The focus of the new NHS 10 year plan is clear – prevention rather than cure. Whilst hospitals will still see budget rises, it’s GPs, mental health and community services who are in line for the biggest boost.
The ambition for this focus is self-evident. We must increase access to primary care and community services if we want to reduce pressure on our A&Es and hospital wards. As any NHS doctor will tell you, reducing the current burden felt at hospital level is vital; you only need to glance at waiting times targets and discharge data to see that the NHS is grappling with extreme supply and demand challenges. And those working in the system have long called for improvements to GP access and better integration with community care services in order to ease reliance on hospitals. But is this £20bn boost in funding and long-awaited plan the right direction to take?
To make a real impact to the NHS overall, we of course need better funding across all levels of health provision. If patients had better access to GPs, they’d be less likely to turn to A&E for help. And if those living with long-term conditions can be supported towards healthier lifestyles, their NHS ‘footprints’ could be significantly reduced. According to the plan, mental health services will receive £2.3bn extra of the £20bn budget, with GP and community care services getting £4.5bn.
But the crucial element needed to ensure the success of this vision is integration. It’s all very well having better funded services, but if they are operating in silos then we will continue to run into the same challenges time and again.
Effective integration has long been a holy grail in British healthcare. Moving people through the system more efficiently is not only cost-effective and reduces admin but also offers a better experience for the patient. Those who have had to grapple with referrals, out-patient services, or securing community care for a relative will understand only too well the lack of integration that exists within the wider system. And we cannot tackle integration without first recognising that communication and digital innovation are at the heart of (and the key to solving) the challenge.
If we are to create a 21st century health service that can streamline provision and make the most of the budget available, then we must heed the comments made by Chancellor Philip Hammond today; ‘To meet this challenge, we must go back to our roots. We must be innovative… We in Britain built a health system…that pushed the boundaries and must do so again to deliver the needs of an ageing population in the 21st century.’ Whilst our NHS services are in dire need of this additional funding, it’s innovation that will stop cash injections from being sticking plasters and instead turn them into pivotal moments for progress. Without innovative approaches to the integration of services, this simply won’t happen.
The NHS has only recently started shedding its reticence towards innovation, despite years of calls to upgrade and digitise the service. Indeed, a few pioneering Trusts are now embracing new solutions across the board. But to achieve the level of cross-sector integration we need, we must fast-track this culture shift and explore new ways of increasing efficiency and breaking down silos. Empowering NHS staff with the digital tools they need to do their jobs is the place to start.
Many of these innovations are simple; the technology already exists. We can ditch archaic technology, such as fax machines, landlines and pagers, and provide clinicians with new ways of communicating between and within wards via apps and bespoke messaging platforms. We can reduce the waste linked to staffing inefficiency by introducing new, fit for purpose platforms for recruiting and retaining staff. We can digitise appointments and move away from paper-based referrals at all levels through cloud-based software. Through these changes, we can create communication pathways from the point at which a patient comes into contact with the NHS all the way through to their discharge; allowing doctors and patients alike to access the information they need quickly. And that’s just for starters. These digital innovations will break down communications challenges to allow clinicians to treat patients quicker, reduce the burden of admin placed on medics, and provide NHS staff with the capacity needed to do their jobs properly instead of focusing on keeping their heads above water.
In my roles within and outside of the NHS, I’ve seen first-hand how much time and energy is lost when the different areas of the health service fail to connect effectively. We cannot run a 21st century health service if the NHS continues to be hampered by communication break-downs at every turn. If the ambitions of this plan are to come to fruition, we must ensure digital innovation and integration are at the forefront of decision makers plans and budgets. As our nation’s health needs become more complex, ensuring patients can access the support they need, where they need it, must become simpler.