Many of you may be familiar with the 1993 Bill Murray/Andie MacDowell movie, where he is forced to re-live the same day over and over again, until he changes his selfish ways for the good. Each morning he wakes to the same radio announcement and the same day ensues, no matter what he does (including trying to kill himself). At first he is bewildered and frustrated. Eventually he uses the opportunity to grow and (eventually) capture the heart of his beloved. Ahhh - don't you just love Hollywood?
The Health and Social Care Act comes into full effect from April 1st. Most of us will have seen many sea changes in NHS structure - GP Fundholding, the demise of 'The Red Book' and the New Contract and now this. Widely reported as the greatest change in the NHS since its inception in 1948, I doubt patients will notice the difference. For clinicians the speed and nature of many changes have left gaps in administration (particularly in education and training) that have yet to be plugged. But as yet another government does its best to 'fix the NHS', the workforce is left wondering if this will be any more successful than the other attempts. Some observers feel there are several diverging opinions (between reformers and the rest of us), which make it unlikely to do so.
Reformers seem very keen to involve doctors in budget management. Most of us feel unqualified in this role; after all we wouldn't ask an accountant to provide a surgery. Successive governments have also tried both to move services from hospitals to the community and to involve the private sector to deliver more services. Both measures are generally unpopular with medics and the public. Neither trend seems likely to change.
So, on one hand we have reformers trying to face the economic realities of healthcare, and on the other hand we have the medics and public - hugely opposed to it. Unwilling to change and willing to forgive its many sins. To convince us the changes really are in patients' best interests and are not merely seeking the cheapest willing provider, we need hard outcomes and real (independent) data. The NHS has become a bit of a national treasure; witness Danny Boyle's reverie at the opening ceremony at last year's Olympic Games. No matter how catastrophic its failings, most of the public are still grateful that they have a service 'free at the point of contact' on which they can call.
If your working world does undergo a seismic shift on April 1st, don't worry. It won't be long until you wake again to the same tune on the radio, but another different plan for the NHS and whatever happens, you will still be able to access our latest evidence-based guidance.
This month we have produced new information for patients and professionals on bedbugs, numbers of which are (apparently) on the rise. We have also updated our guidance on obesity in response to some key opinion papers and references. Our articles on Parkinson's disease have also been updated in response to new European guidelines for diagnosis and management.
For a full list of our content updated in March see http://patient.info/content-updates