On 29 November 2016, AbbVie together with the College of Medicine, brought together over 200 health and care professionals, researchers, commissioners and patient representatives, to share and examine how, by ‘going beyond medicine’, we can address the sustainability challenge faced by the NHS. The conference explored a number of themes relevant to achieving long-term service sustainability: NHS funding, the potential of technology, patient-centred healthcare and social prescribing.
Smarter investment in the health service was hotly debated by a number of speakers. UK health spending, as a proportion of GDP, still lags behind other developed countries.
The separation of health and social care prevents provision of a truly integrated service and leads to inefficiencies. Furthermore, focusing investment on acute care, without action to reduce demand, hampers efforts at sustainability. A greater proportion of funding should be diverted upstream into prevention, health promotion and the tackling of social determinants of health. Financial sustainability could also be aided be finding new ways of the NHS working in partnership with external stakeholders with shared goals.
Revolutionising healthcare through technology
The NHS needs to embrace and capitalise on the potential of technology to revolutionise healthcare. The UK has a great tradition of discovery in pharmaceuticals; however, barriers to adoption of innovation still exist in this area, limiting the benefits to patients. To accelerate the adoption of innovation, the systemic thinking needs to change, with a renewed focus on the methodical application of what works.
The digital revolution presents great opportunities. There is evidence that digital technologies are able to shift diagnostics, care and support out of hospitals and into homes, with a leap forward in the NHS’ ability to accurately monitor ongoing conditions. Vanguards and test beds are showing positive results and political backing for the digital transformation agenda appears steadfast. However, investment varies across geographical areas. Making technology usable for patients, and giving people access to their own records, must remain priorities.
Putting patients first
A sustainable healthcare system has patients at its heart and talks the language of the people living with conditions, considering them as people and not solely their illness. To put people with long-term conditions firmly in control of their care, the health system must change its mind-set and see a shift in resource allocation. Many people would be able to effectively manage their conditions if provided with the right tools. Information and support to enable people to become independent and lead their own health should be widely available and front-loaded. Empowering patients to self-manage would free up NHS capacity to focus on intensive support for complex patients for whom self-management is not suitable.
New opportunities to make services more patient-focused are opening up in the shape of patient support programmes,. Such programmes assess patient ability and willingness to manage their care and provide tailored support, for example by phone or digital technologies, to improve both. Their overriding mission is to make a positive impact on patients’ lives, improving experience and seeking outcomes that matter to patients, and are good for the NHS.
Demystifying social prescribing
Pressures on the health services are evident, with lengthening waiting times and rationing of “non-urgent” procedures. Pressure on primary and acute care is particularly visible. One way of relieving some of these pressures is through tapping into community resources. Social prescribing provides GPs with an option to refer patients to non-medical community support that can be offered alongside existing treatments, reducing the pressures on traditional health services.
The conference heard that social prescribing has the potential to “put the humanity back into the system”, encouraging a cultural shift that recognises individual needs, wants and goals. Social prescribing is attracting ever-greater interest and finds itself at a critical juncture – the point where it goes mainstream. Work is being undertaken, with the support of NHS England, to create guidance documents to embed social prescribing into the health and care system.
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