The Future of Health Event
Life, Death and The Wizard of Oz
A few weeks ago I found out about a health event that appeared directly in line with my PhD. The focus appeared to be about how to make the NHS better through greater patient empowerment. Technology also seemed to be a key theme. I have to go to this event I thought. Then I spotted a Twitter post stating that they were looking for people who have or had lived through chronic illness to join a people's panel for the event. Looks like that suits me perfectly I thought, so I applied to join the panel and was accepted, how exciting.
The weeks leading up to the event were a little challenging for me emotionally however. My uncle died a few weeks before the event, and less than a week before, my sisters long term partner had a heart attack and was dying in intensive care whilst I was at the event. I'd known him for almost 20 years. Whilst in some ways I guess serious illness and dying were not entirely alien themes to the event. I have to also say that this was more than a slight distraction.
The event started really well. I met some other members of the People's Panel (PP) who seemed really nice. The opening speakers were informative. Ceinwen Giles gave a powerful speech using the wizard of Oz as a metaphor. When she reached the end of the yellow brick road she realised that her consultant wasn't a wizard able to perform magic, just an ordinary man hiding behind a curtain. This was when she realised that she couldn't go back to Kansas.
I was also inspired by watching Anya De Longh politely but firmly holding Martin McShane from NHS England to account to ensure he stands by his commitments. She suggested that a co-production approach should have been used to organise the event, involving the expertise of patients in its planning not simply consulting and asking for their views. By making this point she clearly hinted that this approach was needed throughout the NHS not simply in the organising of this event.
It was reassuring to hear Simon Stevens CEO of the NHS talking in
support of the asset based approach to health improvement. Even if my
more cynical side thought that he might just be tailoring his speech to
his audience. I also enjoyed the questions from PP members and other and the responses from Simon Stevens and Martin McShane. It sounded as if the NHS might be in good hands. I did however reflect on the fact that given the fragmented nature of current NHS structures, even if the leadership have the ideas and vision that is needed, getting people throughout the system to make the changes that are needed might be challenging. One of the PP members stated that whilst there may be a lack of activated patients, creating more activated patients isn't going to get us anywhere unless we also have activated clinicians.
Alex Silverstein spoke eloquently about his own positive experiences of using apps to manage his health. In response to the idea that some doctors are critical of patients accessing unreliable information on the internet, he stated that if medical practitioners don't like the information that they see on Wikkipedia they should change it. Tim Kelsey opened his talk by stating that the future is here. I wondered whether he was deliberately quoting William Gibson. Following this he talked about the areas where the NHS has a lot of catching up to do. It is the worlds largest consumer of fax machines and many records are still kept on paper. Following a question from the floor there was some interesting discussion about how waiting rooms could be made more productive. Computer tablets to engage patients and enable them to make better use of their time was discussed as was more use of remote Skype consultations to reduce the need for waiting rooms
In response to a question about the potential for co-production to bring together experts including patients to create the apps that are needed to empower patients and health professionals I was disappointed that Tim Kelsey's response seemed to be that it would be better to simply leave it to the market. Is this not why the NHS is still the worlds biggest consumer of fax machines ? He also suggested that patients should learn to code and create their own apps. I was also a little sceptical about this idea. I am not convinced that this is the best way forward.
Next I went to a talk that was supposed to be about patient empowerment, but seemed more like a sales pitch to GP practices for some new software.
In a session on service integration David Haslam (NICE) suggested that one of the problems is that health and social care providers have a different understanding of what words such as urgent and impact mean. Worse still, very often they don't know that they don't have a shared understanding. He also suggested that NICE guidelines may help improve integration. Luke O'Shea (NHS England) suggested that its not a zero sum game and by sharing power health professionals may end up with more power than they started with.
