Opinions

The Greatest Achievements of the NHS: 1948-Present

On 5 July 1948, the National Health Service was born at Park Hospital in Manchester (now known as Trafford General Hospital) as the result of an ambitious plan: Healthcare free at the point of delivery as a basic human right.

While it isn’t without fault, the NHS has gone into become a national intuition that is admired around the world. It’s survived numerous restructures, has adapted well to innovation and has (largely) met the demands of a growing and ageing population.

However, what is the NHS’s greatest achievement? In a recent poll, more than 5,500 BMJ readers voted on their greatest NHS achievement from a shortlist – from creating the foundations of general practice to its track record in research and development. The results were as follows:

 

  • Providing care based on need and free at the point of delivery (23% of votes) – The NHS was the first healthcare system to offer free care for all, removing the fear of how to pay for care

 

  • Limiting external influence on patient care (18%) – clinicians are not burdened by external influences when offering advice on treatments; treatment is based on need and evidence

 

  • General practice as the foundation for patient care (10%) – This is the cornerstone of the NHS. The role general practice plays within the community that provides the basis for continuity of care

 

  • Comprehensive childhood vaccination programme (9%) – Thanks to the NHS, children are protected against dangerous diseases, such as smallpox and polio, which are almost all but completely eradicated

 

  • Raising the status of anaesthetists (9%) – Anaesthesia is the largest single hospital specialty in the NHS and is widely recognised being at the forefront of patient safety and quality improvement

 

  • Staff working for a common good (7%) – The value of “working together for patients” is a central tenet guiding service provision in the NHS

 

  • Championing evidence-based medicine (6%) – When health professionals make a treatment decision, this is based on their clinical expertise, preferences of the patient and the best available evidence

 

  • Leading the world in cost effective healthcare (5%) – Evidence-based healthcare was created by the Cochrane Collaboration, and then the Centre for Evidence based Medicine, both funded by the NHS research and development programme

 

  • Free contraception for all women (4%) – This has empowered women to take control of their fertility and help to prevent transmission of sexually transmitted diseases

 

  • Promoting patient centred care (4%) – Supporting people to develop the knowledge, skills and confidence to manage and make informed decisions about their own health

 

  • Access to in vitro fertilisation (1%) – Infertility effects one in seven couples and can have a devasting effect on people lives. In the UK, more than a quarter of a million babies have been born because of IVF treatment

 

  • Encouraging and supporting research and innovation (1%) The NHS has supported some of the most innovative and cutting-edge research discoveries in the past 70 years part of the standardised care patients receive today

 

Truth be told, the list of NHS achievements is endless. Personally, I would have liked to have seen the NHS Screening Programme on this list, which is responsible for more than 20 million screening tests each year – that undoubtedly saves thousands of lives. This includes: Abdominal Aortic Aneurysms, Bowel Cancer, Breast Cancer, Diabetic Eye, Fetal Anomaly, Infectious Diseases in Pregnancy, Newborn and Infant Examinations, Newborn Blood Spot Screening, Newborn Hearing and Sickle Cell & Thalassemia.

In many ways, the NHS has become a victim of its own success. People are living longer, more treatments exist, more research is being done, and the general health of the nation is better. Therefore this opens the NHS up to criticism when it does fail to deliver.  However, perhaps the greatest NHS achievement is its sheer survival, as a health service based on need and free at the point of delivery.

Is there anything you would have included to this shortlist?

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