The Pharmaceutical Journal
Vol 279 No 7480 p622
1 December 2007

This article
Reprint   Photocopy

PDF 40K, Acrobat Reader

• Registration (3)
• Retention fees
• Influenza
• NHS
• Community pharmacy
• Ventolin
• The Society

Letters to the Editor

National Health Service (NHS)

Cost savings in the NHS

From Mr N. J. Staunton, MRPharmS

I recently read three articles which, I believe, provide considerable food for thought about the NHS and prescribing in particular.

The first was the Office of Health Economics Compendium of Health Statistics 2007, which shows, in beautifully simple graphical form, that the NHS now spends more per head of population on health care (in terms of pound notes) than both the EU15 nations and EU25 nations.

However when we look at results in terms of process (number of hospital beds, number of GPs, number of dentists, etc) or hard outcomes (death rates from coronary heart disease, breast cancer, infant mortality, adult life expectancy, etc) the NHS is far below European results.

The second article was a Drug and Therapeutics Bulletin article (October 2007, Vol 45, No 10) about cost savings from not prescribing bath emollients. The DTB basically said that there is little evidence for these and not prescribing them could save the NHS £16m per annum.

The third article was a report from the NHS Institute for Innovation, which states that NHS productivity drives, called “Better care, better value” indicators, had resulted in real savings to the NHS of some £346m per annum (Health Service Journal, 4 October 2007, p25). The key contributors to this success were reducing hospital length of stay (a saving of £151m per annum), reduced emergency hospital admissions (saving £78m per annum) and increased low cost statin prescribing (saving £60m per annum).

These three articles together, I think, shed some light on why the NHS is not performing as well as it should — a lack of focus. I wonder that if managers, pharmacists and clinicians concentrated on the big issues, such as the “Better care, better value” measures, rather than wasting time with small ticket items such as bath emollients, NHS outcomes would be similar to European outcomes?

Is it not time that the scalpel-sharp minds commissioned by the DTB actually looked at the billions of pounds spent on unnecessary operations and hospital admissions each year instead of wasting time looking at £16m of bath emollients with which, owing to the nature of the condition and tiny spend, there is never likely to be large randomised controlled trials?

Where is the evidence that the proposed 3,000 new community matrons will make any difference? Where is the evidence that whole teams of infection control nurses make any difference? Where is the evidence that primary care trusts actually commission?

Noel J. Staunton
Pharmaceutical Consultant
Isle of Wight

Send your letter to The Editor

Previous Topic (Influenza)
Next Topic (Community pharmacy)