Looking forward to 2009

image John Coulthard, director of healthcare at Microsoft UK, reflects on the challenges facing the health service in the year ahead. He argues the coming year will be dominated by the need to make extremely demanding efficiency savings, while delivering on the personalisation agenda set out by Lord Darzi.

 

The main theme of the coming year will be the recession, and for everybody involved in healthcare the challenge will be how to do more with less. The years of plenty are over, but delivery of the huge policy agenda set out by Lord Ara Darzi at the end of his Next Stage Review has only just begun.

Lord Darzi has set the direction on quality and responsiveness. We all know what is expected; the task ahead is to act on that strategic direction this year. It is an enormous change agenda and will have to be achieved from within existing resources.

“NHS bodies would be prudent to rule out any return to years of steadily rising budgets for the next decade.”

Quality data should be routinely derived from primary data, using business intelligence tools. The push for quality should not turn into a massive new data collection exercise in the way that 18-week wait has done. The challenges are to capture reliable operational data and then analyse and act upon it.

Efficiency, efficiency, efficiency

As the economy contracts, efficiency and productivity will only grow in importance. On top of the 3 per cent annual efficiency savings the NHS was already expected to make, November’s Pre-Budget Report said it will have to deliver up to £2 billion in cash releasing savings.

Efficiency now looks set to become the 12th criteria in World Class Commissioning. But this may only be the beginning of looming austerity. NHS bodies would be prudent to rule out any return to years of steadily rising budgets for the next decade.

To meet the challenges of Darzi and the straightened times ahead will require very significant change – change that, arguably, should have been the pre-condition of some of the budget increases of recent years. New service models will be needed that will require commissioners to de-commission some existing services.

Future benefits to patient care will have to come from managing, commissioning and delivering health services in new ways. For this to happen, the NHS urgently needs to get relevant.

Getting relevant

Even in a recession, citizens’ expectations of health services will continue to grow more demanding. Faced with rising taxes and economic insecurity, citizens should rightly expect that their hard earned tax pounds translate into modern, relevant services.

Relevant, personal services are what we expect and demand from almost every other provider, be it of banking, retail, travel or news. Citizens are right to expect and demand more in healthcare; and if the NHS can’t deliver other service providers will.

“The websites of primary care trusts should be a key tool to help them improve the healthcare of local populations, delivering highly targeted, personalised health information, campaigns and profiled data to visitors.”

The approach that ensures that when I go to Tesco’s online store I get offers and information tailored to me on the basis of my past preferences, behaviour and profile offers huge potential in healthcare. Tesco personalises the information and services it presents because this delivers results; so should NHS organisations.

The British Heart Foundation has shown how targeted health promotion messages can dramatically improve the success of online campaigns. The websites of primary care trusts should be a key tool to help them improve the healthcare of local populations. They should deliver highly targeted, personalised health information, campaigns and profiled data to visitors.

If I’m a 45-year old male smoker visiting my local PCT’s website, I should be directed to vey specific services such as smoking cessation. Telling me about developments in maternity services is a squandered opportunity.

Keep taking the website

Over the course of 2008, Microsoft has been practically demonstrating the power of the web to deliver relevancy through the Microsoft NHS Resource Centre, which offers software, training and content in a personalised fashion. By delivering relevant content and resources we have seen traffic surge to over 6,000 visitors a month.

The challenge that the NHS has to address over the next 10 years is the digitisation of healthcare. While health is not the same as retail, finance or other sectors of the economy, it can and should learn from hard-won experience elsewhere. And it should take the first steps towards delivering more relevant and personal healthcare in 2009.

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