NHS Plan: Our views

May 23, 2020

Whilst celebrating its 70th Birthday the NHS in the UK also published its long-term plan.  A plan that reflects global macrotrends, cost restrictions, people’s expectations of their health, and the opportunity that new technology brings to improve health outcomes.  People are living longer and an ageing society places massive pressure on healthcare systems, especially as that longevity is often lived with significant comorbidities. This comes at a time when budgets are stretched by years of austerity and rising costs.  At the same time people have come to expect more from their lives as they age than for any other generation.  All of this points to overload, not only for health care systems that are free at the point of use, like in the UK, but also where they are paid for like in the US.  Against this challenge we are seeing new ways of addressing health with technology.  The NHS LongTerm plan does a good job of considering all of these factors.  Let’s explore some of the new approaches in the plan.

Technology is at the core of many of the proposed solutions as it enables in depth tracking, measurement and clinical insight from discrete products that fit into our lifestyles.  Take FitBit as an example.  An item that a consumer pays for and may already be using, that can encourage physical activity which is the cornerstone of good health.  Coupled with heart rate information, if you have a certain model, that can give a very relevant health indicator to triangulate with steps taken.  Sleep is also measured.  All of this gives rich insight into a subject's health, all from a platform that gamifies and encourages participation.

Mr Hancock has spoken in the media about technology like genomics which can give a picture of the future health risks a person may encounter as a result of their genetic material.  This information can be used to give personalised health programmes to manage that person's health to mitigate genetic risks.  This could be a very powerful way to manage future health.  The Secretary of State has gone as far as proposing that people with a family history or other risk factors could be given genome analysis from the NHS, and others could be offered it at a discounted rate from the NHS.  This is forward thinking stuff for the NHS.

In other areas the concept of social prescribing is weighed as a benefit to the NHS.  This is the idea of prescribing people with interventions other than medicines or medical procedures to manage their conditions.  For example exercise and diet for metabolic disease, it has been shown that losing 33 pounds in weight can reverse Type 2 diabetes.  Better for the individual than living decades with a life-limiting disease, and better for the NHS than dealing with heart disease, amputations and multiple other health issues.

Babylon is a UK APP based GP service meaning you can have an appointment with a GP over the phone or using a webcam.  This reduces the burden for the stretched GP whose time is very limited, and also creates data and understanding on the individual who may want to use some of the biochemical tests Babylon also provides.  Babylon is also using its AI to power the NHS 111 service.  They have also shown that the product is more accurate and at least as safe as face to face consultations.  Clearly not everything can be done by telehealth, but it can save resources so that face to face interactions are needed the system can cope.

We can see that all of these approaches are designed to push the responsibility for health onto the individual, reserving the health system for when it’s needed.  Fundamentally this seems a good approach, we all have a responsibility to look after ourselves and our families to look after our health.  The NHS will benefit indirectly as we will interact with it less, and if we do the interactions are likely to have better outcomes and cost less money.  It will be interesting to see what the government can do to stimulate new innovation to power this transformation.  Particularly looking beyond the usual researchers, academics, professional bid writers for solutions.  Treating patients like consumers, which they are as they pay for their health either directly or indirectly, and use that consumer focus to come up with solutions that promote concordance and compliance through great design, user experience and real, measurable user relevant benefits.  A great opportunity for innovators who can think DIFFERENTLY and embrace DIGITAL.

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