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It’s that time of year…
The nativity play is reprised.
A sheepish friend with a youngster told me;
Joseph, complete with a tea towel headdress and Mary, with a cushion up her jumper, knocked on the door of the inn, to be greeted by their lad. Suitably decked-out in another tea towel.
‘Inn-keeper’, said Joseph, ‘we have travelled from afar and my wife is heavy with child. Do you have a room for the night?’
Number-one son looked slightly under-rehearsed and dazed by the footlights... replied; ‘Yes, we have plenty of room, come on in and have a gin.’
And so it came to pass; St Saviour’s Infant School rewrote history and mum and dad… revealed as alcoholics... for weeks lived in fear of social services turning up!
As most eyes turn east for the star of Bethlehem, next year the NHS’ guiding star is to be found in the WEST.
The ten year plan, due for publication in the Spring, will, I’m hearing be ‘late Spring’.
A ten year plan is arrant nonsense.
No one has the first idea what’ll happen ten years from now. Ten years ago we were all using 3G phones and still watched four hours of good old fashioned broadcast TV every day.
That’s why Simon Stevens was so clever. He wrote a long-term plan, that had a compass, not a calendar. It’s still the best bet for the future.
The new plan will be a concoction of speculation, a composite of everyone and his dog having a mention and a cocktail of what the Treasury allows.
Undeliverable, complicated, too long and a wish-list... bet the farm.
There are only three things that matter;
- workforce,
- elderly and
-
technology.
A triangle of doom, set to grind global healthcare systems to a halt.
Solutions?
Yes. Look W.E.S.T.
W… workforce. There’s a global shortage of care workers. We don’t have the money to fix that. We already cap the number of nurses and doctors we train.
Stop and think… what does the workforce do?
Three years ago the BMA were highlighting; 30% of clinical time is spent doing non-clinical things… like admin.
For GPs, bureaucracy can take up to 50% of their working hours. Similarly plagued are our nurses.
The technology exists to put an end to all that and it’s mostly cheap… a quick win.
In 2013, the NHS set a target to be paperless by 2018.
Just deliver that.
A massive effort to make NHS paperwork history would reap a huge return on investment. Around a third of a year, saved by every clinician working in the NHS is a bumper harvest if only half is delivered.
It would create the headroom for clinicians to be more productive, not by running between patients…
... but by using time saved for them to do what is really productive… looking after people.
E… elderly. Apart from Sub-Saharan Africa and Afghanistan, us, most of Europe, US and China are living in ageing societies. Keeping yer-granny fitter for longer is better than keeping her in hospital for longer.
We have virtual wards, think virtual day centres, preemptive frailty visits, all the stuff we know what and how to do… so, actually, get on and do it.
That means…
Shift… think about shifting care, not moving it. Shift the fulcrum point of care.
Stop the expensive and undeliverable nonsense of moving stuff out of hospital. Instead, strengthen primary care in its role of keeping people well. Look at this example from Portugal.
Spend less, live longer. It can be done.
Invest in community nurses, healthcare assistants, health visitors, social care, physio’s. Anyone and everyone that can keep people, well, mobile, happy and families bringing up healthy, well adjusted kids.
Invest in the people to do it.
Divest in buildings.
T… technology. Stay away from futurologists, digital committees and bobble hats. They’re dreamers, seldom deliver anything worthwhile in a world that needs doers.
Mandating interoperability is a good and overdue first step and...
... invest in analytics and things that release the time of professionals, to be professional. Do horizon-scanning and watch what tech the public are using in their daily lives… copy it, steal it and use it.
Barcode a patient's lifetime journey through NHS systems... like Amazon do for customers and suppliers.
And, by the way stop buying diagnostic kit. Rent it, but only if it comes with skilled technicians to operate it, linked with AI to do the first-pass diagnostics.
Four reasons to go WEST...
...make the NHS fit for the future, do anything else and…..
… watch it go bust.
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