Healthcare app

NHS cannot transform healthcare while defending the status quo

By: Ben Gowland
Published: Thursday, July 10, 2014 - 21:50 GMT Jump to Comments

Stark fiscal reality demands transformation of the whole UK health system. The question that is starting to emerge is "can anyone inside the NHS lead the transformation"

When I joined the NHS as a management trainee nearly 20 years ago I was struck almost immediately by the lack of inspirational role models. My first boss was a very capable individual, but was more focussed on securing a redundancy package than on delivering long term change.  My next boss had been moved from a front line clinical role and his days were interspersed with drives in his Jaguar to enable him to keep up his 40 a day habit.

The only time this changed was when I was first involved with the Cancer Services Collaborative in 2000. I was inspired by the insights from the Institute of Healthcare Improvement (IHI): lessons in how to understand improvement; how to implement real change; and how to develop and deliver improvement programmes at scale. 

The IHI brought teachers with a broad Texan drawl, and while I was utterly mesmerised, it became clear that we would need to take steps to make the message ‘acceptable’ to the wider NHS. Broadly this meant teachers with an English accent, and examples taken from the NHS itself. While we had some success with this, it did not take many years for the NHS to create a perceived wisdom that the IHI methodology ‘wasn’t what was needed around here’.

The NHS does not appear to tolerate anything that challenges the existing way of doing things. Any example that is used of how things are or can be done differently is greeted in some areas with an initial enthusiasm, before the weight of the NHS kicks in to present a set of reasons as to how the change is either not real or not relevant (e.g. Jonkoping, Lean etc).

But everyone agrees that real change is required. The step change required in healthcare is a shift from a focus on the delivery of healthcare to a focus on health, and from a focus on healthcare organisations to a focus on individuals. There are few who dispute this.  But the NHS is made up of healthcare organisations that deliver healthcare.  Even public health has now been moved outside of the NHS.

So without the leaders or the change agents in the NHS, how will this change happen? The answer most likely lies outside of the NHS. There is a growing movement in digital health, and the inspirational leaders that I see today are those who operate outside of the NHS and are striving to support the development of digital health, and at the same time to build the bridge to the existing health establishment. 

At the forefront of this group is Maneesh Juneja. Maneesh worries about whether the future will result in unemployment for doctors and talks about how patients in the future will be able to use their own personal health data to create leverage over the healthcare system to make it work for them. These are not conversations the NHS either spends its time on or worries about.

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The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of The Information Daily, its parent company or any associated businesses.

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