Transcript of VPS Podcast 6 - Vulval conditions and the new NHS: a presentation given by David Nunns

This is a transcript of the soundtrack from VPS Podcast 6, which is an audio recording of a slide presentation given by Dr David Nunns at the VPS Super Workshop, 11 May 2013. You can listen to the podcast at Podcast 6 - Vulval conditions and the new NHS: a presentation given by David Nunns


David Nunns: Morning! Hello everyone – thanks for coming again! I’m down on the agenda as a FROG…


David Nunns: I think there’s a typo there! I hate letters after my name, but it’s FRCOG, which means ‘Fellow of the Royal College of Obstetricians and Gynaecologists’, but I like FROG…


David Nunns: …I’m going to stick to that!

I’m going to give a slightly different talk to what I’ve talked about previously, which is to give you an update, my perspectives on what’s happening in the NHS and what’s happening with regards to vulval conditions. I say ‘vulval conditions’ not to just talk about vulvodynia, but lichen sclerosus, skin conditions, any sort of problem to do with the vulva, even infections, recurrent thrush etc. What we’ve seen in recent times is perhaps the biggest shakeup of the NHS ever. This coalition government is very keen that we become the best health system in the world and the fundamental changes to the current setup are that patients will have more of a say in their care, that we’ll really focus on the outcomes of care, and that health services will be bought by GP commissioning teams, so the leaders of this will be the GPs or the commissioners, and this has been a huge shift from what we’ve had in the past. All of us who work in the NHS, we aspire to these following things, and we obviously want in terms of healthcare for it to be of the highest quality: what we’d want for ourselves or our loved ones. We want that level of care to be equal for everybody. What one person gets, the next person gets as well: we don’t want this postcode lottery that you sometimes read about. And importantly, we want it to be effective; we want healthcare to help us to get better – we want it to work.

There’s a huge focus now on patients’ experience of healthcare and how satisfied they are with their healthcare and their experience of the service they get. Everything from waiting times to car parking to communication with doctors, information the patients get, even patients’ involvement in the decision-making process - this is all now hugely important for when we provide care to patients.

Cost-effectiveness – it sounds tainted, that phrase, doesn’t it, something that’s ‘cost-effective’? Because it sounds like you spend money on one thing and not on another. Perhaps a better term is ‘value for money’. We have to have healthcare that is value for money, basically - we can’t just pour pots of money into health interventions that don’t provide high quality equitable healthcare. So that’s very much a part of what we should aspire to in the NHS.

And to focus on outcomes – now this is really very much on the agenda health-wise. What’s the point of doing something, some operation or procedure to a patient if actually it makes no difference? What’s the point of investing huge amounts of money into a campaign, or into a building or into staff, if actually nothing’s changed? The most obvious part of healthcare that springs to mind is cancer care, and we have now in the public domain survival rates for treatment following cancer. They’re out there, we can easily access them, you can see how your hospital, your region does and you’ll see that some hospitals have good outcomes and some have poorer outcomes. This is probably the way forward really in terms of healthcare, to drive up the standard of those hospitals with poorer outcomes. It’s not just cancer care, it’s readmission rates to hospital, the number of patients, for example, who’ve had diarrhoea from antibiotics, the number of patients who report hospitals poorly on a patient satisfaction survey – there’s plenty of those national surveys around. But these outcomes are what are going to be examined very closely by what we call ‘commissioners’, or the GP leaders who are going to be buying up the services in our hospitals and communities.