Elective care reform: more activity does not necessarily mean better care
Plans to reform elective care must avoid the trappings of over-investigation and fragmented and inappropriate care, writes Ella Hubbard “We need more activity, and less waste,” says Wes Streeting in his introduction to NHS England’s plan to reform elective care.1 The recently published proposals set out how this will be achieved via: “productivity-boosting tools,” a “focus on improving experience and convenience,” and paying £20 to GPs who use the advice and guidance system to seek a secondary care opinion before, or instead of, making a formal onwards referral. The plan was illustrated by the story of a patient named Sarah, whose convoluted route to receiving a diagnosis of rhinitis and a hearing aid exposes the risks of focusing on itemisable activity instead of solutions to the deeper problems overwhelming the health service. The case study featuring Sarah was quietly removed from the document after a flurry of GPs pointed out that her treatment managed to be both idealistic and who
