IT CAN be incredibly challenging to compare the different health services in the UK’s four countries, the pro-independence NHS for Yes campaign group say.
Different ways of collecting and reporting data can make it tricky to make meaningful comparison.
“This was keenly highlighted earlier this year, at the peak of winter bed pressures, whereby the performance of Scotland and England’s A+Es was hotly compared showing an outstripping of performance in England compared to at home,” a spokesperson for NHS for Yes said.
“The major problem here was that the reported figures for Scotland showed true A+E attendances – high acuity departments receiving medical emergencies, which was juxtaposed to figures of all NHS England out of hours services, which includes lower acuity departments such as minor injury units.”
For years, the NHS has been a pan-British organisation. But with devolution, Scotland, England, Wales and Northern Ireland all now have their own slightly different versions.
Nuffield Trust, the health think-tank, recently suggested those others services could learn from Scotland’s NHS.
In their report, published last year, they called on the NHS in the rest of the UK to look at Scotland’s unique system for improving the quality and safety of its patient care.
Firstly, up here, there is an emphasis on trusting clinical staff, getting them to drive improvements in care and giving them any extra skills they need to do so. This contrasts with an approach in some of the other nations of the UK, notably England, which involves focussing more on targets and leaning primarily on managers to improve care quality.
Secondly, they say Scotland benefits from continuity in both its policy and institutions:the Scottish NHS, the Scottish Government department that oversees it, and Healthcare Improvement Scotland (HIS) have all maintained their current approach for nearly a decade.
In England, by contrast, the picture is one of constant change and reorientation. In Wales and Northern Ireland, meanwhile, studies have observed that commitments to change and improve healthcare are not always translated into institutions and systems to bring about that change.
Thirdly, better ways of working are in Scotland tested on a small scale, quickly changed if necessary, and then rolled out. Unlike in the rest of the UK, this system is overseen by a single organisation, HIS, which both monitors quality of care, and helps staff to improve it.
NHS for Yes, say healthcare spending is higher per head in Scotland, than in Wales, England and NI.
They praise free prescriptions and free social care, protected nursing bursaries and the baby box.
But Scotland’s NHS boards are set to have some spending difficulties for years to come.
Papers released last week show NHS Greater Glasgow and Clyde is battling to squeeze spending by £87 million.
Other boards struggling include Lothian, Tayside, Ayrshire & Arran and NHS Highland.
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