Monitor has now released the output from the NHS Futures summit held on 21 November 2013, hosted by NHS England, Monitor and the NHS Trust Development Authority. The summit was designed to spark debate about how the landscape of health and care providers could evolve over the next decade to better meet the challenges outlined in the Call to Action. Over 100 senior health leaders took part including commissioners, providers (including GPs), health policy experts, and patient and charity representatives.
The summary Call to Action document makes encouraging reading for those who believe technology can help the NHS to improve patient outcomes at lower cost. Contrary to the consultation exercise held by NHS England last August when we pointed out that remote consultation was not even mentioned, this features prominently in the Monitor summary (see especially Appendix 3, on pages 19-21), together with many other uses of technology such as smart homes, encouraging self-care, telemedicine, single patient record, interoperability, etc.
There are also some great videos – in particular the presentation by Bridget Fletcher, Chief Executive Officer, Airedale NHS Foundation Trust (there is a short preamble before she speaks, so do keep watching) – the Airedale savings from the use of videoconferencing between clinicians and prisons, care homes and patients at home get better every time I see them, and are now so impressive as to make one wonder why more trusts are not embarking on this path. At the West Midlands AHSN stakeholder meeting last Friday, Adam Hoare, Managing Director of Red Embedded, who supply Airedale’s technology, commented that there seemed to be a genuine confusion among many clinicians and healthcare managers about the difference between the secure systems that companies like his and Speakset supply, able to work across NHS firewalls and comply with all NHS requirements, and other systems like Skype that could not; the result was that many refused to use any system. Interestingly on page 29, there is a summary of the results of a consultation with 324 NHS leaders, which both puts technology second-bottom of the list of future healthcare delivery options (genomics is bottom), and also, whilst highlighting “public understanding” as a potential barrier, makes no mention of clinical understanding as a barrier at all.
Following Bridget Fletcher’s excellent presentation on the same video, there is then a presentation by Aimie Chapple, Managing Director, UK Health Industry and UK and Ireland Client Innovation at Accenture which is diminished I think by not being able to see her presentation.*See Update, below* I’m probably biased, however I’m also sad that we need a management consultant to tell us what the future of healthcare provision could look like, rather than any one of the increasing number of excellent home-grown people working in the NHS and allied organisations who, like Bridget Fletcher, both get it, and because their feet are planted firmly on the ground, can use language and speak from a position that sceptical health care managers and clinicians find it harder to ignore.
The other thing I missed in the material I read and watched was any mention of how people were to be motivated to want to look after their own health more. I remember an excellent presentation at a previous NHS Innovation Expo given by the then Cabinet Secretary in which he showed the results of a survey of people with high BMIs. The first slide showed the results of the question “who is responsible for your weight: you, your parents or the Government”; the overwhelming answer was “my parents”. The second covered the question “who will be responsible for managing the situation”; the overwhelming answer was “the Government”. From memory, “me” was never more than 10% of responses to either question.
At the West Midlands AHSN meeting, the issue of co-production was cited as one of the principal ways that the NHS will close the future funding gap (co-production is mentioned in Appendix 2 of the Call to Action too). My understanding of the term is that this is what supermarkets, self-service petrol stations, and indeed almost all online forms do: encourage people requiring a product or service to participate more in its provision so that suppliers can do less. To get patients to want to co-produce does require them to be motivated first though; currently many aren’t.
UPDATE 26 March: Aimie Chapple has kindly made her presentation available to download as a PDF (9.2MB). Click here.