Contributing to Public Health
The Princess Grace Hospital
Sue Smith, Chief Executive of The Princess Grace Hospital in central London, looks at the contribution of private health care providers to public health
Public health is a society-wide agenda, too often seen as "somebody else's problem" - government's problem - rather than an issue to which every individual, family, employer, community and health care professional can and should contribute. By example and by proactively encouraging and supporting others to do all those things that we know are good for us, we can all make a positive contribution to public health.
As an employer and health care services provider, I know only too well the importance of leading by example and the value of continuous education, training, communication and fostering a culture of good health practices both among employees and the patients we serve. Advising patients as well as screening, testing, diagnosing and treating them, is integral to what we do in the private sector as it is in the NHS.
Vigorous infection control is an obvious contribution to public health improvement in this country, where we have virtually no hospital acquired MRSA bacteraemia cases in our own or our sister HCA hospitals. Our award-winning patient safety programmes and overall proactive risk management approach set and implement standards that goes beyond the robust, detailed regulatory requirements for private sector hospitals. Implementing best practices quickly, such as better blood transfusion guidelines, also helps to deliver good public health and develop learning that is shared with colleagues in the NHS. Similarly, we are currently developing new procedures for greater medication safety using new technology bar coding on patient medicines and records that will be used as a case study for other hospitals in the public and private sector to further minimise risks to patients.
Adopting an active, continuous improvement approach to everything we do goes well beyond core care skills and extends to medical technology and techniques. We, with the consultants who have admitting privileges at the Princess Grace, seek out clinically advanced, but thoroughly tested, new diagnostic and treatment services and facilities in which to invest. Sadly, some of these remain on the 'wish list' for many NHS Trusts for months or even years, restricting the public health benefits for individuals. Many of our investments address fundamental diseases that are high on the public health issues agenda. We, though, do not restrict their use to medically insured or self-pay patients, but will make them available for NHS funded patients who can most benefit, on an ad hoc or contract basis.
One of the most recent advanced techniques we have made available for patients tackles prostate cancer - one of the major public health concerns of our generation. High intensity focused ultrasound (HIFU), is the latest in the full range of diagnostics and treatments we provide, tailored to meet the needs and individual choice of patients. We are the only UK hospital currently using the Sonablate 500T HIFU equipment, which has been proven in international trials to be as effective as conventional surgery and radiotherapy, yet with less risk of erectile dysfunction and loss of bladder control.
Another major public health issue is breast cancer and apart from the standard diagnostic, surgery, treatment and counselling services that we provide to patients, we are one of the few UK hospitals to have full field digital mammography equipment with an expert and experienced clinical team.
Around 41,000 new cases of breast cancer are diagnosed in the UK each year, with one in five women being under 50 years old. Digital mammography is particularly suited for younger women because the computerised screen image produced can be manipulated and enhanced to reveal any potential problem, even where no lump or other indication has been apparent. Part of the problem of conventional mammograms is that they are less able to identify tumours and cysts in pre-menopausal women, because their breasts are made up of dense tissue that the X-ray is unable to penetrate.
Of all the women taking advantage of the hospital's routine screening service, nine out of ten aged 50+ have opted for digital screening, because it enables a clear assessment of breast tissue and provides immediate reporting with the image appearing on the screen within seconds. For those having regular scans, the added advantage of a digital image is the computerised comparison that immediately identifies any changes in the breast. That saves time, money and lives.
With millions of individuals undergoing routine, full health screening or specific diagnosis and treatment in independent hospitals each year and occupational health programmes covering millions more via employers, the private sector already plays a significant role in supporting the achievement of our country's public health needs. The latest strategy on public health published in November 2004, aims to increase the participation of all of us - individually and corporately - in improving the health of the nation. It is a challenge that private health care providers like ourselves, will continue to address with relish and effectiveness.
-ends-
