Almost everything I have said about changing the NHS is probably wrong.
As I’ve been in and around the service since 1974 that could be a shed load of wrong stuff!
I’ve always been captivated by the big sweeping structural changes. Standing at the planning table with one of those long sticks pushing the markers across the map. That was me.
Let’s start with the Griffiths report, the Thatcher years and later Andrew Lansley’s disastrous reorganisation of the NHS.
Throughout that time, what happened? People got sick, they went to see the GP. The GP was unsure, so he sent you to the hospital. They fiddled about and sent you back to the GP.
All of that is true today, except for one thing.
People still get sick and they still see the GP. These days, more likely ‘she’ will send you to the hospital. They will have a barrage of machines that beep but they are just as likely to send you back to the GP.
Here’s the change: the GP will tell the patient: ‘go and see the nurse’.
Of all the changes in the NHS that have really meant anything, redefined a care pathway, made the NHS more nimble and innovative, it is nursing.
Practice nurses, specialist nurses, nurse practitioners, nurse prescribers. Nursing has made care more accessible, safer and improved quality beyond anyone’s expectations.
As primary care takes on more of the heavy lifting, practice nurses are making a bigger contribution.
This year marks the centenary of the Royal College of Nursing. One hundred years of representing the views and aspirations of the frontline of nursing and the changes it has been through.
We must protect the frontline, fund it properly and make it fun to work there. Real innovative change that sticks comes from the front line of any organisation. Never was this more true than in healthcare.
So, happy centenary, thank you for what you do and here’s to a wave of nurse-led practices, where the nurses are the partners and the doctors are salaried. Go on, I dare you!
Roy Lilley, former trust chairman and founder of the Academy of Fabulous NHS Stuff