Copperfield offers suggestions to Lord Darzi for his investigation into the state of the NHS
Amazing what you can do in six weeks, isn’t it? It’s taken 76 years to destroy the NHS, but Lord Darzi is only going to need a month and a half to stick it all back together again. That’s how long Wes Streeting has given him to diagnose what’s wrong with our health system.
The process will be ‘fundamental’, ‘raw’ and ‘honest’, and informed by patients and staff. But above all, judging by the deadline, it’s going to be quick. It’s almost like they already know what they’re going to say – so I’m guessing we can anticipate a headline of ‘Darzi centres, Wes scores’.
In the meantime, and working on the assumption that Darzi may well get all ARRSi, I’d like to kick start the process with a suggestion around the Additional Roles Reimbursement Scheme. A quick explainer in case this has passed the dynamic duo by: ARRS involved the then-government realising that: a) There weren’t enough GPs; b) Instead, there were lots of non-GPs down the back of a sofa they could give us cheaply/for free.
But we’ve had all we can eat of pharmacy technicians, podiatrists, care-coordinators, health and wellbeing coaches, social prescribing link workers and, yes, physician associates. What we need is radical change. Something fundamental, raw, and honest. So I’d suggest dogs. They’d be ideal for the ARRS.
As everyone knows, there’s currently a surplus of dogs in this country. And their versatility means they have enormous potential for the NHS. There are guide, hearing and mobility dogs. There are therapy, emotional support and crisis response dogs. There are even dogs who can sniff out covid and cancer. Docile and waggy dogs cheer everyone up just by being dogs. And the more aggressive can be encouraged to bite patients who would otherwise hit us over the head with a metal pole because they can’t get an appointment.
True, we need to avoid the ARRS mis-steps of the past. Dogs would need a clear scope of work. They couldn’t be let off the lead with undifferentiated illness. And only dogtors should do a dogtor role – the last thing we need is nogtors.
So I hope Wes and Lord Darzi agree that a dogs’ ARRS shouldn’t be sniffed at. Alternatively, they could decide to use ARRS money to fund actual GPs, either directly or by diverting the cash into core. But that would be barking, wouldn’t it?
Dr Copperfield is a GP in Essex. Read more of his blogs here
The ARR dogs we really need are ‘Sniffer Dogs’ to sniff out the self-indulgent ostensibly clueless individuals we have within the government , PCNs, NHSE and ICB leads who have seemingly bypassed any common-sense checks at the NHS security gate and to root out the occasional shifty LMC board member looking for early contract information.
These should be accompanied by security guard dogs to ensure this repeatedly failing assemblage -a label apparent to all from the current state of the NHS, are kept at a safe distant from any NHS leadership decisions and for the protection of patients and staff .
I’m really a cat-person I think, but for years now we have been chicken-people, and Damien, Victoria and Fur-Elise certainly consider me their chicken-daddy.
Anyway, to be accurate, Lord D has not been given 6 weeks to FIX the NHS, only 6 weeks to DIAGNOSE IT.
Which in itself is rather ridiculous really, as GPs only get 5 minutes to diagnose; and 10 minutes to diagnose and prescribe, so you would think a superior GP, like a Lord, could manage it in less than a week, surely?
But, then it occurred to me, with the USC wait being only 2 NHS weeks, but about 8 calendar weeks, how long does 6 NHS-weeks cover on a calendar?