Integration

Its clear that the NHS needs reform since there is a lot that needs to be done, but little money to pay for it. The one thing that cannot happen is to fund healthcare by introducing user charges. That is always a threat when Conservatives have won a majority, but it was certainly my worry with Labour trying to improve public services with the funding straitjacket they created during the election campaign. User charges are an admission of failure. But reform can make the NHS more efficient. And the current buzzword when it comes to reform is integration. As a patient, as a user of healthcare across several providers I am very much in favour of integration, but from the patient's perspective.

Over the last few years, particularly in the last year, I have suffered quite serious healthcare issues and it's clear to me that I won't get better. I'll leave the details for the narrative over the next few weeks, but to whet your appetite, in 2023 I had five MRIs, two CTs, two lumbar punctures, two electrical nerve tests, a PET scan, and an ultrasound. Last year I have had numerous blood tests, some for blood chemistry, some for antibodies, some genetic tests and one weird blood test where the sample had to be kept exactly at blood temperature so the phlebotomist had an insulated box with a thermometer and a heater and would only draw the blood when the inside of the box was at blood temperature. Prior to 2023 I saw two hospital specialists on an annual basis. At the end of the year I was seeing three more eye specialists, a neurologist and a respiratory specialist. This year I am about to see another eye specialist (so that means, five eye specialists) because my eyes are getting more complex. I am seeing these specialists every other month, so the number of consultant appointments has gone from three a year to almost 20. I also had 19 days in hospital at the end of last summer.

These specialist appointments have been across four hospitals in two hospital trusts, and when you add in the number of General Practice appointments there are a lot of appointments, a lot of tests and a lot of notes. There is also a lot of duplication. Getting all of these organisations to work together is very hard, but even if that was possible, it is often harder to get specialists in a single organisation to work together. Integration is a long term project, but its clear to me that it is necessary.