for patients, patient safety, and the way in which patients are engaged in their care. It also performed very well on patient\u2013doctor communications and shared decision-making<\/a>.<\/p>\n

The survey \u2013 which included more than a thousand respondents from the UK \u2013 also explored whether patients had a regular doctor and a medical home, defined as a regular place of care familiar with patients\u2019 needs. The United Kingdom came out on top on this measure, reflecting the well-established system of primary care in the NHS, with only Switzerland approaching the same level of response.<\/p>\n

At a time when the NHS has been in the headlines for the wrong reasons \u2013 including well-publicised examples of poor quality hospital care for older people<\/a> \u2013 the survey provides welcome reassurance that many patients are receiving timely care of a high standard. It also underlines that the grass is not always greener on the other side. If other countries, with more generously funded health systems than the NHS, are struggling to match our achievements, it is clear that delivering the right care in the right place at the right time is a universal challenge.<\/p>\n

In reading the survey results, I was reminded of The King\u2019s Fund\u2019s response to the coalition government\u2019s White Paper on NHS reform, Equity and excellence: Liberating the NHS<\/a>. In that response, Anna Dixon and I argued that in the light of improvements in performance in the past decade, further reform needed to be proportionate to the outstanding problems. Then, as now, we were concerned that the wide-ranging organisational changes underway were high risk and could detract from the core business of improving patient care.<\/p>\n

To make this point is not to argue for the maintenance of the status quo. Rather, it is to make the case that any new reforms must tackle areas in which the NHS clearly needs to improve, and to enable other priorities \u2013 like rising to the Nicholson challenge of finding \u00a320bn in efficiency savings \u2013 to be addressed. Readers of the Commonwealth Fund\u2019s survey, especially those from other countries, must be puzzled as to why radical changes are needed when the NHS appears to be doing so well.<\/p>\n

See also:<\/p>\n