17th July 2015

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Health Chat

Minister for Life Sciences - George Freeman - in conversation with Roy Lilley

King's Fund - 16th September - 5.30pm

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News and Comment from Roy Lilley

Ministerial speechifying... easy. Find a new phrase, wrap it around an old idea, find somebody or something to blame, praise everyone else, sprinkle it with a star-dust name, publish a report, rename something, smile a lot and be sure to mention patients and safety.


Jeremy Hunt, The Tinker-Man, is a master.  In his 25 year view of the NHS, King's Fund speech, mainly a 'clearing out his pending tray' exercise, he followed the formula.


'Patients' got 32 mentions, he gave the BMA a good kicking over 7 day working, promised to publish the long awaited M&S Rose Report (here it is), renamed Monitor and the TDA (NHS Improvement) and threw in Martha Lane-Fox (also M&S) doing something about 'digital' what-not and conjured up a Patient Safety Investigation Service .


And, the new phrase; Intelligent Transparency... except it's not 'new'. He pinched it from an article, in the Guardian, by his new best friend the Plastic Peer, David Prior, in 2014. This is the phrase's second outing; he practiced using it at the Commissioning Show in June. It didn't catch on.


He told us 6,000 people die because they go to hospital on a Sunday. Unfortunately the NHS Choices web-site poured cold water on that idea 3yrs ago.


The Tinker-Man has tinkered. As big-brainbox Shibley Rahman pointed out, we suspect he has been reading Oliver Wyman's, the 'Patients to Customer Revolution'.


The BMA; the British Moaners ArmyTheir deified days long gone, will lose the 7 day row. The narrative belongs to The Tinker-Man. B&Q, M&S, Tesco's, Sainsbury's are places we visit and work-in, 7 days a week.


The public will see no reason for the NHS to be different. Can the NHS run hot 7 days a week? Not right now, but it is right we should work towards it.


The BMA look curmudgeonly, Canute-like and tuned in to Radio Luxemburg.


It's very simple; do we want a safe NHS, working when we need it, transparent in its outcomes and connected to the electronic 21st century. I think so.  Right now we have an NHS that, in many places, looks like it runs on candles and coal. It is, truly, time the NHS was dragged out of the dark ages.


The Tinker-Man is right to be ambitious. He has an eye on the baby-boom generation, who are moving, on-mass, into the wired, connected world and will demand standards of transparency, access and interoperability that will make planners wince.


Is the NHS safe? Well, it's a lot safer than some systems. Is 'zero-harm' achievable? I doubt it but we should try and when we fail; find out why and fix it, fast.


Do we want smart-care-teams helping us to stay healthy, longer? Who wouldn't?  Should we use big-data to do it? Of course.


In his speech the Tinker-Man suggested Apps and data could combine to send an ambulance to you before you had a heart attack. Wow! Could they pick up a pizza and the dry cleaning on the way?


I'll give the Tinker-Man a new phrase; creative destruction. The Vanguards could become multiple models of fast moving disruptors in the system. Regulators have to be told 'hands-off' whilst they creatively destroy the NHS from the, ground up, working at integration and demolishing silos.


The future is not just about replacing doctors with nurses, hospitals for GP surgeries or sharing a record with social services. It is about a value adding service, starting with the patient and working backwards.


The problem is the incumbents. All they can see is consolidation, chains and getting bigger. The Shelford Group have become the Dad's Army of the NHS. The Mulberry Group are much more exciting.


The pressures of medical and pharma developments will reduce length of stay without the need for clunky tariffs. Stand back; let innovation do its job.


Diagnostic devices; smaller, low cost, broad spectrum, faster, more accurate. Near-patient testing. Why should I queue for an X-ray, or wait a week for blood tests?  Drop the results onto my iPhone, thank you.


Care teams will replace traditional GPs and eldercare services, designed as eldercare-services. Buurtzorg show us it can be done. We need to change the frame of reference to wellness.


Oliver Wyman says:


Bridging health and wellness, becoming a consumer company, redefining personalisation and deploying big data, complex adaptive workflow and passive monitoring to prevent most acute events - these are massive changes.


... he is right, the Tinker-Man knows it. He's read the book, now he has to get the T-shirt.


Have a good weekend.


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