Richard Kellett
The government's recently launched white paper, Equity and Excellence: Liberating the NHS, outlined their objective 'to increase democratic participation in the NHS with the aim of making it more accountable to the patients that it serves.'
While the paper can be applauded for the radical reform it outlines, the fundamentals of the NHS remain routed in the same model. And that will continue to be its problem.
The biggest area of concern in terms of long term success of the government's vision for the NHS is the use of information. The government calls for an 'information revolution' in terms of availability, but simply publishing data is not a revolution.
In fact, it runs the risk of exposing the inaccuracies of patient data within the NHS, and undermining the whole initiative.
The NHS cannot become more efficient and effective unless they have a better understanding of how they operate now.
They need accurate information on the running of their business so they can understand where they are doing well and where they are doing badly. Without this accurate information and access to analysis on their business performance how can they make accurate decision on efficiency savings?
Deliver patient choice
Furthermore, the government plans to reduce the amount of reporting and in effect create a commercial market for reports by providing data to third parties. While reducing the red tape and overbearing paperwork in the NHS is a good thing, the NHS still needs to produce a certain amount of information itself in order to deliver patient choice.
Therefore, the NHS must decide what to measure and report on so it can deliver the services and patient care demanded by the public. This level of central reporting is critical to delivering on its vision and must be managed by the NHS itself.
At the same time, the NHS must be mindful of the commercial market it seeks to create because like any industry, organisations will only produce something that can be sold. The risk therefore is that important information and analysis of UK health could be ignored in the quest for sales.
A predict and prevent NHS
As radical as the paper is, the NHS still faces a long term issue. While the NHS budget is 'ring-fenced', will avoid cuts as part of the deficit reduction, and in fact will see funding rise above inflation for the lifetime of the parliament, £20bn in efficiency savings are still required this year. While there is much talk about reducing headcount, that will not deliver this number alone.
In fact, with a population rising both in number and age, the NHS is rapidly heading to a tipping point that has still yet to be grappled with by government, past and present.
And the reason is that the NHS is failing to utilise its greatest asset – information. The NHS needs to radically change the way it looks at patient care. The NHS is built on the principle of 'you are ill, we will treat you'. There is nothing wrong with that in principal except the issue we face in terms of the growing and aging population coupled with budget restrictions.
Rather than being a purely transactional organisation, the NHS must use the information it has to start predicting and preventing illness. By finding ways to offer preventative measures, the NHS will reduce the amount of patients demanding care. By modelling the population and identifying trends, GPs, doctors and consultants can advise patients accurately of their risk to certain illnesses and provide preventative care. This approach would spot patients at risk of illness such as diabetes, obesity and heart conditions, and by catching them early prevent the long term impact not just to the patient but the NHS as well.
If the NHS is to truly 'put patients at the heart of everything', 'focus on continuously improving those things that really matter to patients - the outcome of their healthcare' and 'empower and liberate clinicians to innovate, with the freedom to focus on improving healthcare services', then it must identify what it really needs to measure and report on, and utilise its most valuable asset, information, to start predicting and preventing illness, not just treating it. That would be an 'information revolution'.
Richard Kellett is marketing director, UK, SAS
From Bubb's Blog
From Whitehall Watch
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