Over and over again in service delivery, you find that there is somebody with a clear responsibility for delivering one part of the service, somebody else who is equally clearly responsible for delivering another part of the service, or a related service – and nobody at all who is responsible for supporting people in the transition from one stage to the next. And because nobody is responsible for it, nobody thinks to measure it either, so the problem can remain invisible to the service providers (if not to the service users), who may see very positive data about the performance of each of the components of a service, without ever seeing a picture of the complete service experienced by the user. Entirely unsurprisingly, this proves to hold true for health services, as the Guardian reports on a new review of emergency care by the Healthcare Commission:
The Healthcare Commission found most GPs, ambulance services and hospital casualty and walk-in clinics achieved the government’s targets for dealing with people quickly. But many patients were confused about where to go for help and had to wait too long in pain while being transferred from one service to another. The NHS does not measure these hidden waits and nobody takes responsibility for unnecessary suffering, the commission said.