Boris’ Billions: How could the NHS spend an additional £350m per week…?

In the wake of the EU Referendum result that shook us to the core on Friday 24th June 2016, the Brexiteers’ key headline incentives quickly unravelled.

Aside from the dominant immigration debate, one of the most eye-catching carrots for voting ‘out’ was the claim blazoned across the side of the Vote Leave battle bus:

“We send the EU £350 million a week, let’s fund our NHS instead”

I don’t intend to unpick that statement; by now, we’ve all heard the pre-referendum analysis and post-referendum admissions that this money was not all it seemed, and it absolutely will not flow directly into our NHS.

But. What if it did?

We asked our experts at Moorhouse to consider how the NHS could invest a sudden influx of cash amounting to over £18 billion a year – circa 15% of the current NHS budget. It’s fair to say our team proposed ideas that could create much needed momentum behind a range of transformational initiatives – covering: technology, workforce, estate, social care, and public health:

Investing in technology:

  • Support implementation of digital roadmaps, so that they can genuinely deliver the sustainable positive change they describe. We’ve seen the impact digital has had in other industries; let’s see the difference it can make to health services.
  • Accelerate telehealth to enable individuals with long term conditions to be cared for in their own homes. It has long been recognised that telehealth improves patient experience and reduces the financial burden. Let’s seek to industrialise and broaden its application.
  • Enable data sharing so that clinicians have access to patient data and their care preferences. This could cover long term conditions, palliative care, medication requirements, mental health challenges, and so on. But… care should be taken to learn the lessons from previous attempts.
  • Building on the last idea, equip ambulances with the ability to access key patient data – and to share information from a scene that enables early clinical intervention and decision-making.
  • And finally, do drones have a role in the NHS? Urgent delivery of medication? Routine delivery of repeat prescriptions? Transporting samples to laboratories for rapid investigation? Maybe not in 2016 – but it could become the future…

Read our recent perspective[1] on technology and the NHS.

Investing in workforce:

  • With funding pressures arising (in part) from the use of agency and contract staff, investing in the long-term pipeline of staff seems a sensible place to focus. Naturally, this starts with understanding the future shape of the workforce given the ongoing transformation of models of care; creating attractive, viable roles will be key to future sustainability.
  • Along those lines, ensuring NHS management is an attractive option for graduates will help to attract the leaders of the future. There are some fantastic leaders in the NHS, so let’s ensure the pipeline remains populated with the best available talent.

Investing in estates:

  • We know that the backlog of estate refurbishment is significant – so let’s seek to eliminate that backlog. Not only does this improve quality of patient experience, but it also helps staff to feel proud of their working environment.
  • With the consolidation of specialised services, investing in genuine centres of world class excellence – working with leading research institutions. This, in turn, would attract some of the greatest clinical minds, for the benefit of all NHS services.
  • Provide the necessary investment in the capital infrastructure required to deliver the new models of care and hubs for health and social care. Integration of health and social care is so clearly at the heart of the next phase of NHS, that investing in these facilities is essential.

Investing in Social Care and Mental Health:

  • Building on the above capital investments, we would suggest major investment in social care. For example, increasing capacity of palliative care and community care for an immediate impact on transfers of care from acute settings.
  • In addition, investing in facilities for those with learning disabilities so that they can be cared for in modern facilities – or in the community – rather than the archaic Victorian buildings that still exist in places.
  • Related to this, the budget for mental health could be doubled – and we’d focus on prevention and early identification, plus the reduction of the current long waiting times for specialist treatment. The economic benefits for better management of mental health illness have been well argued over recent years.

Investing in prevention:

  • Fitbits for all – not just the self-selecting, already healthy cohort of society!
  • Personal training and better focus on nutrition – again, not just for those who already use it…

And finally, no shopping list would be complete without investment in Primary Care – and, specifically 8am to 8pm access. And we’d also ensure Primary Care and Acute Care have better channels for sharing information…

Thanks Boris.

[1] http://www.moorhouseconsulting.com/insights-publications/perspectives/2016/the-rise-of-digital-and-how-it-can-help-to-transform-the-nhs/

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Richard Jones Partner