In 1948, UK households received a leaflet telling them they were entitled to free health care. The UK’s National Health Service (NHS), funded from general taxation, free at the point of delivery, and available to all based on clinical need rather than income, was born. The NHS still exists, but the way it is organised and care is delivered, has changed considerably. The government of the day sets its budget and spending has grown, on average, by 3.9% in real terms since the 1950s. The NHS is huge. It prioritizes emergencies ahead of treatments which are not immediately necessary but are important for maintaining or improving a patient’s life. Waiting lists can thus be long and are something the NHS can use operationally to stay within financial constraints. They are currently high and only responding slowly to government initiatives, as this 3-minute video highlights. The public remains sceptical about whether improvements are real because they still encounter frustrations with their NHS interactions. The care received from NHS doctors and nurses is rated highly, but navigating ‘the system’ to get it can be irritatingly problematic.
Everyone has a story about dealing with the NHS. In May 2025, after more than a year waiting, an acquaintance had a day-surgery procedure with an overnight stay and discharge the following morning. They were told on discharge that they’d receive a follow-up clinic appointment by letter for 4 to 5 months’ time. This was also recorded on their formal discharge letter. Having heard nothing by the end of October, they phoned the relevant hospital department to enquire about the appointment. They were passed between different extensions and ultimately to an answerphone where they left an appropriate message and their contact details. Having heard nothing again by early December, they phoned again and were ultimately redirected to a different extension to leave a message on an answerphone! Again, nothing had happened by early January 2026, and so they sent an email to an address buried in their discharge notes. An email reply appeared within two hours saying that the appointments team had been asked to make an appointment. Since then, there’s been nothing!
Yesterday the acquaintance asked the Badger, ‘Given your service operations and IT experience, is this a symptom of a failing service?’ They added, ‘In the old days, I’d have been given a card with my clinic appointment on it on discharge before leaving the ward. Who’s to blame for replacing that for the woeful process of today?’ The Badger answered the first question with yes, and the second with ‘Blame rests with governments, NHS leaders, and the external management consultants whose advice rarely improves NHS efficiency.’ To the Badger’s surprise, his acquaintance, a retired management consultant, agreed fully and added ‘more technology won’t help unless these processes get sorted’. They have a point…
