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This is the speech i made during the vital debate about how the NHS will be funded in the future.

It was a very interesting two hours and very special to listen to the expertise in the chamber.

“I come at this debate from a very personal and a professional angle and particularly thank lord patel for instigating it.

firstly, the personal – I am a long term patient whose life was saved by the orthapaedic department in the john radcliffe in oxford and who therefore owes her life to a properly funded nhs.

I am also someone who fervently believes in harnessing the power of technology to improve public services – it is through its more effective deployment that will we provide world class healthcare in the future at a dramatically lower cost.

I am not talking about expensive and costly top down nhs IT projects but instead about better use of data, open standards, more agile development and a more digitally minded culture in our healthcare sector. I would like to give some examples –

This era is often called the age of big data – we now have the ability to aggregate the information gathered from a mass of different sources. This analysis ofdata is changing the way we work and live – the government already has a longstanding commitment to opening up its own data and encouraging its use. It produced a white paper in june on its open data roadmap and launched data.gov.uk so that anyone could access its datasets.

However we are only at the very beginning of the journey – a wonderful project to have come out of the open data institute illustrates why. In 2011-12 the NHS in England shelled out more than £400m on statins out of a total drug budget of £12.7 billion.

In collaboration with Mastodon C, Open Health Care UK (a start-up founded by a doctor and a programmer) examined a vast open data set: the prescriptions written by every family doctor in England. They looked at regional patterns in the prescription of statins, The researchers estimatedthat, had every doctor prescribed white label as opposed to branded statins, the drugs bill would have been more than £200m lower. The variation is remarkable—imagine the potential savings if the exercise was repeated for other classes of drugs.

As the economist recently wrote “A study in theBritish Medical Journal in 2010 reckoned that the NHS could save more than £1 billion by switching from branded drugs to generic equivalents.” The new analysis backs up that claim. Smart use of more datasets will fuel many improvements – as long as interoperability of systems is central to improvements.

Secondly, as 80% of the nhs costs come from the 20% of the population with chronic conditions, it is going to be essential to focus resources on how to help them manage their lives more independently – I believe this will be done by innovation in how care is developed. There is growing evidence that many health issues can be significantly reduced through the use of online tools and there are already many compelling case studies. Mindfull, launched just last week, is a website that helps young people with mental heath issues share stories seek confidential help and find cbt techniques to improve their lives. Similarly, Big white wall is a social enterprise focused on supporting mental health patients. HealthUnlocked, a London-based start-up works with patient groups to give a million people a month information and support when managing long term illnesses such as diabetes and obesity.

In the 3million lives web site The Department of Health (DH) believes that at least three million people with long term conditions and/or social care needs could benefit from the use of telehealth and telecare services. Implemented effectively as part of a whole system redesign of care, telehealth andtelecare can alleviate pressure on long term NHS costs and improve people’s quality of life through better self-care in the home setting.

Over 70% of us look on the web before we go to the doctor and every day millions of people are using health apps on their mobile phones, logging into websites to find out health information and chatting to other people with similar conditions in online forums. New technologies such as Up or jawbone or Nike fuel band allow people to gather their own data and make better lifestyle choices and therefore prevent health issues.

It is vital the nhs is able to deliver services of the same quality as citizens find on the web and on their smartphones or we will be danger of undermining our valued public services. This will require a cultural change within the sector so that all the people working with patients are able to provide high quality relevant and modern care and connect with the innovations that could help patients.

While I spent two years in hospitals rebuilding my body I met some of the most remarkable people – from doctors to nurses to healthcare assistants but even then there was a gap between the technical advances in the commercial sector and what I observed in hospitals. All staff should be helped to be digitally literate and the internet must be put at the heart of design of services, surgeries and hospitals. On this the 65th anniversary of the nhs – surely one of the greatest innovations in the uk’s history, I believe it is imperative to be even more imaginative in how we incorporate another of the uk’s great inventions – the web into its future – this will help us to meet the future funding challenges.”

