Thinking about the big themes that might kick off in 2011, I have kept them short and in doing so I would imagine all sorts of things can be read into the gaps. I have tried to look at the opportunities and while I know there will be blockers …I have chosen to ignore them.
Citizen becomes the agent of change in the NHS
After 60+ years of trying to change itself it is time for the citizen to be given the chance to demand the change. We will therefore see considerable political and legal changes to the constitution of the NHS to enable citizen power.
NHS hospitals become the Acute Care Service
NHS hospitals become proper acute organisations, no longer treating chronic disease or warehousing the dying. You don’t go to “A&E” if you have a paper cut, you don’t go to hospital if you have diabetes.
Managed Care Practices
GPs become the managers of wellness, they become responsible for the whole of life of the citizen and not the manager of episodic patient driven events. They are rewarded for the proper evidence based management of wellness. They manage the individual healthcare budgets of citizens. They are “penalised” for use of Acute and CDMS.
Chronic Disease Management Services (CDMS)
Those with chronic conditions are managed outside the formal structures of the NHS, commercial and not for profit organisations provide single and co-morbidity services
Self- care becomes the channel to better access to Managed and Acute Services
Those that self-care and are shown to be competent at looking after their wellness gain faster access to managed and acute services
Information Strategies give way to Intelligence Based Medicine
The analysis of basic vital signs data and the use of early warning scores becomes the norm in the NHS, diagnosis without effective clinical data becomes a negligent act for any clinician.
Clinical Decision Support closer to the patient
Citizens become responsible for their data, co-production is the norm, failure to do so slows access to services.
And I have thought of 3 things that the NHS must do this year as a start:
- Standardise the Acute Clinical Record across England
- Enables clinical Audit
- Enables the development of co-production systems
- Enables cross org collaboration and intelligence
2. Every Patient in the NHS to be monitored provided with a weighted early warning score
- Will reduce mortality
- Reduce Acute sector costs
- Will enable audit of GP wellness activities
3. Create the standards and processes for clinical record sharing
- Enables citizen control
- Other providers
- Provides information and intelligence for CDMSs