Radiology redesign: Will competition help?
Many will have seen the headlines about Health Secretary Patricia Hewitt’s suggestion that patients waiting over 20 weeks for CT and MRI will be able to choose where to get the scan done more quickly. There was a hidden message that competition between different NHS hospitals and between the NHS and independent sectors will somehow help the NHS to use its resources more efficiently.
Mrs Hewitt was clearly vastly impressed when she visited the radiology service at Hinchingbrooke Hospital recently. She was careful to point out her appreciation of this NHS service and how service redesign has helped the team to bring waiting times down. She also wisely said that this sort of process can release unrealised capacity in all NHS services. However, instead of looking at how to encourage redesign in the places where positive results have been obtained (and there are lots of good examples), the Secretary of State couldn’t resist the opportunity to take the easy political option: you can make it happen by bullying the service. Once again, the idea of choice is being used as a blunt instrument to effect change.
Of course it is critical that NHS diagnostic and therapeutic services improve rapidly and that wasted capacity is released. And of course everyone wants to see a better service delivered for patients. The evidence is that service redesign, including implementation of a four tier structure for the radiographic workforce and the promotion of multidisciplinary working, is an incredibly powerful tool in achieving these important objectives… and quickly. The process invariably requires local management and clinical support, including, critically, the will to provide resources if these are shown to be necessary.
The other requirement is that the local radiology and radiotherapy teams are given the opportunity and support to improve their own services. External influences are about facilitation of this process, not imposition.
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