How to save the NHS

The Health Service in the UK has been a symbol of national identity since it was introduced – and for good reason. However poor service, ballooning budgets and huge regional disparities have led to the most recent round of reforms that are attempting to move control (and funding) closer to GP’s, whilst integrating Health and Social care. There has already been fierce debate from all sides of the establishment, and this will only get louder as we move into the election season. Our election countdown will discuss these in depth as they unfold, but we can already highlight one area in which more has to be done – digital healthcare.

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The NHS Chief Executive Simon Stevens recently unveiled a list of reforms in line with his overall strategy for 2020. The new ‘Vanguard’ areas will attempt to join up local services from social care and community nursing through to hospitals and pharmacies into one unified system. This is a strong step in the right direction, but it is not without risk – be it cost, infrastructure or deterioration of care as the different organisations attempt to combine. This is a huge opportunity to capitalize on the recent string of innovation and investment, and ensure the NHS emerges as the world leader we have come to expect.

The idea is to bring health-care closer to the patient, and logically this would suggest moving responsibility towards their local provider and away from institutional services like hospitals (themselves often well above capacity). This is a sensible move, but with GP’s already hugely overworked and national shortages for new talent, there are clear questions as to whether they can bear the additional burden. Doctor’s regularly cite overwhelming administration as one of the primary reasons for their disillusionment; with the weight on them only likely to increase, it is vital that we bail out our healthcare professionals from this sea of paperwork.

Apple Health

The recent launch of the Apple watch (and wearables in a broader sense) offer one possibility for a reprieve. Hype around fitness apps, movement trackers and the like has faded recently, with some people going as far as to suggest they may actually backfire. They may not be a magic-pill for weight loss as the marketing would have you believe, but they do highlight three wider trends with the potential to revolutionize our health service: real time monitoring, data driven insights, and on demand provision.

How often do you go for a check-up? Most of us would be impressed if the response was more than annual. Doctors are only involved once the symptoms become drastic enough for us to notice – and often we often still struggle through. Wearable technology provides an opportunity for round-the-clock monitoring, to ensure that problems can be identified before they have even emerged. There have been step tracking and calorie counting devices for years, and there are a multitude of different apps that you can install on a smartphone with similar functionality. Heart rate monitors are one sensible addition, but we are now seeing groups starting work on devices tracking things like glucose, respiration and even stress – in real time. Empatica has even developed a wrist band to predict the onset of seizures.

Empatica

These are clearly valuable insights, but the benefit extends well beyond a second-accurate report on our inner chemistry. By aggregating the huge amount of data being produced, researchers are already uncovering valuable insights into new drugs, complex diseases and wider trends. For example, Intel is currently working with the Michael J Fox foundation for Parkinson’s to analyse the data produced by a variety of wearables for insights into the progression of the disease. This is just one example of the potential of combining real time and personal information with big data style analytics.

The final key to the future of healthcare is in on-demand provision. We already mentioned how the NHS is seeking to decentralize provision away from hospitals and into the community, but skeptics have already been vocal in their concerns over quality and viability. One possibility is to follow Walmart’s example in America, where simple and routine checkups are provided over the counter in your local shop. Patients in the UK are not exposed to medical fees to the same extent as our American peers, but only because the NHS absorbs the cost. This actually dilutes the incentives for efficiency, and the current plans should learn from the US example in shifting provision towards the private sector.

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Moving healthcare closer to the people that need it is a valuable initiative – indeed, what if we could bring the NHS right into your home? The video capabilities of modern smartphones and tablets provide an opportunity for doctors to perform remote check ups on patients. When combined with the data tracking capabilities mentioned above, there is every possibility that most patients could be monitored on a daily basis without ever having to leave the house. This is clearly a hugely valuable opportunity for such an overworked NHS, and could prove instrumental in the success of Mr Stevens’ vision.

Health-Tech is a vibrant and growing industry, but our government has clearly not grasped the full potential. For starters, universal and electronic health documentation would revolutionize the NHS, freeing doctors to do the jobs they’re actually paid for. Improving monitoring and analysis are fundamental to unlocking both difficult diseases and emerging treatments, and technology has the potential to bring delivery right to your doorstep. The NHS is a symbol of modern British identity, but it must adapt to remain relevant in the 21st Century.

 

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