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Transferability – The Solution to Systemic Bottlenecks in the NHS

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by John Brian Shannon

Unfortunately for large healthcare providers like the UK’s highly rated National Health Service (NHS) people don’t always get sick near their local hospital. Rather, people will become ill, get injured, or encounter long-term illness everywhere throughout the United Kingdom regardless of where hospitals are located. Which is why some UK hospitals are full to overflowing while others have spare capacity.

One way to improve healthcare outcomes in the NHS is to incorporate transferability of treatment to relieve bottlenecks in the system.

Patients who can’t be treated in their local hospital due to lack of available capacity could be transferred to other hospitals in the UK where some amount of spare capacity exists and receive their treatment sooner than waiting for treatment at their local hospital. And even accounting for airline or rail tickets, possibly an overnight stay in a reasonably priced hotel in cases where the airline vs. operating room schedules don’t match, and for other incidental patient costs the health service would be required to pay, it would save the NHS money and dramatically improve healthcare outcomes for patients.

Patients who desire an upgraded hotel room could pay the difference themselves between the (covered by the NHS) standard room rate and the upgraded room rate.

When a patient has cancer, heart problems or other serious health issues, nothing is gained by making the patient wait for a treatment date in a hospital close to their home, because almost 100 per cent of the time those conditions will worsen as the patient waits for treatment.

Delayed treatment significantly increases treatment costs — because during the days, weeks or months of delay, the patient’s disease is certain to worsen.

Even those with slipped discs or other musculoskeletal impairments find their condition worsens over the amount of time their treatment is delayed. To say nothing about the suffering of the individual and their families while the person remains in a precarious health situation.

But if patients with serious conditions receive treatment sooner, healthcare outcomes for patients will improve and NHS statistics would improve because the disease or condition won’t have progressed as far in the case of faster treatment vs. waiting extra weeks or months for treatment at a local hospital.


Increase in Productivity

Workers who can’t work, can’t contribute much to GDP.

What is also true is that with faster treatment workers can return to work sooner and contribute to their company and by extension to the GDP of the United Kingdom.

Unhealthy people cost the economy, while healthy people contribute more. It’s therefore in the best interests of the government to get everyone the treatment they need with the minimum of delay.


Little Room for Improvement in the NHS

For an idea of just how highly the NHS is ranked in the world, please view the following chart courtesy of The Commonwealth Fund, an organization which ranks global healthcare systems via a number of metrics.

UK NHS and 10 other countries, Health Care System Performance Rankings

Health Care System Performance Rankings for the UK and 10 other countries. Image courtesy of The Commonwealth Fund.

It’s easy to see there is little room for improvement within the NHS, but Access (the ability to access treatment within a reasonable timeframe) and Health Care Outcomes (the success rate of treatment — which is often related to waiting times associated with treatment) could be significantly improved.


Scotland, Here I Come!

Some amount of transferability of treatment exists within the NHS at present, however, those in England tend to be treated or wait for treatment within England only. Scottish patients may be transferred to other hospitals in Scotland, and Welsh patients may be transferred to other hospitals in Wales. It’s likely a similar situation exists within Northern Ireland.

What would work to decrease bottlenecks in the NHS and thereby improve healthcare access and healthcare outcomes would be treatment transferability for patients throughout the entire United Kingdom.

Doctors could provide their patients with options for treatment when full transferability becomes the norm; (Example) “You can wait 6 weeks for treatment at your local hospital, or we can fly you to Scotland tomorrow, put you up in a reasonable hotel overnight and your operation will be scheduled for 7:00am the following day, and we’ll fly you home a day or two after the attending surgeon approves you for travel.”

For patients in severe musculoskeletal pain, or experiencing rapid cancer growth, or increasing difficulty in breathing or experiencing other serious symptoms, the sooner they can obtain treatment the happier and healthier they’re likely to be. That’s a win for patients, for doctors, for under-booked operating rooms in far-flung regions, for NHS statistics, and even for UK productivity stats and GDP.

There are so many ways to win with treatment transferability throughout the entire United Kingdom. It’s really the only systemic improvement left for the NHS.

Building more hospitals is expensive (and necessary in any case) but directing patients to underutilized hospitals (now, and even after more hospitals are built) can help patients towards sooner and better health while improving Access and Health Care Outcomes statistics for the NHS.


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