Category: NHS

Everyone has a story about their dealings with the NHS…

Posted on by The Information Badger in Consulting, Information Technology, Leadership, NHS, Processes and Practices, Technology

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…

The NHS doesn’t engage or communicate with patients on waiting lists at all…

Posted on by The Information Badger in Digital Transformation, Information Technology, Leadership, NHS, Online Services

Statistics show that >80% of the UK population engage in online shopping, an impressive number given Amazon et al only launched in the 1990s. The Badger uses Amazon, amongst others, because the ‘customer journey’ from choosing goods, payment, through to and including delivery, is straightforward, reliable, and provided with  informative tracking information about the journey of the goods. This ‘customer journey’ is founded on solid, integrated IT, designed to engage and communicate with the customer throughout the whole process. Good, proactive, interaction with customers is a norm in today’s online world, which means that any public facing service that doesn’t have it sticks out like a sore thumb!

Last week the Badger visited a neighbour, a statistician long retired from the UK Civil Service,  who’d recently had a fall in the street. Their wife invited the Badger round for coffee and a chat to lift her husband’s spirits. The coffee was good, the conversation lively, and her husband’s spirits were indeed lifted! Given their Civil Service career, government and the NHS inevitably came up in our conversation. At one point the Badger laughed when the statistician asserted that ‘All governments are somewhere on the incompetency spectrum’. They were forthright about the NHS too, saying ‘Unlike Amazon with its customers, the NHS doesn’t engage and communicate with patients on waiting lists at all’.

What triggered this remark is the fact that a NHS hospital consultant told them a year ago not only that they needed an operation, but also that its clinical priority meant it would happen within 2 to 3 months. After 3 months had elapsed with no communication from the hospital, the statistician called to enquire what was happening only to be told they were on the waiting list and would hear something soon. After another 3  months of no contact, they enquired again and got the same response. A year has now passed and there’s been no proactive communication from the hospital at all. Understandably, their trust in the NHS has almost completely evaporated. It wasn’t surprising, therefore, that we decided during our conversation that government should get Amazon to implement proper, ‘customer journey’-like,  21st century ‘patient journey’ engagement, IT, and waiting list communication practices for the NHS. Radical, wacky? May be, but the status quo isn’t working. Not proactively communicating with patients who’ve been on waiting lists for months sticks out like a sore thumb as being behind the times and is plain wrong!

The IT for the online shopping ‘customer journey’ is well established, so surely its principles and mechanisms can be adapted to proactively keep patients informed during their ‘patient journey’? The government’s consulting about NHS changes but can it cut through NHS vested interests? It has to, because there’s a mountain of waiting list patients who’ve already lost confidence that this complex 20th century supertanker will ever be truly fit for the 21st century…

The NHS; a super-sized jumbo jet flying with only one engine…

Posted on by The Information Badger in Delivery, Digital Transformation, Health & Social Care, Information Technology, Leadership & Management, NHS, Public Institutions

There’s one thing currently dominating the chatter of many people the Badger encounters, and that’s the UK Budget on the 30th October.  ‘How is it right for me to pay more tax for politicians to fritter away, when the Prime Minister doesn’t buy his own clothes or glasses?’ one pensioner commented. The Badger tries to maintain political neutrality, but there’s little doubt that the new UK government has got off to a bumpy start. However, it’s now starting to flesh out its ‘Change’ agenda and also setting expectations regarding the budget. On the former, for example, the government is calling on the nation to ‘help fix our NHS’. As reported in many places, e.g. here, it wants people to share their experiences and ideas given that we are all users of this huge institution employing more than 1.34 million people. The Badger, having had some exposure to NHS IT during his career and as a patient, has thus contributed to ‘help build a health service fit for the future’ via the government’s website here.

The NHS has been a political football for decades. There’s a regular clamour to give it more money. When it gets additional money, however, it never seems to make an impact, other than to fuel clamour for even more funds – at least that’s how it seems to the Badger. The NHS’s use of modern, integrated, IT is woeful, as neatly illustrated by this New Statesman article in March. By IT, the Badger means the systems that support basic operational processes within and across the NHS’s entities, not the diagnostic and robotic tools that get airtime in the media.

People often tell the Badger of their frustrating NHS experiences, most of which involve aspects where IT plays a part. For example, an NHS phlebotomist bemoaned needing 13 different logon/passwords to deal with blood tests. A relation was appalled on receiving a letter confirming a hospital appointment with Audiology when it should have been with Cardiology! A neighbour was dismayed when a consultant at a post-operative outpatient appointment told them they couldn’t find a CT scan ‘on the system’ even though the scan happened 6 weeks previously at the same hospital. A pensioner, referred from a local hospital for urgent follow-up at a regional hospital, enquired after hearing nothing for 2 months only to be told that ‘there’s no record on our system’ of the referral. The list of similar experiences is long.

Building a ‘health service fit for the future’ is like modernising every aspect of an aging, super-sized, jumbo jet while it’s flying with only one temperamental engine. Few government transformation programmes deliver real change to time and budget, but this one must break the mould, or the jumbo will soon spectacularly crash. That’s why the Badger has not only contributed on the website here, but also urges you to do the same regardless of your political views.