One thing that is being under-remarked on, in my view, is the daily in the social care funding. In raw budget terms, it is understandable since it is a huge additional cost that we are not yet paying.   But: it is very well known that one of the big problems with the NHS 'efficiency' is the number of NHS hospital beds occupied with people who cannot be discharged as there is no person or organisation to care for them. If you really want to improve the efficiency of the NHS, one of the biggest single things you could do is invest in social care.

One more remark on NHS efficiency - and efficiency in general, come to that. A friend I had worked in NHS admin and part of her job was consolidating notes from various sources. She was hauled over the coals and eventually sacked because she was too slow and did not meet the daily average of others in the office, most of whom highlighted a section of notes and then copy and pasted it into the combined document. As a result they processed many times the amount she did.

Now to the related story. A friend of my wife broke her left arm and they decided she needed an MRI scan. After around three weeks she turns up and they are all ready to scan her left wrist. She objects, pointing out it is her right arm in the sling. No, the notes say they need to scan he wrist. If, however, she signs to say she is refusing treatment ... No way, she says, I am not having "refused treatment" in my notes.


What is happening here is that in the drive for 'efficiency' the wrong thing is being measured, and 'effectiveness' is being lost. The two are three seconds saved by not checking whether the notes were being pasted into the right person's notes (which is what I suspect went wrong)