by Karen Taylor, Director, Centre for Health Solutions
In the three weeks since the NHS celebrated its 70th birthday, much has happened. From the appointment of a new Health Secretary, Matt Hancock MP, to the unravelling of the details of the national pay award. Meanwhile, hospital activity shows no let up and concerns over staffing and other resource shortages continue to build. This week’s blog provides my take on the Health Secretary’s maiden speech and its implications for the current health care system.
In his first speech, delivered on 20 July at his local hospital West Suffolk NHS Foundation Trust, the Health Secretary set out his top three priorities for health and care. He stated at the outset that he views the NHS as one of our nation’s greatest achievements and that his commitment to the health service, and the fundamental principles that underpin it, is not just professional, but is deeply personal. He acknowledged that there are many challenges facing the sector such as:
- growing childhood obesity
- increasing antimicrobial resistance
- the impact of modern living on mental health
- huge workforce issues, from constraints on pay to increasing workloads.
He also highlighted a number of achievements such as the NHS’s response to increasing demand, and the fact that the NHS treated more than half a million extra patients within 18 weeks of referral compared to five years ago, and that thousands of more people are alive today due to improved cancer survival rates. He also discussed another theme ran throughout his speech, namely his ‘frustration’ about patchy take up of technology innovation.1
He noted that the Prime Minister’s funding announcement of a 3.4 per cent average annual growth over the next 5 years is equivalent to a real term budget increase of £20 billion; which should help provide a sustainable approach to NHS funding over the medium term. However, he made clear that, in response, he expects the NHS to reduce and tackle waste in the health service, and focus on using this new money to work smarter and more effectively. He emphasised that of the many areas that are vying for his attention, his three earliest priorities across the whole health and social care system are workforce, technology and prevention.
On workforce, he committed to identifying opportunities to give the whole workforce the chance to fulfil their potential to enable the health and care system to operate at its best. He acknowledged the point argued in our recent report, Time to care: Securing a future for the hospital workforce in the UK, that the nation’s health is determined by the health of the health and care workforce. He was concerned to see first-hand how undervalued NHS staff often feel and promised that the commitment staff show to patients will be matched by the commitment his Department will show to staff. Specifics included providing staff with the best training and support – to ensure that the right number of people with the right skills are able to provide the safest and highest quality of care to patients. He also emphasised the importance of leadership development, and that the NHS leadership community must do more to reflect the wider workforce. He was therefore setting up a panel of clinical and professional advisers, from a cross-section of the NHS and social care workforce to address this issue. It will be interesting to see how this impacts the national workforce strategy which initially expected to be published alongside the NHS birthday celebrations, is now postponed until autumn? Lest hope the explanation is as simple as that.
His second priority is technology, and emphasised that “the entire £20bn proposed for the NHS will be contingent on modern technological transformation.” Moreover, the overarching message from the speech suggests that additional money will be ring fenced for digital technology, and that access to the new funds could be contingent on deploying the “very best” technology. Moreover, technology that facilitates integration and sharing patient data at a system level will receive more favourable consideration.
He stated that the appropriate use of technology is a catalyst for greater connectivity and empowerment – not only saving time and money, but also in improving patient safety. To emphasise this point he highlighted ‘Scan4Safety’ – a barcode tracking technology in hospitals that enable staff to track all patients, their treatments and manage medical supplies. This technology driven innovation is driving improvements in patient safety while saving money as demonstrated by a pilot across 6 hospitals that have already saved £8.7 million.2
Other innovations highlighted during the speech include:
- an initiative in West Suffolk in which junior doctors and nurses will shortly install a new smartphone app, removing the need to phone colleagues for details after getting paged. A pilot has shown that the app could save nurses more than 20 minutes and doctors almost 50 minutes every shift
- the RCN’s ‘every nurse an e-nurse’ approach is showing how electronic health records and other smart tools can help nurses in and out of hospital work together to address the needs of patients who have a range of health problems.
The Health Secretary noted that “only in health and care has new technology always seemed to lead to inexorably higher costs, compared to every other area of life, where innovation reduces waste and drives costs down not up.” To make this happen he announced a half a billion pound package to help jump start the rollout of innovative technology aimed at improving care for patients and supporting staff to embrace technology-driven health and care.
Finally, his third priority, prevention, described as key to taking pressure off staff and improving patient outcomes, including keeping people out of hospital. Prevention will be particularly important, given that over 10 million more people will be living with a long-term condition by 2030. He emphasised that prevention, like technology, is mission critical to making the health and social care system sustainable. In addition, the integration of the NHS, social care and wider services in local government is vital to getting this right. He announced that part of this will be addressed in the green paper on social care that will be published in the autumn. He also highlighted his ambition to invest more in primary care and community pharmacies so people do not need to go to hospital, and to empower people to keep themselves healthier at home. “One NHS and social care system, working together to improve patient safety and outcomes, in a spirit of collaboration, not competition, towards a common goal.”
There are still many unanswered questions, and of course, the devil is in the detail. Many commentators have welcomed the emphasis on the three above priorities, while noting that they are not new and questioning how the barriers that have historically undermined progress will be tackled this time round. Moreover, many of our recent research reports have focused on the role of technology enabled care, whether our, Vital Signs: How to deliver better healthcare across Europe report, Time to Care: Securing a future for the hospital workforce in the UK, or our latest report, Medtech and the Internet of Medical Things: How connected medical devices are transforming health care. They all highlight a number of the barriers to the adoption of technology at scale and illustrate by way of good practice case studies how some organisations are overcoming these barriers. We will therefore monitor with interest how the above policy agenda supports our thinking on these issues.