It’s that NHS no money time again. Every new paper clip to be signed off by the chief finance officer. Hiring freeze, travel ban, recycle the teabags. These savings are a matter of familiar ritual - as much as the spending frenzy of late March. Badged as efficiency, managers flex and pump their iron fiscal will on the profligate and wasteful clinical teams who get on with business as usual.
In addition to the “efficiency” savings, the rationing chat volume gets turned up from normal distracting background hum to persistent shrill whistling. Can’t do everything for everybody, patients need to take more responsibility for their own health, care needs to be provided closer to home. Patients however continue to thwart and dodge the various hurdles set for them by having complicated illness that doesn’t algorithm too well and gets worse when ignored, deferred or redirected.
Meanwhile lurking in the shadows ready to burn through massive piles of fivers are the lost opportunities to prevent the eye-watering cost of disability and long term care needs. Patients no longer able to feed themselves because they didn’t have their airway secured quickly after their head injury. Families giving up jobs to care for a relative with severe neurological complications due to prolonged hypotension and hypoxia post cardiac arrest. Beds blocked for months by patients with complex infected compound fractures that lead to life-changing amputations for want of early reduction and antibiotics.
The dividend from good emergency care preventing secondary insults and early intensive rehabilitation adds up to an awful lot of paper clips and teabags. We can’t afford not to invest in preventing harm when money is short. As the man said: "Nothing is more expensive than a lost opportunity".
