Patient self referral
By Georgina Adamson
Blog 1 September 2015

Transformation doesn’t tend to come cheap whatever line of business you’re in, and the NHS is no different. In the world of business and commerce, transformation is subject to large pots of money facilitating brand launches, new value sets, new processes and refinement of skill mixes to become more appropriate to new workforce needs of the organisation. Here investments in I.T can open up new markets, drive efficiency and add to the ‘bottom line’ which is great news for everyone (customers, investors etc.).

During my 25 years in the NHS, I have learned that there is an abundance of transformative ideas. There is no shortage of new evidence-based medicines and procedures, no shortage of plans to improve efficiency through refined processes and no shortage of enthusiasm.  There is however, a shortage of money to fund bridging the gap between closing old processes, and reaping the benefits of the new. Where business and commerce has investors, the NHS has the odd opportunistic fund to fight over and the occasional injection of emergency cash.

Take for instance this years Health and Social Care Innovation Expo event. This will be awash with good ideas, technologies and hints on how to improve the NHS.  It will even continue the NHS Test Beds project, in which innovators all manically woo each other in the hope of finding their perfect partner.  I doubt very much if at this year’s event we’ll see an army of financial institutions offering bridging loans to cover the time between the implementation of the new technology and the phasing out of the old – the ‘double running period’.

In the absence of a transformational fund what can industry do to help?  We can rely on the centrally inspired ‘funds’ to support pilots or test programmes, we can commit commercial suicide by giving stuff away, and we can even try and get the patient to pay, or we can be creative in our contracting to enable new services to get to the required scale at which cash is released, then we have sensible repayment arrangements.

An example is the NHS Health Call digitally enabled INR self-testing service. We know that there is a lot of money tied up running anticoagulation clinics.  The clinics are full so we hold back at wider screening programmes for atrial fibrillation because we don’t have the capacity to meet the demand this will place on the clinics.   We also know there is a lot of guidance supporting self- testing – it’s good for patients (doesn’t interrupt their lifestyles), it’s good for health outcomes (TTR rates are much higher and more consistent) and because of the improved clinical outcomes (fewer strokes, adverse incidents etc.) and it is cost-effective.  The problem is that providers can’t afford self-testing at scale until they’ve released cash from the clinics.

Because we at Inhealthcare are a commercial partner of NHS Health Call, they are able to work with providers to understand how much activity over what period is required to release cash to then fund the new digital health service.  An agreement is then reached where service charges are deferred until cash has been released.

So it is possible to transform clinical services. Inhealthcare has created the wherewithal to support providers through the challenging cash release phase of their transformation process in providing digital health services.  If you have the opportunity come and talk to me at this year’s Health and Care Innovation Expo at stand 89 and I’ll discuss how you really can transform without going anywhere near a bank.

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