Monday, 22 November 2004
Crystal ball gazing at patient experiences in 2015
My local PCT asked the question:
If you had a crystal ball, what would you want PPI and the patient experience to be in 2015?
Here are my thoughts ...
- There is community ownership of the NHS through various models including community interest companies and public benefit corporations. “NHS” is only a brand name. No one remembers what “PPI” meant. You have to go to a dictionary to find it.
- There are no joins between services and sectors. No matter how users access care, they will end up in the right place, getting the right treatment. And it will still be free on the basis of need.
- People have the capacity and are expected to do much more self-care and prevention; health professionals have time to do more active listening and teaching. There are tax incentives for people to look after their own health and lots of community opportunities to help them do it.
- The principles “Nothing about us without us” and “no penalties for participation” truly underpin user involvement in service planning, quality assessment and revalidation at all levels. Users take commissioning decisions and evaluate services. They are supported and paid for their inputs and accountable for their decisions.
- The primary care-secondary care interface has disappeared: users and practitioners move along continuum rather than between sectors. The same applies to the sectoral barriers between health and social care – it’s all the same from the standpoint of the service user. Long term care for older people who need it is free of charge, paid for by higher central taxation.
- GPs and community nurses are a thing of the past. A new breed of first contact health practitioner has emerged. A range of salaried primary care professionals work in first contact health centres as the norm offering expanded services, prescribing and cross-referrals, including to recognised complementary practitioners.
- Automated diagnostics and other ICT applications are the norm.
- User-carried “smart” health cards are standard. Patient registration and “practice lists” are long gone as money follows users wherever they access care, including at work. Implantable chips in children are being piloted to do away with the smartcards.
- Users and practitioners move easily across sectors and public-private provision reflecting informed choices.
- First contact mental health care is something to be proud of and is delivered by a new kind of community-based health worker backed up by rapid response teams in the community.
- Most NHS Trusts are closed except for trauma centres and former hospital specialists routinely see patients in primary care settings.
- Accessible dental services are a reality for everyone; dental and optical services are free of charge
- Online consultations are routinely available for those that want them.
- Effective complementary therapies are widely available as referral options.
- The system of redress available to dissatisfied health and social care users is a model of speed, effectiveness and consumersatisfaction which is the envy of the commercial sector.