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Shooting the messenger will get the NHS nowhere



I have never met Dr Helen Thomas, but I could understand if she felt somewhat vexed right now.

NHS England’s lead for integrated care, Dr Thomas is a woman with a responsible role. A GP for 25 years, she has brought much-needed clinical experience to the design of urgent care services. 

But her reputation has been thrown under a bus by the organisation that employs her.

Dr Thomas has been blamed for ‘misrepresenting’ plans for walk-in patients to be barred from A&E departments unless they had called NHS 111 or out-of-hours services first. Dr Thomas told an urgent care conference that the health secretary had pushed for trials of a ‘talk before you walk’ approach to A&E, adding ‘we may well pilot that’.

One of the Pulse team was present and approached Dr Thomas to confirm what she had said. Dr Thomas said discussions of a pilot were at an early stage, admitting ‘it’s going to be tricky to do it’.

The story was written up and NHS England and the Department of Health were duly contacted for comment. Neither responded in time for publication, but went on the offensive as soon as the story was published and the national media took an interest. 

They originally tried to say the Pulse story was false, but switched tactics when we published a recording of the comments from Dr Thomas, which was as clear as a bell. An NHS England spokesperson suggested Dr Thomas had misled them about what she had said, and then a DH press officer protested: ‘Dr Thomas’ comments were not representing the actual situation, do please let us know if you plan on taking this story down.’

Of course, Pulse did not take it down; we are not going to be told what to publish by the DH. And eventually NHS England apologised for suggesting our reporting of Dr Thomas’ comments was false. But the real casualty in all this was Dr Thomas. I have listened to the recording and she sounds like a straight-talking, sensible person who perhaps was not aware there was a Pulse journalist in the room.

The plans she spoke of may be questionable, particularly for their potential impact on GPs, but the instinct to pilot them is sound. The problem here is a system that is so politicised that any sensitive ideas are binned at the first squeak from the Daily Mail.

There is a real need for the NHS to think radically about how it can cope this winter. I don’t know if barring all walk-in patients from emergency departments is the answer, but I have yet to see any radical ideas that could help convince patients to think twice before they attend.

The strange thing is that Dr Thomas has been in post while some positive changes have been made. NHS 111 is finally bringing more clinical input into calls and there have been moves to improve triage of ambulance calls, albeit with an additional two-minute delay now. She is precisely the kind of person who should be shaping how the health service responds to its challenges. But I wouldn’t blame her if she walked away from NHS England in protest at how she has been treated.

We need more radical thinking, not less. Leave playing politics to the toddlers in Richmond House.

Nigel Praities is editor of Pulse. You can follow him on Twitter @nigelpraities