11.04.18

Will the NHS balloon pop?

Whatever the tale of numbers and statistics, I can honestly say, having worked in and with the NHS for over 20 years, that we need different approaches and new solutions more now than ever before.  For the first time, I am seeing Trusts and systems, who have achieved significant efficiencies, implement ambulatory care services to stop people being admitted if they don’t really need it, in addition to continuous reviews of patients staying longer than expected. However, their buildings cannot cope with more patients and neither can the systems the way they are currently configured.

What is undeniable is the increasing queues of ambulances outside hospitals waiting to offload patients, the stories of patients dying in the community while waiting for a response and the nursing of patients in corridors now being a matter or course and is a sad reflection that this no longer horrifies everyone. Some of these changes have become necessary evils to try to absorb the continuously growing demand, but we must address these now to deliver change and improve care for patients.

Will the NHS balloon pop?

Another major hurdle that we need to address and overcome is the colossal gaps in our workforce. Reports of as many as 10,000 EU staff have left the NHS post the Brexit referendum decision. Add to that the fact that almost half of GPs in some parts of England are aged 55+, and local hospitals that can’t compete for staff with specialist teaching hospitals with great reputations – we undoubtedly have a people problem.

Our current system is not adequately responsive nor adaptive to cope with this incessant rise in demand and performance figures confirm this. Yet there remains a culture in the NHS where it is unacceptable for CEO’s and Boards to tell regulators and ministers that they cannot achieve everything. While this approach keeps people fighting to deliver, it fails to provide an environment where an honest conversation about the reality and the potential future solutions can be had.

Now, this isn’t a blog about complaining though – the challenges are obvious but the solutions are not. If we are to encourage politicians and regulators to support change then we need to be able to give them credible solutions for making things different:

  1. We need to embrace technology to satisfy the need for instant access to healthcare.
  1. Machine learning and AI are already capable of identifying things like Sepsis with frightening accuracy with no clinical data used.
  1. We need to harness social media and maximise social change marketing to inform and educate the masses on what services exist and how best to access them.
  1. We need to explore the emerging world of robotics to embrace opportunities to narrow the massive workforce challenges and maximise the impact of the great staff we do have.
  1. We need to use real business intelligence and invest in ensuring we have the most accurate information on what patients need.
  1. We need to accept that lots of data and information on which we base current service decisions remains poor in relation to what can be provided by true BI experts - even large-scale change programmes are regularly based on assumptions and best guess modelling which is a position that cannot continue in the future if we are to succeed.
  1. And, we need to share that evidence across the whole system so that commissioners and providers design services together.

There are currently too many barriers in place to stop this happening but, only when we have this objective view, can we design clinically-led services that will truly meet the needs of patients and bypass silos agendas.

Improving the quality of the BI, AI and machine learning will also increase our ability to identify current conditions earlier and move towards prevention rather than reaction and response.  We should be identifying elderly patients long before they become frail, using the masses of intelligence we have in the NHS to plan ahead with accuracy.  Only then can we develop and put in place measures to prevent.

One thing is certain, we need to create a system which encourages and rewards radically different ways of working.  If we are to create a sustainable NHS that will serve patients for decades to come, we need to embrace opportunities, adapt our system design and create truly new solutions for improving healthcare together.

Neil storey

Guest blogger: Neil Storey, CEO Revolutionise Ltd

Neil is CEO of Revolutionise, an organisation that works alongside healthcare professionals to identify solutions that boost performance and improve patient care.Neil has worked in the healthcare sector for over 20 years, as a clinician, Board director and consultant. He has made an invaluable contribution to the NHS and utilised his innovative thinking to build a successful business and enhance the performance of many healthcare teams and organisations. His approach incorporates team-based support for healthcare professionals, a bespoke diagnostic and a revolutionary new workforce management system. Together, this helps enhance patient experience, improve quality of care and save money.His broad experience and understanding of healthcare sector has facilitated the bringing together of health professionals and the Board to improve performance and achieve successful change. He is motivated by the wellbeing of patients and helping healthcare professionals tap into innovative solutions to improve delivery.

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