Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts

Monday, 19 July 2010

Reforming the NHS

Last week, health secretary Andrew Lansley unveiled his ‘radical’ new proposals for the NHS, outlining changes which many commentators have hailed as the most revolutionary since it’s inception in 1948.

The reforms aim to rid the health service from the tyranny of "unnecessary" bureaucracy by outlining a vision for an NHS led not by politicians, but by patients and healthcare professionals. The restructuring will see the dissolution of strategic health authorities and primary care trusts (which at present manage the majority of the NHS budget) with GPs across the country becoming responsible for managing a sizable £80bn NHS budget. Ministers hope that the new system will reduce bureaucracy and give doctors and patients more control over treatment, whilst also helping to reduce management costs by up to 45% (the NHS is tasked with making some £20bn savings by 2014).

At the heart of the reforms are GPs, which Lansley believes are better placed to make decisions than managers. Through the creation of some 500 GP consortia, the new plans will see GPs working together to select and commission the NHS services their patients need. Each local GP consortium will take charge of local hospital, mental health and community services (specialist services and dentistry excluded), whilst local authorities will take control of public health. The GP consortia will in turn be held accountable by the formation of an independent NHS board which will be responsible for setting standards across the country. Hospitals are to be moved outside of the NHS and are to be turned into freestanding ‘social enterprises’. The gradual phasing out of the 10 strategic health authorities and 150 primary care trusts will occur over the next 4 years as GPs begin to take control of their managerial responsibilities.

Patient empowerment is also at the core of the shake-up, with an aim to give them more involvement within the decisions that affect how and where they are treated. The freedom to choose is also provided, with the abolishment of GP boundaries, allowing patients to register with any doctor they want. A new body called Health Watch England is also to be set up to help ‘strengthen the voice of patients’ and to share information on the performance of local health services.


The inevitable impact on those working within NHS administrative roles is obvious; thousands of jobs will be lost. There are also concerns over whether GPs have the time or necessary skills to discharge their new responsibilities effectively. It is expected that GPs will have to outsource; commissioning support from private firms, which many believe would do little to reduce spending. It has also been announced that £1.7bn will be set aside for the reorganisation – more than seven times what it aims to save on management.


The public sector union Unison has warned that the proposals were “a recipe for more privatisation and less stability”. It is perhaps this concern of ‘denationalisation’ with the expansion of private firms’ involvement within the NHS which appears to have produced the greatest controversy. Opponents have already pointed towards the ‘conspiracy’ to privatise the NHS, predicting an environment of conflicting interests, where patient needs ultimately fall foul to profit margins.

Nonetheless, we are living in an economic environment which can no longer support the NHS as it stands. The British Medical Association’s response to the restructure, reflected positively in agreement, stating that ‘doctors are ideally placed to help determine the health needs of their local population’. These changes, whilst representing a significant gamble, do offer the potential for savings whilst maintaining a quality health service.

It is clear that the government now has two major hurdles to overcome as the new plans are rolled out over the coming years. Firstly, the restructuring must be carried out efficiently and in consultation with GPs so as to avoid any needless disruption to frontline services. Secondly, and perhaps more importantly, these reforms must bring about the improvements we have been promised they will provide. The future of our national health service now rests delicately in the hands of the coalition Government and it's health reforms. Fingers crossed.

Thursday, 12 February 2009

NHS Healthcare Innovations Day - Review

The NHS Healthcare Innovations Day (see original post “NHS Healthcare Innovations Day” Tuesday 10 February 2009) proved to be an interesting experience on a number of levels. While the content of the presentations were both interesting and thought provoking, the pioneering aspect of this meeting was that it could be attended online through Second Life.

The Second Life event drew a respectable audience with over 35 delegates attending the meeting online, set in a bespoke open-air auditorium. Within the Second Life auditorium, meeting delegates could view video screens showing live video feed from the real-life venue as well as other supporting materials they needed to follow the meeting.

There were a few issues with the audio feed during the first session, but the Second Life audience still remained strong, with over 20 delegates present by the time the meeting broke for lunch.

Given that approximately 80 people attended this meeting in person, it is of significance that the online event attracted an additional 25% more delegates, with attendees from the UK, USA and Sweden amongst others.

The Second Life audience wasn’t passive either; like the real-life setting, the Second Life auditorium was equipped for audience voting with some 10 snap polls taken with both audiences able to vote interactively. Delegates attending the meeting through Second Life could also contribute questions for panel discussion.

All this was achieved with relatively low cost, low carbon footprint and a global reach that wouldn't have otherwise been possible.

Much of this could have been achieved with one of a number of web-based conferencing solutions, but there was one significant aspect that was truly unique to the virtual world experience and was the personal highlight of my day: a guided tour of the NHS Second Life training hospital.

Based on a faithful replica of a London hospital, the Second Life training hospital has been constructed to teach familiarity in terms of the layout, equipment and processes the hospital follows. For example, a trainee must follow the correct sequence of operations and be wearing the correct clothing in order to enter an operating theatre. Failure to do so triggers an alarm and instructional training on the correct procedures, right down to video segments showing how to safely open and handle sterile packaging.

Therefore the Second Life training hospital is able to accurately simulate hospital procedures and provide contextual training on how they should be followed, without compromising real-life patient care. However this doesn't just stop at the operating room, but extends to a simulated ward with accompanying equipment and patients. The virtual hospital is even being used to help nurses gain familiarity with a new type of bedside infusion device ahead of its implementation in everyday practice.

What the NHS Healthcare Innovations Day has shown us is that the NHS is already delivering innovative solutions, and has made a success of integrating real life and the virtual world for effective communications, collaboration and training.

Alan


Tuesday, 10 February 2009

NHS Healthcare Innovations Day

The NHS (with the help of the National Physics Laboratory and Imperial College) has been active in Second Life since late 2007. It therefore comes as no surprise that they will be broadcasting live debates from their Healthcare Innovations day in their Second Life auditorium. The real-world presentations and debates will be held at the BMA House in London on the 11th February from 10am GMT. The second life auditorium will be operating from 9:30am onwards. You can register as a Second Life attendee (free) and get more information at their booking website http://healthcare-innovation.eventbrite.com/. Of particular interest will be the ability to pose questions in real-life panel discussions and a special Second Life break-out group.

Both myself (Second Life name: AlanTVF Proto) and Chris Degg (Second Life name: ChrisTVF Nightfire) will be attending the Innovations day and I will be blogging the event live.

Alan