By Dr Tom Oakley, CEO
The next day’s headlines reported a significant increase in NHS spending. But in the long term the Budget may be remembered differently – as a key step towards a new NHS care model, where services are organised around the patient rather than the other way around.
Extra resources are welcome. The Budget means that health spending will increase at its historic rate of around 4 per cent in real terms. But just as important was the commitment to invest new resources into a new approach, rather than more of the same.
In her speech, the Chancellor repeated the three big shifts highlighted by Wes Streeting: from hospital to community, from analogue to digital and from sickness to prevention. Writing two days later, the Prime Minister said that a similar approach would apply across the public sector:
“Just as we cannot tax and spend our way to prosperity, nor can we simply spend our way to better public services. That is why reform is an essential pillar of this government’s agenda. Reform of our creaking central state. Reform of our public services.”
Specifically the Budget set the framework for a step forward in NHS performance and productivity based on new technology. This will be achieved in three ways:
- Better care pathways, meaning more convenient patient journeys with fewer touchpoints on services (“The settlement will also support reform to patient care pathways to deliver better patient experience for lower cost, enhancing patient choice and embedding best practice right across the country.”)
- A major expansion of spending on technology, with a focus on improving the day-to-day experience and productivity of NHS staff (“Over £2 billion will be invested in NHS technology and digital to run essential services and drive NHS productivity improvements, to free up staff time … and enhance patient access through the NHS App.”)
- New funds for service improvement, made available through productivity gains across the whole service (“In implementing the settlement, the Department of Health and Social Care (including the NHS) will deliver 2 per cent productivity next year.”)
Ahead of the Budget, Keir Starmer and Wes Streeting launched the Change NHS public consultation, to give citizens and other organisations a voice in the writing of the new ten-year plan for the NHS, expected next year. The launch gave more detail of the investment into technology. The objective is to create a single patient record, summarising patient health information, test results and patient communication in one place through the NHS App. The Department of Health and Social Care estimates that better sharing of information will save an estimated 140,000 hours of staff time every year.
Our work is directly relevant to this new agenda. Our key product, Bleepa®, is the only system that allows clinicians to communicate instantly and securely via mobile devices, including the sharing of diagnostic-quality images as well as historical records, blood test results and case management. We have documented the savings in staff time and the consequent improvements in the patient journey, with a high proportion of outpatient appointments becoming unnecessary.
(Because better care pathways reduce outpatient appointments, it may be that the Government’s manifesto commitment to 40,000 extra appointments per week becomes redundant. That would free up even greater funds to support new approaches.)
With the right mandate, Bleepa® can deliver a common digital care record across providers, which would facilitate the shift from acute-based care to community. That would include the ability to track and report activity so that it can underpin new models of payment for new models of care.
NHS spending increases are high for the next two years and then fall back for the rest of this Parliament. The Government appears, rightly, to want new funding to be used straight away so that it achieves a decisive advance on elective waits. The NHS is working towards a ten-month plan of immediate action as it waits for the ten-year plan next year.