The NHS at 75

The NHS at 75

Ms Clare McNaught, RCSEd Vice-President, reflects on 75 Years of the NHS.

Today marks the 75th anniversary of the introduction of the NHS. The concept of providing a free, at the point of delivery health service to the entire population was a bold initiative and a key part of the wider Beveridge program of welfare reform, designed to address post-war social inequality. Over the years, the NHS has been a beacon of hope to many in need, and there is perhaps no other organisation in the UK that is held in such high regard.

As we celebrate this milestone anniversary, it is right to take time to reflect and contemplate the remarkable journey that the NHS has taken since its foundation. In particular, it gives me huge pride to see how our profession of surgery has developed over this period, with pioneering new operative techniques and technology which have led to better outcomes and quality of life for our patients.

There are so many examples of how far we have progressed. Over my thirty years in clinical practice as a coloproctologist, I have seen how the treatment of colorectal cancer liver metastasis has changed from simple palliative care to the multiple options of treatment including chemotherapy, liver resection, and even transplantation. It really is wonderful to be able to give patients with advanced cancer some hope for their future and this also brings me such great professional fulfilment, which helps sustain me during the more difficult days of my clinical practice.

Admittedly, the NHS is not having its best year. The ageing and expanding population has increased the clinical demand on the service exponentially, with waiting lists at a record high and the depleted workforce struggling to keep pace. In addition, morale is at an all-time low, with nurses, junior doctors and consultants all voting to strike. Sometimes it seems that these problems are insurmountable. But if you look at the last 75 years, the one thing that the NHS has demonstrated is its resilience in the face of adversity and its ability to rise to any challenge. We only have to look back a few years to the Covid-19 vaccination program, perhaps best considered as a modern miracle, given its significant impact on all our lives.

For the NHS to survive another 75 years, we must invest in and support the most critical aspect of the organisation which involves the staff who work in it. RCSEd, along with our sister colleges, have been campaigning for the publication of a long-term workforce solution for the NHS, which has finally been released this week. This is a welcome first step toward addressing the high vacancy rates that exist in the NHS but further action is required to tackle the poor workplace environment and culture that we work in.

The wellbeing of our surgical workforce has been a key priority for our College over the last few years. RCSEd has been pivotal in highlighting and addressing the bullying and undermining culture of the NHS through our #LetsRemoveIt campaign and the recently launched conflict resolution course. In addition, our incredible trainees committee have just held their third ‘wellbeing week’ with many events and resources which you can still access online at our website or through our app.

Over the next decade, the NHS will need to evolve and adopt innovative technologies and working practices to cope with the volume of patients who will access the system. We are already seeing the rapid uptake in robotics in many of our specialities and the tentative first use of AI in specialities such as radiology. As a College, we continue to be at the forefront in ensuring that these new techniques are introduced safely to minimise patient harm. We are incredibly proud of our new robotics training facility, and have recently published guidance on the safe introduction of robotic surgery.

The NHS has come a long way in the last 75 years. At the heart of this success are the amazing staff who work in the organisation. If we can find a way to further invest in their wellbeing and value the contribution they make on a daily basis, who knows what we could achieve in the next seven decades and beyond.

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