Locum's Nest, the NHS & the bigger picture

Not since its inception in 1948 has the National Health Service been under such pressure in demographic, economic and structural domains. For the frontline workers of the 5th largest employer worldwide, it seems that their pleas for additional funding have fallen on deaf ears as the Sustainability and Transformation Plans (STP) roll ahead. 

The NHS is a behemoth of an organisation, which achieves great and extraordinary things on a daily basis.

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Around 1 million patients are seen and treated by the NHS each day. However, the hospital balance sheet deficit of around £2.4 billion last year combined with rising demand across all levels of care is leading to key targets being consistently missed. The consistently balanced and informative King’s Fund produced the graph adapted in Figure 1, which demonstrates the multifaceted pressures on Accident and Emergency departments throughout the country. There are two major points to take away. Firstly, that both attendance at A+E and admissions from A+E have increased over time. Secondly, that a third of those increases have occurred in the last two years. 

A report from the Royal Society of Medicine last week outlined the gravity of the situation. An additional 30,000 deaths were recorded in 2015, the largest single rise in mortality since the post-war period. The authors’ elegant paper used statistical methods to correct for factors such as seasonal influenza and cold weather. Their analysis revealed a particular increase amongst elderly people, which they suggest is reflective of the crisis in social care.

The size and complexity of the NHS makes it impossible to attribute its problems to a single or even a handful of problems – an aging population, the squeeze on funding or increasing demand. Nor can we conclude that an increase in the NHS budget will solve these problems straight away. There is little doubt that additional funding is required, particularly for General Practice and community care, however a shift in productivity and efficiency is arguably more necessary.

How should this step change in productivity occur and who should lead it? We believe that novel ideas, technological disruption and strong leadership has to emerge from within the NHS workforce; For it is this workforce that makes the NHS great. It has been encouraging to see programs such as the Clinical Entrepreneurs training scheme and the Faculty of Medical Leadership and Management come to the fore to facilitate these changes.

As a group of doctors, through Locum’s Nest, our staff bank and locum app, we offer one route to a step change in productivity and efficiency.  We are strong advocates for technological disruption in healthcare settings, an environment that is ripe for evolution. On this blog we hope to publish some data demonstrating our lovely locum app’s proven ability to cut costs and solve staffing issues. In addition we will attempt to engage you in an interesting discourse about some of the above issues and celebrate some of our wonderful users.

If you’d like to find out more about Locum’s Nest as a Doctor, please download the app and get started using your GMC number.  As a representative for an NHS trust please contact us directly. We’d love to hear from you! 

Nicholas Andreou