Long read
The NHS long-term plan explained
On 7 January, the NHS long-term plan was published setting out key ambitions for the service over the next 10 years. In this explainer, we set out the main commitments in the plan and provide our view of what they might mean, highlighting the opportunities and challenges for the health and care system as it moves to put the plan into practice.
Comments
I would suggest there should be a 'fourth' way! if Carers were respected for what they do, and the knowledge they have acquired while providing often the ONLY SUPPORT and CARE to their relatives, we could eliminate STRESS, and ANXIETY that all Carers experience, while at the same time improve the lives of those we CARE for.
The 'forth' way? Multidisciplinary assessment of both the Carer and the Patient 'INTERESTING' identify their Health and Social Care Needs.
Ask any CARER why they are stressed and anxious, and suffer from anxiety. It is because we can never contact anyone in emergency, often providing Health and Social Care without any support, NOT acknowledged for what they do, no respite. and finally we ALL worry about what will happen to these vulnerable son's daughter's and friends when we die.
The above is probably me, but having experienced this 'feeling' for thirty years, we find other ways of 'coping'.
Carers are NOT given sufficient help or support for what they do. It is has become a 'battle' of the 'Titans' A war that lasted 10 years, which we don't have.
As the mother of a son who committed suicide I can only look on now and hope this will help,unfortunately my experience with regards to mental health provision and support in the community leaves me fearful.
There is, and has been for sometime, benefits for patients with long term conditions (e.g. diabetes, cardiopulmonary disorders, chronic pain) in understanding and treating their mental health, with potential benefits to their wellbeing and the efficiency of services (e.g. reduced unplanned admissions). Similarly there are benefits to those with mental health problems who have long been known to have poorer physical health care and subsequent outcomes.
However, the relationship comes with significant risks, often specifically for mental health. Risks to mortality often are perceived to outweigh those of morbidity; it can be easier to justify cuts to mental health services in favour of those supporting physical health care on safety grounds at the costs of parity of esteem. From experience these risks are not insignificant and increased collaboration whilst providing significant benefits needs to be considered in the light of ensuring that mental health does not become neglected to support the physical healthcare of patients and the public.
This is a quote from Prof R Grahame, from a paper about EDS. He goes on to discuss that the symptoms of EDS/JHS were – and sometimes still are - considered to be a form of ‘illness behaviour’ He concludes by saying “To dismiss disparate symptoms as ‘illness behaviour’ is, in my view, wrong and does much disservice both to our patients and to our reputation as a profession.”
In the light of what happened to the late Dr Lisa Steen, I have to hope that the medical profession will take a long, hard look at how easy it is for patients to be inappropriately labelled as having ‘medically unexplained symptoms’ and take appropriate measure to prevent this from happening to anyone else. My area of interest is rare conditions and it is stunning to know that, according to the 2016 RDUK report, the main barriers to diagnosis are that patients are not being believed and/or are told that their symptoms are ‘psychological’. This is not OK.
Meanwhile, whilst I agree with Mrs Wenn that patients need to take action if their GPs label or diagnose them inaccurately, this can be very difficult. Doctors have been known to wriggle off the hook by saying that these diagnoses are ‘only an opinion’ and that all patients are entitled to a second opinion (see the NHS Choices information on ‘MUS/functional’ diagnoses). And far too often I hear reports back from patients who challenge these labels only to be told that they are resistant to mental health diagnoses because they are prejudiced against people with mental health conditions. This is also not OK.
Ultimately it doesn’t surprise me that people who are diagnosed as having ‘functional disorders’ cost our health service so much. It would be interesting to know how much of this cost is due to patients having to go to their GPs (often after consultations with neurologists) in an attempt to find out what ‘functional’ means. The only answer to this question that has ever made sense to me is that a ‘functional’ diagnosis ‘is a form of lazy psychological profiling.’ We deserve better.
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