The 6 Cs of the National Health Service
The National Health Service in the UK is the world’s largest publically funded (i.e. through tax) health system. It was created after WW2 and was launched on the 5th July 1948 with three core principles:
- that it would meet the needs of everyone – from “cradle to grave”
- to be free at the point of delivery
- to be based on clinical need and NOT on the ability to pay
In 2016, the budget for the NHS was over £120 billion and in 2017 the NHS finds itself in a state of crisis, being overwhelmed with patients, lack of available beds and critical funding issues. It has become so bad that many hospitals recently declared major alerts as they failed to cope and patient safety was potentially at risk. The causes for this ongoing crisis are complex and various, but boil down to six key factors:
- UK has an ageing population
- Cuts in social care funding have caused delays in discharging patients (usually the elderly – bed locking)
- Difficulties in seeing your GP have resulted in more people going directly to A&E
- Rising costs in healthcare
- Lifestyle factors – e.g. drugs overdoses, excessive drinking, obesity and mental health issues
- Restructuring - in an attempt to make it more efficient, how the NHS operates is constantly changing
Despite all the doom and gloom the NHS is very likely to continue for many years to come and with extra funding and possibly a shift to 7 days GP surgeries, things may improve in the short term. Whatever the current situation, those who have used its services are generally positive about its professionalism and the degree of care that it provides. To help reduce it patients’ stress the NHS does syndicate work to the private sector, and although costly, this process helps ease the pressure within the system.
Significant changes have occurred in the NHS over the last few years and one of the most important catalysts has been the Health and Social Care Act 2012. For students who are applying to medical school, understanding some of the key implications of this act would be useful.
The 6Cs of the NHS
These are a set of values that underpin health and social care in the UK through the NHS. These six Cs are:
- Care is core to all NHS activities and involves care at all levels of NHS structure, primary (GPs surgeries), secondary (hospitals) and tertiary (hospices). Care defines the purpose of the NHS and every patient has the right to expect the highest level of care. Care should be non-judgmental and patients’ dignity and beliefs must be respected.
- Compassion is central to care and involves empathy and an understanding that patients’ dignity must be respected throughout their experience in the NHS.
- Competence is fundamental to care, and health professionals in the NHS must have the necessary competence to provide care through operations, medical advice, dispensing the right drugs, and have the necessary clinical and technical skills to make patients better or manage their pain.
- Communication is fundamental to any caring relationship as without proper communication and the ability to explain what is happening and possible outcomes, patients can become stressed and overly anxious. But it is not just patients that need to be listened to: friends and family are also a vital relationship link in the NHS, as these are the people who provide the critical support to the patient, especially following an operation.
- Courage is required to do the right thing by patients and to speak up about issues of concern within the health service. When something is not right or standards slip, it can require courage for someone to take a stance and ensure that patient standards are never compromised.
- Commitment is the cornerstone of all of the above Cs. Without commitment to standards, compassion and care, nothing gets properly done and the general public look to healthcare professionals to be fully committed in their roles.
Despite the crisis, it is important to remind ourselves of what the NHS has achieved and why, as an institution, it is so important to protect, both financially and politically. Even with some questionable statistics over UK cancer survival rates being below the European average, the NHS is still recognised as one of the best healthcare systems in the world and we in the UK should all be proud of it.
John Dalton, 2017
Head of Science