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5 thoughts on “Future funding models of the NHS

  1. Some excellent points – and whatever happens it’s essential that world class health care remains available to all citizens free at the point of delivery..

  2. Super speech. It hit so many points that should help to reshape NHS services and funding. My current focus is to help families of elderly people living independently. There’s so much that can be done with digital technology to improve quality of life – and save billions to the NHS and personal savings. Hear my story on https://vimeo.com/69536549.

    The video helped to pass Stage 1 of a bid for funds from the Nominet Trust for an Open Care EcoSystem. A key objective is to create open standards for care and health sensors in the home. Standards for the Internet of Things. It make economic sense for building a £billion industry in the UK. By vesting the IPR in a Community Interest Company, profits will have to be returned for public good. If all goes to plan, we will need non-executive directors in 2015. Interested?

  3. Pingback: MLF supports open standards: Open Care EcoSystem? | Quarkside

  4. Martha,

    I experimented with the internet back in ’95 / 96 and stayed online as soon as I discovered that I could find out lots of information about and support for a serious health issue I was going through at the time (yes even back then!). This led me into doing a degree in this area, studying for a PhD (not completed) and then effectively becoming a community lead on ‘digital’ in my local area.

    I really despair when the same barriers to expansion of use of electronic tools within health are still trotted out now. I agree that top down IT projects don’t work – but I fear that the true lessons about the failure of ‘Information for Health’ and NPFIT haven’t really been learnt / understood /discussed. Until they are then I don’t think that there will be large scale transformation of the way that the health sector (in particular) engages with telehealth and telecare.

    Why can’t I as a patient with a chronic illness engage regularly with my specialist nurse using electronic tools by uploading my self test results to a shared resource rather than having to go for a blood test then fit into a (usually) not convenient clinic spot 2 or so weeks later to get the results? The technology is here but the cultural transformation isn’t. We do it that way because , well, it has always been done like that… Why isn’t there a project where obese people are given a pedometer that communicates online with a fitness monitor who can set targets and encourage when ctivity dips – why do ‘fitness and activity’ prescriptions have to be centered around ‘gyms and exercise classes’?

    Its not just health – I’ve been told that papers for a Governing body can’t be delivered electronically – imagine the time & costs saved – because ‘the papers need to be on different coloured paper so that Governors know they come from different sources’. Umm what about the governors actually reading and digesting them?

    I know that you know all this but how do we generate the head of steam that makes everyone else see this? From my point of view – how do I convince funders and workers in the area to listen and not dismiss ‘digital’ projects as mere fads or ‘it will never work’ ?

    As Nick Atkin from Halton Housing Trust said at a presentation last week, digital has to change the relationship between parties – hopefully to a more adult level of relationship.

  5. Interesting speech, though can’t help but thinking that the greatest opportunity is simply giving healthcare professionals the technology the rest of us take for granted.

    Some examples from my medical friends:

    – why does the Royal Marsden hospital require requests for CT scans to be made on paper?

    – why are doctors forced to use ancient browsers like IE6 and IE7 (much of the army, too, is stuck on IE6), which make much of the web inaccessible?

    – why is the productivity of highly-paid doctors destroyed by ancient, slow laptops when a Chromebook only costs a couple of hundred quid?

    – why not take advantage of geolocation technology available to every smartphone user, rather than outdated (and open to abuse) pager devices?

    – why send out teams by road costing hundreds of pounds to “repair” (often unsuccessfully) a printer that a doctor could buy from the Tesco next door for £30?

    – why is it that doctors, among the most mobile of professionals, can’t get email on their mobile devices?

    – why does it take patients two weeks to access their records, requiring them to scan documents sent via second-class post back into electronic form? Why does the health service hide behind the veil of the Data Protection Act and refuse to permit Dropbox and similar technologies for file transfer?

    – why sting patients and their families for tens of pounds per day to use internal premium rate phone / wifi / TV technology, when they can just install free wifi and un-ban mobile phones?

    Fixing the above would provoke a productivity revolution in the NHS.

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