ABSTRACT
In the aftershocks of Covid, it is not entirely clear what the state of the National Health Service (NHS) is at the present time. When needed in acute care, the NHS can be fantastic and for diagnosing and managing rare conditions. However, there are times when it can let people down. The challenge is the complacency that patients and doctors have started to feel. There needs to be a shift to a more open discussion. Knowing the costs can help people understand what they are paying for and what they are getting. Of course, patients are often very grateful when it helps them, but fundamentally they don’t appreciate quite how much things cost, the complex nature of interventions and how their choices have knock on effects. Making incessant demands can be difficult for both sides of the equation. The challenge is to make it very explicit to people that even though they are paying the same as everyone else, actually the choices they make are putting them at an increased risk of ill health. Also, often the staff feel bullied and not appreciated. The staff being valued is really important.