The event ended with an inspirational talk by Ben Goldacre. It was good to see that he is as inspirational and entertaining in real life as on his TED Talks. He talked about the potential for accessing data from the results of real treatments. He also stated that doctors need to be more like life insurance salesmen, more focussed on giving patients options so that patients can make their own informed decisions. I was also lucky enough to speak to Ben at the end of the event. I asked him his thoughts on IBM's Watson. He suggested that it was probably just smoke and mirrors. If it really did what they claim, it would be used more extensively already. Despite this, I still think that its likely that it will be predictive analytics combined with patient empowerment that will revolutionise healthcare.
Following the event I reflected on my own thoughts about how the UK health system could be improved. Recent personal experiences flowed into my thinking. The NHS is good at dealing with physical symptoms but less good at treating the whole person. 75% of NHS expenditure is now used to support and treat people with chronic health conditions. More than 50% of people with chronic conditions have more than one of them. A system based on experts with specialist knowledge of one condition is now no longer appropriate. The current system is unsustainable. Patients are a largely untapped resource that could be used to create a radically different, better and more efficient system. Chronic conditions are not just physical, the psychological aspects of these need to be treated with the same parity as the physical. A holistic, whole person approach is needed. Drug, alcohol and mental health conditions also need to be regarded as chronic conditions and treated in the same holistic way.
Alex Silverstein spoke eloquently about his own positive experiences of using apps to manage his health. In response to the idea that some doctors are critical of patients accessing unreliable information on the internet, he stated that if medical practitioners don't like the information that they see on Wikkipedia they should change it. Tim Kelsey opened his talk by stating that the future is here. I wondered whether he was deliberately quoting William Gibson. Following this he talked about the areas where the NHS has a lot of catching up to do. It is the worlds largest consumer of fax machines and many records are still kept on paper. Following a question from the floor there was some interesting discussion about how waiting rooms could be made more productive. Computer tablets to engage patients and enable them to make better use of their time was discussed as was more use of remote Skype consultations to reduce the need for waiting rooms
In response to a question about the potential for co-production to bring together experts including patients to create the apps that are needed to empower patients and health professionals I was disappointed that Tim Kelsey's response seemed to be that it would be better to simply leave it to the market. Is this not why the NHS is still the worlds biggest consumer of fax machines ? He also suggested that patients should learn to code and create their own apps. I was also a little sceptical about this idea. I am not convinced that this is the best way forward.
Next I went to a talk that was supposed to be about patient empowerment, but seemed more like a sales pitch to GP practices for some new software.
In a session on service integration David Haslam (NICE) suggested that one of the problems is that health and social care providers have a different understanding of what words such as urgent and impact mean. Worse still, very often they don't know that they don't have a shared understanding. He also suggested that NICE guidelines may help improve integration. Luke O'Shea (NHS England) suggested that its not a zero sum game and by sharing power health professionals may end up with more power than they started with.
The event ended with an inspirational talk by Ben Goldacre. It was good to see that he is as inspirational and entertaining in real life as on his TED Talks. He talked about the potential for accessing data from the results of real treatments. He also stated that doctors need to be more like life insurance salesmen, more focussed on giving patients options so that patients can make their own informed decisions. I was also lucky enough to speak to Ben at the end of the event. I asked him his thoughts on IBM's Watson. He suggested that it was probably just smoke and mirrors. If it really did what they claim, it would be used more extensively already. Despite this, I still think that its likely that it will be predictive analytics combined with patient empowerment that will revolutionise healthcare.
Following the event I reflected on my own thoughts about how the UK health system could be improved. Recent personal experiences flowed into my thinking. The NHS is good at dealing with physical symptoms but less good at treating the whole person. 75% of NHS expenditure is now used to support and treat people with chronic health conditions. More than 50% of people with chronic conditions have more than one of them. A system based on experts with specialist knowledge of one condition is now no longer appropriate. The current system is unsustainable. Patients are a largely untapped resource that could be used to create a radically different, better and more efficient system. Chronic conditions are not just physical, the psychological aspects of these need to be treated with the same parity as the physical. A holistic, whole person approach is needed. Drug, alcohol and mental health conditions also need to be regarded as chronic conditions and treated in the same holistic way.
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