The rationing of care: Valuing public services is not, and should never be, an exercise in accountancy

A recent BMJ study showed that reducing cost through shedding or not replacing frontline nursing staff impacts negatively on the quality and safety of care which, in turn, is detrimental to not only on patient outcomes but also on the financial costs of the health and social care system. Chih Hoong Sin argues that the NHS needs to adopt a whole-system and outcomes-focused approach that illuminates the true costs of various services and staff, as well as the range of direct and indirect benefits.