10th February 2016

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Prof Sir Mike (Deep-Diver) Richards - CQC
In conversation with Roy Lilley - King's Fund March 1st, 5.30pm
Tickets and details HERE

News and Comment from Roy Lilley
How did you start the day, yesterday?  Dive out of bed, run through the shower, gulp a coffee... leg it to work? 
Maybe, sort the kids out, do the lunch boxes, find the headmistress' letter inviting you to a parents evening last week... aargh!
Perhaps a well ordered couple of Danish rashers a free range egg or two, a slice of stone-ground and a bone china cup of Earl Grey?
However you started your day you would not have wanted the mood music to be this:
Rise in public dissatisfaction with NHS, 
King's Fund survey reveals
There you are working your backside off and that's the King's Fund's contribution to the start your day.  Let's dig a bit deeper.
First, it's not a King's Fund survey; it was carried out by NatCen.  The KF paid for it and provided the gift wrapping.  (Full report here)
Second, it is a British Social Attitudes survey.  Britain, get it... not just our bit of the NHS.
Third, the small print in the survey says:
"The results show that public satisfaction is not a straightforward appraisal of NHS performance. It is a multi-faceted measure influenced by respondents' views on politics, policy and public institutions, as well as their experience of the NHS."
Who were these 'public'?  The survey-bobble-hats tell us they were a group of people who;
"... will not have recently used the particular service they have been asked to comment on. Because of this, they are asked to consider either their own experience or what they have heard from other sources in their answers."
They tell us older people, who vote conservative, are more likely to be satisfied with the NHS.  But, Labour supporters satisfaction with the NHS jumped 11% during the coalition years - go figure that one out.  Your guess is as good as the bobble-hatters.
Satisfaction with hospital services?  

Here's what they say:
"As only a small proportion of the population has direct experience of hospital services each year, respondents are likely to be reflecting on a range of factors when answering these questions, many of which will also contribute to their overall levels of satisfaction."
In other words, in any other life, they'd be a 'don't know'!  As a witness in court they'd be 'unreliable'.
For the 23% of respondents who said they were very or quite dissatisfied; waiting times, staff shortages, underfunding and financial inefficiency were the top four reasons for dissatisfaction... quality of care being cited by a quarter. 
... but, I can't tell you if they were waiting for an operation, had a son who was a nurse, a granny with a pressure-sore, or was a mate of the finance director.  They might just have read the Daily Mail?
The survey was conducted during the general election campaign whilst the press was raging with difficulties in getting a GP appointment, the higher weekend mortality row, the run-up to the Doc's strike, social care on its knees, deficits and Addenbrooke's ChEx quitting.
Who was interviewed?  Randomly selected households, where a single, +18 year old was interviewed choosing answers from a preselected list.  

The NHS sample size was 1,062.  The data weighted and 'corrected' for the 'unequal probabilities of selection' (like the general election polling?) with a margin of error +/- 1.8 to 3.5%.
So, what have we got; a headline based on the feelings, guesses and attitudes of fewer people than could fill the corner of a football stadium, who may have heard some gossip about the NHS, their answers 'weighted' and fiddled about by the dark arts of polling with big-spread margin of error.
My view?  They are right about the money, waiting times, staff shortages and underfunding but... it's still OK to be proud of what you do.
After all the horrible headlines and the bobble-hats having their annual best-guess-fest; is the NHS better or worse than it was this time last year?  

Answer: Probably.
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