By James Tout on 6 September 2016
This Expo, these are the big changes experts are predicting will transform the NHS
This year’s NHS Health and Care Innovation Expo promises a heady mix of policy insight, top-level debate and a panoply of technological innovations transforming the NHS.
Ahead of the two-day event in Manchester, we spoke to some of the leading experts working alongside NHS organisations to bring about change through innovation.
With expertise in many of the key topics being debated at Expo, we wanted to pick their brains on how the health service can overcome the challenges it faces and continue to deliver excellent patient care outcomes.
Here are their thoughts on the top six developments to watch:
1. Re-engaging the workforce through health and care devolution
David Rose, Chief Executive, Dr Foster
“The devolution of responsibility for health and care to Greater Manchester is a defining moment that is likely to be replicated across England over the coming years. With the right will and careful implementation, this could be a golden opportunity to structure services according to local needs, as well as re-engaging parts of the NHS workforce that have become disillusioned by too many top-down changes.
“There are a number of practical things NHS leaders can do to assist the process. Understanding unexpected variations in health and care within defined geographical areas is a critical part of ironing out the health inequalities that still beset too many communities.
“Regularising care pathways across regions will also be important to ensure patients get consistent care wherever they live. Some trusts are already doing good work here, but there is now a job to be done to spread learnings across devolved authority areas. Finally, NHS leaders must trust frontline clinicians to scrutinise their own care outcomes, and free them to work collaboratively to address any concerns constructively.”
2. Mainstreaming of Personal Health Records (PHRs)
Dan Moulin, eRedbook Project Director, Sitekit
“The digital transformation of pathways using collaborative Personal Health Records (PHRs) is really exciting. Connecting PHRs with clinical records across services is a win-win for citizens and the health system. The eRedbook is an excellent example of digital transformation in child health and helping to progress the ‘Healthy Children’ agenda.
“Parents find it easier to access their Personal Child Health Record through their digital devices, which they tend to have with them. This enables parents to create a whole system record of their child’s health. It’s easier for parent’s to engage online with personalised information, get a greater understanding of their child’s health and development and therefore much easier to keep their children healthy.
“The NHS benefits from empowered parents, improved quality of care, quality of data, better data sharing and communication across services, while at the same time making cost savings from having more efficient paperless processes.”
3. Technology increasing efficiency
Simon Hudson, Director, Cloud2
“The NHS has many challenges, as has always been the case, however its ability to innovate effectively remains foremost amongst them.
“The issue is not invention within the NHS, which is rife and often first rate; rather it is diffusion and adoption which remains endemically poor. As a large group of loosely connected organisations, the NHS lacks a central process for sharing innovation, measuring adoption and for holding executives accountable for driving the disruptive new practices required for innovation to deliver the outcomes it promises. This is especially true in the vital non-clinical activities.
“All is not doom and gloom. While institutionalised innovation is in a risible state, grassroots initiatives remain healthy. The continued uptake of Kinesis, a platform for connecting GPs with hospital consultants, in South London – driven by word of mouth, robust evidence and a willingness to invest in and resolutely drive the change management – is one example where innovation is successfully delivering strong benefits.”
4. More integrated care through Sustainability and Transformation Plans (STPs)
Dr Mark Davies, European Medical Director, Mede Analytics
“STPs represent a unique opportunity to take a whole system-wide view of financial sustainability and service redesign. For the first time in the history of the NHS this links funding directly to longer term initiatives such as prevention programmes. The danger is that the sense of immediacy to address short term financial stability may crowd out the debates on local transformation plans. Local community engagement is really important here to avoid this being reduced to a narrative about ‘cuts’.
“The ability of the STPs’ leaders to create a shared vision amongst their constituent organisations and provide an antidote to ‘organisational myopia’ is going to be critical. This is a time for leaders to lead. This approach, based on a population rather than individual organisation, is predicated on a joined-up view of the whole system which shows interdependencies and opportunities. Joining up data is not only possible in the current framework – it is essential . The effective sharing of data is essentially the foundation that an STP will be built on.”
5. Digital adoption at scale
Robin Vickers, Chief Executive, Digital Life Sciences
“For me, Jeremy Hunt and Simon Stevens have got the strategy right. Making local organisations, centred on registered populations, accountable for our care and the financial performance of healthcare is critically important. System-wide change has to come from those who are accountable at a local level.
