What next for the NHS in an era of innovation?
How to encourage the uptake of technology in the NHS was the key theme explored at Cambridge University Health Partners’ (CUHP) ‘No More Empty Gestures’ conference. A curious title, perhaps – have healthcare improvements thus far been “empty gestures”?
There's no doubt the potential uses of technological and scientific advances means better health can be expected for longer periods of time, via a mix of earlier diagnosis, improved treatments and a renewed focus on wellbeing both physical and mental. How to integrate this within the NHS is the issue, bearing in mind that the government has announced its decision to increase NHS funding over five years from 2019-20.To decide how to use this funding, ministers have tasked the NHS to come up with a 10-year plan, which has very much focused minds, albeit along “how on Earth are we going to do this?” lines given the current chronic staffing shortages and the looming Brexit fiasco.
The first keynote at the McGrath Centre in St Catharine’s College was by Charlie Davie, managing director of UCL partners, “a London version of CUHP”.
Name-checking the life sciences sector which “has helped to catalyse new approaches to healthcare”, Dr Davie said that “the big challenges are around people living longer but not necessarily healthier lives” and the healthcare industry “needs to do things quickly and at scale”. All the components required to activate this are already in place, he said, thanks not least to the fact that “academic health networks now cover the whole of the country”. Two of these networks, CUHP and UCL Partners, were founded in 2009 and have established nationwide benchmarks and, added Dr Davie, they will make significant contributions to delivering the 10-year plan.
“We’re very blessed with the scientific and academic assets we have, which have the potential to transform millions of lives,” he said.
Malcolm Lowe-Lauri, CUHP’s executive director, followed with a case study of how industry and healthcare can work together, focusing on the collaboration between Philips and the Royal Papworth Hospital. Last June the two organisations agreed to team up on a number of projects.
“Philips has sold a lot of equipment into Papworth, such as respiratory support and patient monitoring, and in the course of that Philips realised there is a fair bit of convergence with Papworth,” he said. “They are developing a vision – how to improve the lives of three million patients in the UK by 2025.”
Professor John Wallwork, chairman of the Royal Papworth Hospital, added: “At the beginning we were sniffing around each other and now we know what we want to get out of it. Nobody is being taken for a ride. Better patient pathways are what’s emerging, and that’s what you want. Equipment, drugs or therapies is what you want to come from collaborators.”
On the NHS 10-year plan Prof Wallwork said: “I think the biggest change will be in social care and primary care.”
Next up was Tracy Dowling, chief executive of Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), who started off by referencing her original role as a radiographer. To go from radiographer to chief executive, she said, “typifies what the NHS can offer people over their life course”. The role of technology in healthcare for Cambridgeshire and Peterborough’s one million citizens in the trust’s 50 sites is crucial in creating a healthier population.
“Technology can transform dementia care,” she said. “We’re increasingly working in primary care to help with people’s lives. Working with Addenbrooke’s, we’re really bringing body and minds together and we want to take that out to the people in our area.”
Ms Dowling’s concerns on the how industry and healthcare work together related to the diagnostic process.
“We think of mental and physical care as very separate things,” she said. “We scare industry off, we’ve structured things forever along parallel lines, and that’s a struggle for people with, for instance, multi-morbidity conditions, where there’s inevitably a psychological component.”
The afternoon’s final section was a panel Q&A. The first question involved how to get doctors and nurses involved in the new practices. The panel’s Roland Sinker, chief executive of Cambridge University Hospitals NHS Foundation Trust, said: “Healthcare has a long way to go to make itself open to business in the way Philips has achieved with Papworth.”
Karen Lightning-Jones, head of Future Place at Roche, said: “Senior leadership needs to spend time on these programmes.”
Andy Richards, the Cambridge-facing serial biotechnology entrepreneur and business angel, said from the floor: “Why is it that something that works really well in one part of the NHS is so hard to scale up?”
Mr Sinker appeared to agree. “The NHS should be using resources much more effectively,” he said.
The panel chair, Professor Patrick Maxwell, regius professor of physic and head of School of Clinical Medicine at the university, reminded the conference that industry needs to adapt to the healthcare profession, rather than the other way round. “We’re not driven by profit," he said, "we’re driven by what we can do for patients. I have been extremely impressed by industry partners and their level of commitment for patients – and that makes good commercial sense too.”
Let’s hope so but, while this was heartening, this event had omissions. No time was allotted to the increased expectations on staff whose numbers are already overworked running the service as it is, and the genomics sector was only mentioned in passing, when a question was asked about “cleansing” data.
Part of this process of cleaning up data – including digitising all paper trails – is to deliver a better service, and of course ambulance paramedics need immediate access to patient records without having to wait until the patient arrives at A&E. However, part of the process will inevitably involve the data being commercialised. Do we want that? Innovation is good but, as Mr Sinker asked: “How are these new and exciting innovations affordable for the taxpayer?” You do the math.
NHS England says measures in its 10-year plan will prevent 150,000 heart attacks, strokes and cases of dementia over the next decade, with another half a million lives saved in the same time by tackling killer diseases with earlier treatment, healthy living improvements, and technology to remove waits and assist diagnosis.
It’s asking a lot of the nascent NHS/business intersection to find the sweet spot consistently enough to confidently guarantee these targets.
None of these problems is the fault of the healthcare network, let alone the CUHP, which is a beacon of light in troubling times. They just make for a difficult backdrop, is all. Shackling the NHS with demands to meet business-driven quotas might be challenging at the best of times, but this isn’t the best of times: at the start of 2019 Britain it’s impossible to determine what policies to adopt for the next three months, let alone the next 10 years.
Just underneath the surface of a very instructive afternoon at the McGrath Centre was the knowledge that planning ahead in such circumstances is fraught with difficulty. But what we do know is that CUHP has been successfully nurturing a network and developing broad-platform consent in the midst of a concatenation of unpredictable forces, and this conference showcased the success of its programme.