The challenges facing the NHS could be viewed as overwhelming.
The news is full of big numbers: big numbers of patients waiting for appointments, diagnosis and treatment; big numbers of A&E breaches, cancer deaths, obese patients, big numbers of vacancies; big numbers of agency staff. It all seems impossible to manage
However, what one person might see as a hopeless situation, another looks at it in a different way and sees it instead as an opportunity. Sometimes we need to look at things differently – we need to re-frame things.
We at Kayhill have been hugely impressed by the work done at Blackpool and Fylde & Wyre CCGs.
They were faced with a seemingly intractable problem – shared with many commissioners and providers – that of very high unscheduled activity. Attendances at A&E were through the roof, and a small number of service users accounted for a disproportionate number of those attendances.
In this case the re-framing was instigated by a single paramedic in the course of attending one of these “frequent flyers”. She had a simple but nevertheless startling revelation: – that this person was “just like one of us”. This set her to thinking about their problems and how they might be better supported than by regular calls to 999; attendances at A&E and hospital admissions.
The story and the initial outcomes can be read in the NHS Right Care case book but, to cut to the chase, in the first 15 months of one individual working with the top 100 service users, 999 calls made by this cohort reduced by 89%, and incidences of self-harm by 98%. Patients’ lives were radically improved and, at the same time, the NHS saved over £2.5m.
A different view of the same situation can bring about radical change.
“We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right – one after the other, no slipups, no goofs, everyone pitching in.”