Tuning into national media with stories of an NHS in crisis, horrendous waits in Accident and Emergency departments, Hospitals on red alert and ever longer waits to see a GP, you might think there’s never been a worse time to work in the NHS.

However, I’m very pleased to be able to tell you a very different story, an optimistic story, and a story that you can share in.

A lot of very good things are happening locally in the NHS currently. Clinicians are more involved in decision making and this is creating some real improvements in patient care as well as in balancing the books.

Good relationships are being forged between hospital services and community services and these will lead to better care pathways.

GP’s are getting together to form Alliances to protect the continuity of care that they deliver and enable them to get involved in innovative delivery that again will benefit patients.

All in all I can say that I have never felt more optimistic about the NHS and the ability for local providers to get heads together and sort problems out locally. But a really important piece that is not necessarily paid enough attention is involvement of the public.

So how can people play a part to share in the emerging success story of our local NHS services?

In general people are very respectful and considerate in the way they use NHS services in our area. But still there are some very important considerations that might seem small on an individual basis but cumulatively could make a really big difference.

It isn’t well known that 90% of the total money that is spent on healthcare in a person’s life on average gets spent in the last six months of that life. Often decisions get made in these crucial times that are not always thoroughly thought out or necessarily obviously in the patient’s best interest because of one pressure or another.

The first serious question I think that people and possibly their carers need to be asking themselves and their doctors is “how do I want that last phase of life to go and is there anything I can do to plan ahead?” It is possible to set up advance directives to make absolutely clear what is and is not desired but this is still quite a rare occurrence.

Sadly, all too often, people end up in extreme situations having futile treatments and heroic interventions at great cost to the NHS when it’s clear that if properly consulted nobody would have chosen this route.

Secondly, more people need to be thinking about their major risks to health and whether they are doing enough to reduce them.

The obvious one is obesity associated with lack of exercise and unhealthy diet but your doctor will help you with others such as cardiovascular risk, diabetes risk or even risk of bone fractures from osteoporosis.

It isn’t good enough anymore to assume that the NHS will operate as a safety net to catch people as they fall because of long term unhealthy lifestyles. The NHS needs to do its bit to support people with health promotion but people should keep their end of the bargain by taking more responsibility for themselves.

Thirdly, as a service provider it’s easy to feel that people are getting less self-sufficient and treating the NHS more and more as a convenience service for illnesses that they ought to be able to manage themselves.

This takes up precious resources of time and money that could be more appropriately available to chronically unwell, elderly or even dying people. It’s really important that we ask people to pause and consider whether they really need to be seen or whether they can be more self-sufficient and seek other forms of help rather than going to A&E or booking a GP appointment.

People are waking up to the fact that the NHS is the most precious of all national services but that it is under immense pressure as it tries to sort itself out while politicians continue to play political football.

Locally we have good opportunities to preserve the NHS family and keep care provision at excellent levels and we need your help and support to do that. Together we can and must keep the NHS going.

- Dr Andy Field works at York Medical Group