Now I know why NHS is ‘not fit for purpose’
Management Consultants lack common sense 

What happened when this novice entered NHS minefield                                                                             NHS                                                                              It’s no use moaningat bad NHS service – we need to TELL them what WE want.

So I kick-started myself and volunteered for a local NHS committee as a ‘Patient Representative’.

I found myself on two committees.  Both running concurently, so for first few meetings I could never work out which one I was in.  Both were run by hired-in ‘Management Consultants’ , appointed by the NHS – at taxpayers’ expense.  And talking incomprehensible jargon to this lay member.

Until I got my feet under the table and felt confident to ask for explanations, I hadn’t a clue what we were talking about!

Thanks to a wonderful book called ‘NHS for Sale‘ – and their explanations of NHS jargon – all became clearer, and gave me courage to question.  The book  had explained that, in their eyes, CCG  (the consortium of doctors and ‘professional’ patient reps that now commissions our treatment) stood for CYNICAL Commissioning Group  – so I got the giggles and didn’t care whom I interrupted to ask for explanations of other Acronyms bandied about. (CCG means Clinical Commission Group – but I prefer the NHS for Sale version).

And boy, were these committees eye-openers.  I learnt that

  • when it comes to new initiatives, the NHS has unlimited funds
  • And doctors don’t know what patients actually want.

Good and Bad

Surrounded by GPs, I felt intimidated;  until I found out often they had no idea what patients actually wanted – and I, being a patient – DID.  I even got a nice email from one team of Management Consultants thanking me for my contribution, and saying how valuable was my insight !!!

The other team went their merry way, committing every sin in the Presentation Book, from mis-using Power Point, especially crowding the screen, reading from the screen as though we were illiterate, flashing through screens at the rate of knots, and scowling if we asked a question, etc.  They had forgotten to supply tent cards so we could write out names and place in front of us; it took ages before we recollected each others’ names, and even longer to identify which organisation we represented.


Their Proposals

We were meeting to devise a new system of looking after over 65s.  First idea we shot down was the four-page letter, detailing (in NHS words) what this was about, and instructing the receiver that they were to attend an appointment at a certain time and date.

When we finally made them realise their ideas wouldn’t work, we said

  • “two pages ONLY (I wanted one but lost out to bureaucracy!)
  • Make it an INVITATION for an appointment at Patients’ convenience – to sound like a benefit, rather than a COMMAND
  • Patients should be told approximately how long their appointment will take – they do have other things to do
  • Designs for the new Centre showed patients came into a Reception area;  if they wanted a cup of tea they had to walk down a long corridor to a ‘quiet room’  well away from the noise and action.  We explained some elderly people had difficulty walking;  once off transport and in to Reception, they would want to sit and recover!  And, this might be only time they had left their home that week, so wouldn’t want to be shut away from life down a side corridor away from the action.

Fight Goes on

At the beginning, there was the usual expensive survey, which threw up that Patients wanted a social meeting place, with tea and coffee, and a chance to discuss their care in a holistic way.  Half way through the planning stage, strong letters went out to big-wigs saying patient Reps were unhappy at the way the ‘holistic care pattern’ was developing with too much emphasis on clinical outcomes, and holistic care had disappeared,

Patient Reps suggested Specialist Nurses should be involved, and available for consultation by Patients and Carers (Admiral Nurses, staff from Heart and Polio Foundations, Macmillan, Age UK. etc).  Patients could be told which day a Specialist Nurse was present, and book accordingly.  I even sent an email with 10 suggested charities to approach, plus an email from the National Osteoporosis Society saying they thought this a good idea.  But surprise – surprise – it got ‘LOST’ .  Seems some Management Consultants didn’t know much about Specialist Nurses.- or perhaps they can’t charge a management fee?

At last  meeting Patient Reps became vociferous, and we are waiting to see what else blocks holistic care!

In the meantime, it has been interesting seeing how to play the system, what goes on behind the scenes, and how us Patients can sometimes make a differencey.

Sometimes a quiet question suddenly makes medics see what WE need – and not just what officialdom thinks is needed. It’s in my interest – like everyone I am getting older, and want better care !


Wherever you live, if you are worried about what your care will be like as you get older – GET JOINING.  Your local Healthwatch is probably a good place to start, or if you have a good relationship with your GP ask them.

There are too many ‘Professional Patients’ on these committees;  they are known, and when Reps are needed, it is easier to send for someone you know.  But many of them have become embedded in the system, and start to think like the NHS, rather than stand up for what patients want. Se genuine patients are really needed.

Good luck, and Go For It!  It’s your future care you will be working on!

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