“Indeed, to deploy new digital technologies as an enabler of transformation, has to be done with organisations that are genuinely bought in to the need for system-wide change in the way in which health and care is delivered to local populations.
“We’re working closely with primary and community organisations to plan and deliver meaningful change. Some are emerging multispecialty providers/Vanguards such as Modality and West Wakefield, while others come from commissioner-led environments such as in Aylesbury, where the CCG has driven a programme of transforming and scaling up primary care, to gradually shift the focus towards preventative population health management at a local level.
“Whilst there are a growing number of people starting to make this change happen, the pace is slow and too many primary care operators are still thinking like small businesses. Too few are actively looking to scale up their activity like a larger business or PLC might do. This is critically important to making the revised health and care resource model and consequently the revised health and care economy of the future viable at scale.”
6. Seeing clinicians as innovators
Felix Jackson, Founder, medDigital and DefinitiveDX
“The best clinicians innovate automatically throughout every part of their working lives. They aren’t the kind of people who sit back and watch the wrong things happen, repeatedly. They diagnose the problems and resolve them so that the knowledge and treatments they offer to care for their patients is constantly improving.
“However, the problem they face is how to go about fixing the massive issues experienced within the industrial-sized and indescribably complex NHS? The solution is for these clinicians to engage with technological innovation.
Engaging with technological innovation doesn’t mean deciding that ‘we need a mobile app’, it means ‘we need to find a solution that actually works’. A disciplined approach to innovation means solutions can be developed incrementally and refined iteratively based on genuine feedback so they actually work for real-life applications on an ongoing basis.
“Clinicians are superbly placed to be technological innovators due to their extensive experience with the scientific method and the diagnosis of problems. However, they often need to escape from the dogmatic thinking that medical training can encourage.
“Technology is only ever part of the solution, as at some point there will be a human involved. But technological innovation is a great place for every clinician to start solving the NHS problems they experience every day and this is something managers need to actively encourage and not stifle.”
7. Tackling workforce debt worries
Asesh Sarkar, Chief Executive, Salary Finance
“With staff having suffered a real-terms pay cut of 10% over the past five years, financial pressure is fast becoming a primary factor impacting overall NHS staff wellbeing.
“Rising disconnects within the NHS hierarchy, reflected by the most recent NHS staff survey’s finding that only one in three staff felt understood by senior managers, is perhaps indicative that not enough is being done to address this.
“Indeed, scant regard is being paid to the financial hardships faced predominately by people aged under 35 earning less than £28,000 per year. Many are needing to borrow to make ends meet. But mainstream lenders are regressive, only providing affordable personal credit to those that need it least. Leaving people with lower credit scores resorting to payday lenders, trapping them in situations of spiralling debt with no means of affordable consolidation.
“In Italy, where banks have long provided payroll services for government organisations, loan repayments made directly through salary contributions have been in place since the 1980s. Italians have never heard of payday loans, as they don’t need them. In the UK, by contrast, the number of public sector workers wanting a payday loan has quadrupled in the past five years.
“As major local employers, NHS organisations have the power to take a lead in breaking the debt cycle for their workers by consolidating high-rate loans into affordable monthly salary deductions, so their staff can get quicker into saving. When offered as a staff benefit, Salary Finance is already being shown to boost staff motivation and productivity.
“By tackling employees’ debt worries head-on, we can dramatically boost NHS productivity by taking the weight of financial hardship instability off their shoulders. All at no cost to the NHS at all.”
8. Involving communities in change
Nick Goodman, Managing Director, Membership Engagement Services
“It’s impossible to please everyone when proposing big changes to the way people access local health services, Plans that move services out of hospitals, whether to others or into the community, are politically supercharged – as we saw again over the summer with hostile media coverage of STPs. But.
“A large majority of people can and will support plans if they feel engaged and involved in a proper, carefully planned and, above all, authentic and meaningful ongoing consultation process.
“I have had the privilege of seeing what proper democratic involvement in health services can deliver working with Foundation Trusts for over a decade. They have shown how genuine involvement of lay members can deliver transformed and improved services that also save money.
“We are now seeing similar results among CCGs determined to ensure local people feel involved in designing their own health services. In my experience, people are actually very open to change as long as they feel its architects have listened to, and acted on their views.
“As we surge forward into the brave new world of transformed models of care, we must redouble our efforts to ensure the principle of “no decision about me without me” is never forgotten.”