What has gone wrong in the NHS? Part three: improving the prognosis

Concluding her series of articles on the current state of the NHS, RCP president Professor Jane Dacre encourages doctors to take control and make decisions together that will bring about progress despite government underfunding.

It is clear from the lack of government action during the winter NHS pressures that no-one is now going to help, no-one is coming to the rescue, and no-one is going to provide more funding. In March, chancellor of the exchequer Philip Hammond chose not to give the NHS a penny more in the spring budget. I am grateful for the increase for social care provision, which I hope will go towards supporting people to leave hospital, but has been referred to as only a sticking plaster.

As with our patients, we are leaning towards self-management – the more I think about it, the more I think that we are going to have to come up with the answers ourselves. We need to involve physicians and patients in coming up with solutions. Most of the truly innovative transformations in care over the past decade have been developed by doctors – we need to harness the experience and intellect of physicians and patients working together, backed by the independence of the RCP as a royal college.

Most of the truly innovative transformations in care over the past decade have been developed by doctors.

Professor Jane Dacre, RCP president

As physicians, our voice can be powerful – we all need to lift our heads above the parapet, above the day-to-day grind. I know that we are struggling to maintain morale, but that will improve if we take more control of our situation.

Be those decision makers – push your trust into finding time for consultants and trainees to take part in local decision making and in sustainability and transformation plans (STPs). Talk to your colleagues and support each other to ask those uncomfortable questions on behalf of patients. Sort out your ward or your clinic if it isn’t working well. You can do it! Don’t look back in 5 years’ time and regret you hadn’t been more involved. 

What is the prognosis?

Progress will only come if we refuse to accept the situation and work together locally and nationally to make it better. If we do that, we become part of the solution and improve the prognosis.

So my message to you is:

  • What can you do, as a physician, to improve care on your ward, in your trust, for your patients?
  • How can you get involved in local service planning via your STP?
  • How can you involve your patients to do the same?
  • How can your local managers support you to do that?

Be the do-ers, not the done-to. Be the leaders, not the led.

If we physicians can’t, who can? If we physicians won’t, who will?

Professor Jane Dacre, RCP president

This text has been adapted from Jane's address to RCP members and fellows on 16 March at Medicine 2017: RCP annual conference.

The RCP launched Mission: Health in autumn 2016 to campaign for concerted national and local action to preserve the NHS and ensure that it can continue to provide the gold-standard care that patients deserve.

What has gone wrong in the NHS? Part one and part two are available to read now.