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I have met clinicians and patients in many parts of England in the last five years and here is a list of the type of questions that cannot be answered.<\/p>\nI have met clinicians and patients in many parts of England in the last five years and here is a list of the type of questions that cannot be answered.<\/p>\n
1.\u00a0\u00a0\u00a0 Is the service for people with seizures and epilepsy in Manchester better than the service in Liverpool?<\/p>\n
2.\u00a0\u00a0\u00a0 Who is responsible for the headache service for people in Warrington?<\/p>\n
3.\u00a0\u00a0\u00a0 How many liver disease services are there in England and how many should there be?<\/p>\n
4.\u00a0\u00a0\u00a0 Which service for frail elderly people in London provides the best value?<\/p>\n
5.\u00a0\u00a0\u00a0 Which mental health service for children with mental health problems improved most in the last year?<\/p>\n
6.\u00a0\u00a0\u00a0 Who is responsible for the quality outcome and value of the service for people with bipolar disorder in Norfolk?<\/p>\n
7.\u00a0\u00a0\u00a0 Who is responsible for the service for women with pelvic pain in Devon?<\/p>\n
8.\u00a0\u00a0\u00a0 How many services are there for people with musculoskeletal disease in London, and which gives best value?<\/p>\n
9.\u00a0\u00a0\u00a0 Is the variation in outcome heart failure increasing or decreasing?<\/p>\n
10. Who is responsible for publishing the annual report on care for people with Parkinson\u2019s disease in England?<\/p>\n
Forget the names, you can put any name of almost any health problem and any place in any question and still not answer it, so here are some generic questions:<\/p>\n
1.\u00a0\u00a0\u00a0\u00a0 Is the care for people with XXXX better in A than in B?<\/p>\n
2.\u00a0\u00a0\u00a0\u00a0 Who is responsible for the care of people with WWW for the population of D?<\/p>\n
3.\u00a0\u00a0\u00a0\u00a0 is the variation in outcome for ZZZZZ increasing or decreasing?<\/p>\n
4.\u00a0\u00a0\u00a0\u00a0 Is the service for people with TTTTT improving in E?<\/p>\n
5.\u00a0\u00a0\u00a0\u00a0 How many population based local services are there for frail elderly people in YYYY and who is in charge of each of them?<\/p>\n
It seems inconceivable that we cannot answer these simple questions. We can answer questions about individual patients. We can answer questions about the service that is provided by institutions, for example the number of people attending respiratory clinics in a particular hospital, and we can of course answer to the nearest pound details about the real estate, but we cannot answer these simple questions.<\/p>\n
As the going gets tougher we need to get more value from resources and we will only do this by having population based accountable integrated services. I am very confident that we will be able to answer the above questions within five years, but then again I have been very confident about this for the last 30 years. (1)<\/p>\n