Not that impressive, really – given the money that was thrown at the contracts. It’s not rocket science to notice that bread n’ butter stuff can be done in production line fashion, or that complex ops are better carried out in larger centres (e.g. the current review of children’s congenital heart services http://www.specialisedservices.nhs.uk/safeandsustainable ). ISTCS were simply an overly-expensive way of ‘bolting-on’ extra capacity for minor ops. Where I worked (surgical admissions in a major city hospital), they creamed off the easy cases, and we did the tricky stuff. Beyond the nominal charade that is choose and book, there was no ‘competition’ in the way you seem to envisage.
The medical outcomes are a little better than the standard NHS, even allowing for the different mix of patients.
I wouldn’t jump to easy conclusions – given that a ‘difference mix of patients’ can mean the difference between a knee op in an otherwise fit and healthy individual, and the same op in somebody with a high anesthetic risk. And customer/patient satisfaction can be a pretty complex sliding scale – anything from admiring the new carpets, to simply being glad to be alive.
what we want to do is open up the space
Handing it over to Serco et al isn’t exactly experimentation. Call it what it is.
and the general answer is, umm, OK really
Not that impressive, really – given the money that was thrown at the contracts. It’s not rocket science to notice that bread n’ butter stuff can be done in production line fashion, or that complex ops are better carried out in larger centres (e.g. the current review of children’s congenital heart services http://www.specialisedservices.nhs.uk/safeandsustainable ). ISTCS were simply an overly-expensive way of ‘bolting-on’ extra capacity for minor ops. Where I worked (surgical admissions in a major city hospital), they creamed off the easy cases, and we did the tricky stuff. Beyond the nominal charade that is choose and book, there was no ‘competition’ in the way you seem to envisage.
The medical outcomes are a little better than the standard NHS, even allowing for the different mix of patients.
I wouldn’t jump to easy conclusions – given that a ‘difference mix of patients’ can mean the difference between a knee op in an otherwise fit and healthy individual, and the same op in somebody with a high anesthetic risk. And customer/patient satisfaction can be a pretty complex sliding scale – anything from admiring the new carpets, to simply being glad to be alive.
what we want to do is open up the space
Handing it over to Serco et al isn’t exactly experimentation. Call it what it is.
ps – for your reading pleasure:
ihttp://www.allysonpollock.co.uk/administrator/components/com_article/attach/2011-10-10/Lancet_2011_Pollock_NoEvidence_Cooper.pdf