The NHS is under pressure like never before. Unfathomable demand, with an aging population needing more care, combined with an imperative to find £22bn of efficiency savings by 2020… just to keep afloat.
How to do it? Undoubtedly as one of the world’s last remaining nationalised industries there is bureaucracy, waste and procedures and practices that would drive business entrepreneurs around the bend and back again.
Despite its imperfections, affection for the NHS remains at an all-time high. Public fear of alternative systems; top-up-payments, insurance premiums and co-payments means these are all no-go areas for politicians.
Buying better, doing things better and cranking up efficiency are some of the approaches the NHS has to embrace.
Doing things differently.
At the heart of change is innovation; the management of information by the use of technology, device based self-care, remote care and diagnostics are all technologies that are available now; many on the smartphone in your pocket.
Why is the NHS such a slow adopter of technology? Stung by catastrophic forays into ‘big-technology’ and national programmes for IT, many of which ended in costly failure, the NHS is cautious and saddled with procurement rules that prevent it from being nimble.
Since its inception in 1948, the NHS has collected patient data; a treasure trove for public health planners and commissioners. Fears of breeches in confidentiality and the sheer size of the task to unravel it and who should have access, means this vital opportunity remains stalled in consultation and officialdom.
The NHS Digital Technology programme is a fresh approach to harness the power of technology and introduce the devices and systems we take for granted in our daily lives.
But, the step-change the NHS needs, the big push, is most likely to come from a frustrated public. Already apps are appearing that give 24-7 access, via Facetime and Skype to a GP. For a monthly fee a busy executive and their family can have access to instant opinions, diagnostics and prescriptions. No more hanging on the phone to make a GP appointment or juggling clunky websites to find a time that fits with a busy life.
A recent announcement that all NHS premises will have Wi-Fi access, at last, puts the NHS on a par with every coffee shop in the high street. Opening this highway means creating an opportunity for Apps and the type of contact that is long overdue.
The market is full of smartphone based technology that can monitor everything from blood-sugar levels, to meters measuring lung function, blood pressure and a host of other vital signs. Linked to algorithms, patients with long-term conditions are spared the torment of practice and hospital clinics and waiting rooms. The moment they post an ‘outlier’ reading they can be called, counselled and cared for. Quicker, better and cheaper.
Recent entries include:
- Chat Health Hertfordshire – A school nurse App giving 11-19 year olds confidential help on a range of issues.
- The Lister Hospital’s RRC – An exciting ‘remote’ renal clinic connects dialysis and transplant patients from their own homes to the renal unit by video, an idea funded by the Small Business Research Initiative.
- Telehealth hub at Airedale Hospital – Remote face-to-face consultations have been made possible in nursing homes; improving care and reducing hospital admissions by over one third.
- Ieso digital health – In mental health, talking therapies are available, live from a conative therapist, on-line.
- Change4Life Sugar Smart – The latest entry is from Public Health England; their sugar App reads bar-codes and advises on sugar content.
The technologies are coming thick and fast. Interoperability is the next worry for the NHS. How to knit them together, interface them with legacy systems and make them meaningful for clinicians and helpful for the public.
It’s likely that Millennials (and soon enough Generation Z too) will be impatient for change. If they can book a holiday online, why not a doctor’s appointment? If they can access their bank on the move, why not their healthcare records, too? If they can buy an item from Amazon, delivered the same day, why not a prescription for their regular medication?
The shifting requirements of people lives, the need for austerity and the abundance of innovation might help re-launch the NHS. Digital technologies certainly are helping to strengthening communities across the UK, but how much of a part the NHS will play – only time will tell.