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In 2010, figures were released, showing that ‘unnecessary’ visits to accident and emergency in the North West were costing the NHS £79.25m each year, apparently enough to fund 752 GP’s. (BBC, 2010) choosewell.org.uk is a response to this problem; getting people to choose the appropriate service for their need. Alcohol related admissions have also increased, with no one main cause being attributed, but a mixture, including low price alcohol and licensing. ‘Statistics show there were 1,057,000 admissions in 2009/10...There were more older than young people admitted. Figures also indicate alcohol dependency costs the NHS £2.41m in prescription items.’ (Meikle, 2011) The admissions include alcohol related accidents, as well as cirrhosis, cancers, heart disease and mental health problems. Another area of potential cost savings, is to encourage the use of all prescribed medications. Various technologies have been invented to help patients to remember to take medications, not just for ones own health, but to also save money from wasted drugs and potential hospital admissions as a result of what is termed ‘nonadherence’. According to NICE (National Institute for Health and Clinical Excellence), up to 50% of prescribed medicines are used incorrectly. (NICE, 2009) Within the same paper, entitled ‘Costing statement: Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence’, NICE indicated that ‘Medicines supplied on prescription cost the NHS £8.1 billion in 2007–08. If as many as 50% of patients don’t take their medicines as recommended, this could mean that £4.0 billion of medicines are not used correctly.’ (NICE, 2009) To clarify, this project is not one complete answer to solving issues around increased personal responsibility, or punishing those who do not comply with what is best for their health. An article in the New York Times explains why this area is so complicated; ‘Unhealthy habits are one factor in disease, but so are social status, income, family dynamics, education and genetics. Patient
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noncompliance with medical recommendations undoubtedly contributes to poor health, but it is as much a function of poor communication, medication costs and side effects, cultural barriers and inadequate resources as it is of willful disregard of a doctor’s advice.’ (Jauhar, 2010) As stated, the focus of this project can not be to solve this issue. Rather, it is a possible part of a solution; in attempting to shift attitudes of the service towards a more complete awareness and understanding of health provision. Service expectation, satisfaction and value: Ipsos Mori, a Social Research Institute, were commissioned by the Department of Health to conduct an ongoing study into public perceptions of the NHS. A paper that was published in April 2011, showed general satisfaction levels within the NHS in 2010, at 70%. However, in terms of how respondents felt about issues surrounding value for money, budgets and waste, opinion was less positive. When asked whether they would agree or disagree with the statement ‘The NHS provides good value for money to taxpayers’, 63% agreed. Similarly, just 36% agreed that ‘The NHS is doing everything it can to reduce waste and inefficiency’, and 25% agreed with ‘The NHS is getting better at managing its budgets.’ Over two thirds agreed that ‘There is waste and inefficiency in the NHS’. (Ipsos Mori, 2011) The paper also highlighted some interesting points around how non-users of the service judge it more negatively than those who had experience; ‘Public satisfaction with the NHS remains high (70%) but is drifting downwards. Most of the fall is due to non-users becoming more critical – perhaps in response to media coverage, as they have no direct recent experience. In contrast, users of the service remain very positive (73% satisfaction rating versus 61% of non-users).’ (Ipsos Mori, 2011) These statistics really only provide very general attitudes; to claim that most people using the NHS are satisfied would require more qualitative research and a clear definition of what satisfaction
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