NHS: Honest conversations are needed

Is it time for patients of the NHS to stand up and do their bit to save the NHS further pain?

We need to give Patient Engagement a new lease of life if we are going to make inroads into Health Inequalities.


The NHS (and Primary Care in particular) is facing a critical moment in its history. The pandemic has left a wake of problems behind it.

  • Growing demand, waiting lists and undiagnosed conditions being handled by a tired, burnout workforce, whose numbers are dwindling everyday

  • Patients who have been used to accessing care with little or no accountability or responsibility for self care

  • A more vocal population who criticise often without being in full possession of the facts

  • Rising health inequalities and unrealistic expectations that the NHS can solve all of those

  • A PR crisis with some of the people who stood on doorsteps clapping for the NHS a few short months ago, now baying for blood because they cant get to see a GP on demand.

All of this would be complex enough to navigate but we are about to see a new Health and Care Bill that will herald yet another top down restructure that will burn up precious resources and use time to embed new ways of working whilst battling growing waiting lists.

We have to rethink the importance of patient engagement and put more effort into building a more mature dialogue.

The NHS needs to have honest conversations and be willing to listen to what their patients have to say and Primary Care is an obvious place to begin. The mechanism already exists in the form of Patient Participation Groups that every GP Practice should have. The difficulty is that they are such a mixed bag. Some are brilliant, function really well and exceed their purpose. Others are poorly attended, unclear about their remit or have been hyjacked by members with an alternative agenda. Some practices are apprehensive about them because of the perceived extra workload they create, but it doesn't have to be like that.

PPGs were created to support the implementation of positive change in their communities by working with their General Practice collaboratively. Traditionally, patients have experienced a valued relationship with their GP but the dynamics of that relationship have changed over the last few years. Patients want more say in their own healthcare, they are better informed and expect to be treated as whole people, not just as a condition or ailment. If General Practice is to weather the current storm is needs to become responsive to patients in a different way.


PPGs can help to develop a more effective partnership with their patients. They can help them to communicate accurately and honestly with individual patients, and with the wider community about key health matters. They can also help to reduce costs and improve services by identifying changes that the practice may not have considered, allowing resources to be used more efficiently. Most importantly, they can develop mutually supportive networks for patients and the practice, outside of individual appointments. As new models of delivering GP services emerge (Telephone consultations, Pharmacy & nurse practitioner appointments, on-site testing) it is crucial that patients are well informed, understand the necessity for changes and offer feedback from the user perspective. They can also play an invaluable role providing accurate information to educate patients about self care, conditions, prevention and general health and wellbeing.


Change will not be easily won without those honest conversations and people are ready and open to them at the moment. Primary Care should strike while the iron is hot.





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