As the NHS continues to deal with long waiting lists, staff shortages, and the ongoing effects of the pandemic, Jonathan Patrick believes that now is the time to capitalize on the momentum we saw during COVID and expedite solutions that can help create a better and stronger health system
It’s tricky to work in or with the NHS at the moment. Waiting lists are constantly discussed across the media, many people can’t get an appointment with their GP, ambulance services are struggling to meet time targets, and there is more; you’ve already heard it. Like I said, it’s tricky.
Is the good news that it’s not as bad as all that? I’m sorry, but I think it’s probably worse. Those of us who work with the NHS get to see more than makes it onto television. What we’re seeing suggests we’re not yet at the low point.
Last March, the Integrated Care Boards – the ICBs – in England were told that they had to cut their running costs by 30%. Running costs are basically a euphemism for staff. For those who don’t know, the ICBs manage how healthcare is delivered in an area. You can probably imagine what happened when they received news of the impending staff cuts. A lot of work was put on hold, not least because the demoralised workforce wasn’t sure who’d be left to do what when the exercise concluded. The process has dragged on until this year, and the skeleton staff left in most areas is now mainly focused on keeping disaster at bay. It’s not the plan we need to get back on top of the problems that stalk the NHS.
There is worse coming, though. On 22 April, the Health Services Journal published a story about Mid and South Essex Trust, which runs hospitals in Basildon, Southend, and Chelmsford. The financial position of the Trust is now so bad that it is being required to cut clinical staff. My guess is that this area is the canary in the coal mine and that there will be more of this in the coming months. How on earth are we going to reduce waiting lists and improve the NHS with fewer clinicians? We are already 9,000 clinicians short according to the BMA!
I’m not going to apologise for being negative. We often hear management mantras that the way to solve problems is to be positive. But, in this case, I think we desperately need to appreciate where we are. It’s a political decision to be positive about the NHS if you are part of a government that has been in power for so long and has overseen the decline. It’s also dangerous because it hides the extent of the problem. Whatever your politics, knowing where we are is key to deciding what needs to be done.
Opportunities in the NHS
So, after the negative, the positive: this NHS disaster presents an opportunity. Even more positive, we have recent experience taking these opportunities in the NHS.
When COVID hit in 2020, it was quickly apparent that we weren’t prepared, and the early days of the pandemic seemed to bring one jaw-dropping challenge after another. As I was doing my hour’s exercise in deserted streets during the first lockdown, it was hard not to think that life could have changed forever.
A couple of months later and, we were already seeing the NHS’s incredible ability to adapt. Can’t see your doctor in person? No problem! You can see them by video. Can’t send people to hospital? No problem! We’ll involve hospital clinicians in your GP appointment using technology. The pace of adaptation and change was mind-blowing. I said it then, and I’ll say it again: we got ten years’ worth of technological adoption in ten months.
Consultant Connect
Our company, Consultant Connect, saw our service coverage spike across the NHS as large areas, including the whole of Wales, took on our app that connects GPs and ambulance staff with hospital consultants in real- time. Every day, we’d hear positive stories from users who had been worried about patients and appreciated having a specialist to talk with. Now and then, we’d also hear how a patient’s life had been saved by a conversation with a specialist. It was a tremendously difficult time, it was the weirdest time, but it was also an amazing time in the NHS.
And we find ourselves back there again right now. Although the challenges are different, we need to try and capture that same spirit of experimentation again together with a sense of urgency. We need to identify the changes that can be made to build a better NHS and then make choices that bet on the most promising options.
As it happens, we’ve got a lot of things we can choose from. Why? Because the NHS has been under pressure for so long that different areas have all tried different approaches to solve the problems of long waiting lists. We’ve ended up with the world’s greatest environment for healthcare trials simply because we’ve had to.
For example, we’ve found out at Consultant Connect that 50% of patients on neurology waiting lists can get the care they need immediately without waiting for their hospital appointment when a remote specialist reviews their case. That’s 50% of patients in one of the most challenged specialties in the NHS! Imagine what else is out there being done by other companies. And don’t forget the enormous potential impact of AI in reducing workload and improving care, it’s already having an impact in dermatology and stroke medicine.
So yes, it’s bleak. And yes, we’re allowed to be worried about the situation that the NHS finds itself in. But it’s not OK to despair; we were up to the challenge during COVID, and we can be up to it now with the right support from the government.
