The general election is nearly upon us. It will be interesting to see what it brings for the future direction of the NHS and plans for healthcare in the UK.
Regardless of the nature of any changes, we will continue to face significant challenges with funding, staffing and delivery of services. With rising healthcare costs and increased demand from an ageing population, we need to consider how we can improve the quality of life for our patients by using current resources judiciously.
Many aspects of care cost little but can significantly improve wellbeing, fitness and resilience to disease and its treatment, enhance recovery and reduce hospital stays. That is the low-hanging fruit we should focus on.
One example is the early identification and management of iron deficiency. A patient is much more able to cope with chemotherapy when iron deficiency isn’t contributing to exhaustion, anxiety and risk of infection. And yet evidence shows it goes unnoticed in most patients, and early opportunities for treatment are missed.
On the flip side, we should question the use of drugs, investigations or procedures that may be unnecessary.
For an informed cost-benefit analysis of services and treatments, the next government needs to work closely with healthcare professionals and listen to the patient’s voice. I don’t believe this has happened with the planned NHSE Outcomes and Registries Programme. It proposes moving some of our most valuable NHS haematology registries to a third-party commercial data platform.
That seems to me like selling the family silver. These registries, led by our members committed to their patients, are internationally renowned. They have informed best care for patients and supported national procurement and commissioning decisions. Furthermore, patient participation has been integral to their development.
Centralisation risks loss of speed and quality of both input and output and the goodwill of clinicians to whom immediate access to the data may be lost. We have clearly raised and documented our concerns and those of our patients, and we hope to receive a better understanding of the registries’ objectives, processes and target outcomes.
Indeed, recognition was given to the National Haemophilia Database in the report from the Infected Blood Inquiry (IBI), with a recommendation it is maintained and further funded.
The IBI report made for a very harrowing read. We must make sure such a stream of errors never happens again. The BSH is teaming up with other relevant organisations to ensure the recommendations from the report are delivered. The propositions are both specific to transfusion safety and care for haemophilia patients, as well as to our general practice related to transparency, shared decision-making and duty of candour. We will consider the means and resources to support our members with these actions.
Another regular item on our board agenda will be our intention towards a zero-carbon world. Hugh Montgomery, Professor of Medicine at University College London, gave an impactful and sobering lecture at our Annual Scientific Meeting. He has shown leadership in this field for many years and makes sensible and realistic recommendations for change.
We are motivated to align our organisation to support the transition to net zero in every way we practically can. We are reviewing our travel, power, bank and food suppliers to use low-carbon economy providers. We urge our members to do the same. Individual efforts seem like a drop in the ocean, but with an R-value of 7, behavioural change spreads faster than COVID-19 did.
Our journals are one of the main channels for sharing information on research and best practice. John Barrett, Editor-in-Chief of the British Journal of Haematology, will step down from his role at the end of the year. He has developed the journal over the last 15 years and ensured all areas of haematology are covered. John has built a team of 23 Associate Editors, all experts in their respective fields. He has overseen new initiatives such as the ‘Commentary’ article type linked to key papers and the new ‘In a Nutshell’ article, which provides an authoritative condensed summary on a topical area of haematological practice. He also steered the journal through the COVID-19 pandemic, managing the additional influx of submissions.
We hope his achievements and legacy will be maintained and wish to remind BSH members that the advertisement for his replacement is in the front pages of the journal. If more information is required, Claire Dowbekin is happy to receive email correspondence.