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Why does the NHS lag so far behind education and other sectors with respect to choice and transparency driving quality?

July 15, 2015


…or, Why do most people spend more time researching and choosing their holiday destination, restaurant or hotel, than they do their choice of GP or hospital? (clue, it’s not because it is less important to them, or because quality is even close to consistent across the NHS!)


There has been a lot of talk about transparency in healthcare – but the measures so far have had negligible impact on the quality or value of services.

In stark contrast to most other public and private services, there is still virtually no useful information to empower citizens and as a result we have seen little change in quality across the vast majority of the NHS.

Inequality and social disparity remain high, with the “pushy middle classes” still able to access better care, whilst the less-well off “get what’s left”.

Waste, inefficiency, variance and inconsistency still bedevil virtually all of the NHS with near total opacity characterising the information made available to patients.

Equally worryingly, the morale of NHS staff (and the resultant inexorable climb in agency and temporary staff costs) continues to be a major cause of concern for virtually all NHS Boards, yet we know that transparently sharing user experience (“ratings and reviews” from patients) improves staff morale, directly and rapidly reducing spend on temporary staff.


Bringing the NHS into line with other services and meeting society’s expectations for independent, transparent information to empower choice will deliver the following benefits:

  1. Bring market forces of informed, empowered patients to the NHS, thereby creating inexorable pressure for quality improvement and a truly, continuously, patient-focused service.
  2. Highlight and reward those delivering modern, innovative services, eg 7 day/week GP opening, remote consultations, integrated care, improved dementia services that really care.
  3. Better expose sub-standard care, outdated attitudes and poor patient experience.
  4. Increase public trust and confidence in the NHS, whilst making it easier for new innovative providers to enter the market.
  5. Level the playing field for all patients – anyone with a smart-phone should be able to access and understand the information they need to make a better choice for their family.
  6. Rapidly improve morale of NHS staff and reduce spiralling costs of agency staffing.


Old thinking: evidence-based care

Current thinking: transparency in care

Future thinking:  empowered patients transforming care

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