Friday, 11 March 2011

NHS Expo 2011 - day two

I attended both days of the ‘Innovation for a healthier future’ event encompassing several alter-egos. As a healthcare commentator – anything to do with the future of the NHS is rich fodder. Innovation in health is an exciting and very necessary element of patient care. I was also researching opportunities for the likes of me – change managers and business consultants with health expertise. And last but by no means least, it was a great networking opportunity to catch up with old friends, including a university pal whom I hadn’t seen since Glam Rock first graced the airwaves!

This event has provided a wealth of material for my blog and I shall share much of this over the next few weeks but in the meantime would like to give you my overall impression resulting from the presentations, seminars and discussions.

This current spate of NHS reforms will stifle innovation: My view on this first conclusion is unequivocal. This could have short, medium and maybe even long term effects in reducing the UK’s capability to climb up the World Health Organisation’s rankings. There is no incentive for GP consortia to fund new treatment initiatives and in order to gain Foundation status, Health Trusts will be forced to cut costs. They may have to gamble on innovation in the hope that they can gain commercial advantage for their investment.

GP Consortia are in danger of becoming expensive versions of Primary Care Trusts: I attended some very interesting seminars regarding practice based commissioning and pathfinder GP consortia. The commitment and passion by these practices cannot be doubted, but they are the first to admit that they are on a very steep (and potentially expensive) learning curve. Many will need training in leadership, communication, pathway mapping, stakeholder engagement, bidding and negotiating to name but a few essential skills.

The patient pathway will become unbalanced. As GP’s make commissioning decisions, their default position will naturally to increase investment in primary care at the expense of secondary care. Yes, scalable services nearer a patient’s home in a community setting are an excellent idea. But we will still need centres of excellence for complex imaging (and interpretation) and surgical or medical interventions. One GP mentioned during his presentation that they had made some ‘quick wins’ with cost saving commissioning decisions which funded more equipment for their practice. I’m concerned that the hospital consultant voice may not be heard.

Patient ‘power’ must be very carefully handled. Andrew Lansley’s soundbite ‘no decision about me without me’ is becoming a very hackneyed mantra and is open to misinterpretation. I wonder whether we may face ‘healthcare by Wikepedia’ or even worse, newspapers like the Daily Mail (a right wing tabloid  in the UK) will direct patients to demand certain treatments which may not even be appropriate for them. Many presentations at NHS Expo concentrated on the patient voice and as one wise speaker noted – it must be a two-way dialogue.

All of these issues can be addressed. As widely reported, the speed of change is mind-boggling but somehow, thought leaders and change managers working with the NHS need to stop looking to the politicians for the answers and get on with implementing therestructure in a way that minimises these risks.


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