NHS

Five Year Forward View requires unprecedented behaviour shift

By: The Leader @theleaderspeaks
Published: Friday, October 31, 2014 - 13:03 GMT Jump to Comments

Can health and social care delivered through smart technology and the internet really save the NHS as the NHS England 5YFV suggests it can

NHS England has just published a five year forward view (5YFV). Every word in the 40-page document is carefully chosen. And with good reason, for the future of a cherished institution, the health of a generation, and the future of more than1.2 million people who work for the behemoth depend upon what happens next. It may also turn out that the fate of the next Government turns on what happens to the NHS on their watch.

5YFV asks for more money from the public purse. £8 billion more over five years. At the same time NHS England is promising to save twice as much (£16 billion) over the same period. Simon Stevens the Chief Executive of NHS England and the lead author of 5YFV, has made it plain that without both savings and extra cash the whole NHS project may very well fail.

Finding the extra money could be simple. All it takes is a political party that can win a workable majority, in May 2014, on a tax-raising platform. This does not look very likely at the moment. It is, however, possible that one or other of the parties might recognize that taking their head out of the sand, telling the electorate the truth and asking them to join the fight to save the NHS could be a election winning point of difference in a political landscape populated by fantasists and ostriches.

Making the extra savings is more difficult. A single assumption underpins all of the plans to get more for less out of the system.  The health (and social) care policy makers and service planners need the users of the system – staff, patients, and patients supporters including relatives – to accept the closing of many of the “branches” and embrace the delivery of all sorts of services through the internet. These screen delivered services will include clinical interventions.

This is not just about repeat prescriptions online. The patient will present via call centre, triage may be by algorithm, talking to "your doctor" will often be online and many resulting clinical interventions will include remote consultations and through the screen delivery.

There will be fewer GP practices, and the entire health and social care system will be redesigned to keep people away from hospitals that are horribly expensive to run.

Those who think this sea change will work, point to the many high profile businesses that offer their services and products online and the business sectors, like banking, that are closing branches and moving their customer transactions online.

The truth is that the online retail revolution is still a work in progress and no clear conclusions can be drawn from what has happened so far. METRO Bank is opening branches as fast as it can. Clothing brands like Bonobos and DIY suppliers like Screwfix are moving away from pure online to a mixed offering, online groceries are loss leaders and even Amazon the online uber brand is talking about opening shops.

Even if the technology is delivered on time, to budget and fully functional it seems unlikely that the entire population will turn up and apply to become early adopters. 

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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