Is the NHS fit for the future?
Like nearly one in three men, I have high blood pressure. When I went to the doctor with this condition, he wanted to put me on statins to reduce my cholesterol. He didn’t mention taking up exercise, losing weight or eating healthily. It was me who decided to take those steps.
My experience shows that the for the NHS to be fit for the future it has to go through a fundamental reevaluation of its purpose with the British population. There is too much expectation that the NHS will give you whatever you want, at no cost, free at the point of delivery and with no concept of taking responsibility for yourself.
So instead of prescribing more drugs, the NHS has to start asking people what they can do to make themselves fitter and healthier. And if it embraces the massive opportunities presented by digital technology, I truly believe that our beloved service can become more productive and deliver much better outcomes for patients.
At a time of massive financial pressure on the NHS, there are far too many vested interests whose very existence depends on being paid by the activity they carry out. Being paid by activity does not encourage clinicians to do less. On the contrary. If we can change that topsy-turvy model, our NHS could be transformed so it is fit for the future.
But on its current course, it will need tens of billions of pounds of extra money that our nation can ill afford just to meet demand. Brave people must be prepared to shut units, close down hospitals, centralise services and challenge patients and the Press.
The public would never allow the NHS to go bust but they will have to accept more welfare cuts and increased taxes to pay for the lack of reform. Unfortunately, politicians have the tendency to believe that the NHS should not be tampered with and anyone who does tends to have a short career. Andrew Lansley lasted two years as Health Secretary. His successor Jeremy Hunt is probably on his way out.
But if you talk to people and look at their habits, you will find they are actually highly likely to engage with the new ways of working offered by new technology. In Leeds, there are thousands of internet searches every month asking, ‘have I got type 2 diabetes?’ This shows that for many people, it is Google that they go to, not their doctor, for information.
The public are far more open minded to be treated in a new way than a lot of clinicians and politicians think they are. They should be embracing the wish to do things digitally with digital apps, content and connections with support services and not fight against it.
Technology can revolutionise a service based on practices dating back decades and even centuries. The NHS has evolved into a service that is heavily dependent on how many tools it has available, how many appointments it can see and how much capacity it has.
But clever software and hardware allow doctors and nurses to develop new ways to treat people that will lead to better outcomes, both for patients and the NHS.
Take warfarin as an example. This drug is widely prescribed to stop blood clotting but must be closely monitored to ensure safety. This means the patient must take time out every couple of weeks to visit a clinic to be checked.
Using simple, safe and secure technology, it is possible for the patient to test herself, eliminating the need to visit the clinic. The clinician assesses the data remotely and provides the appropriate medical advice.
In Leeds, some 10,000 warfarin patients a month are chained to the routine of visiting the clinic. Imagine the freedom that such self-testing technology could have on their lives, not to mention the freeing up of valuable space and time at the hospital.
It can also ‘activate’ the person to make her more aware of her condition and treatment. Our experience as a digital health company is that patients who self-tested improved their compliance with treatment far greater than the patients that didn’t self test. Nurses think that it is because they can make the connection between their diet and their lifestyle.
Technology has an amazing ability to engage, educate and communicate. All of these things are what the NHS needs to do more of. Technology allows hospitals, general practices, community health care centres and care homes to deliver care at a distance. Technology bridges the gap.
The NHS is one of the last industries not to have embraced the innovations available through the rapid advances in computing power. As the headlines show day after day, this resistance is becoming increasingly costly, both financially and in terms of staff morale.
The challenge is considerable: under Government plans, the health service has to improve its output by £30bn by 2020. It is only through close working between technologists and clinicians in the development of new branches of medicine that we can square the circle and show that the annual budget of £140bn is quite enough to look after and care for our population of 65m. Which is all we expect.
A version of this article has been published in The Yorkshire Post.