We know from the recent Lib Dem conference that reform of the NHS provokes strong emotions. The politics are fraught, but what about the practicalities?
In a report to be published next week, the Management Consultancies Association sets out some of the challenges facing our health service and suggests ways that they can be overcome. These are some of the toughest management and organisational tests ever tackled in our country. No other organisation this size is confronted by the scale of demographic change, budget pressures and legislative reform that now faces NHS managers. Not changing is not an option. Fortunately, there is a track record of superb leadership and innovation that the health service can draw on.
We identify that social and medical care need to be linked more effectively. So much of what the NHS should now be about is helping people to manage their own care and avoiding inappropriate and expensive care options. But the quality of data about the costs of existing services is often poor, and working across the health and care sectors is frequently difficult. PwC’s work with health and social care providers in Birmingham has helped it to identify gaps in service, secure improvements in the quality of care and save vital millions of pounds.
We also say that the public sector should be a leader in the deployment of IT to make services more effective and closer to the citizen.
Our report highlights work that has been carried out by Ernst & Young with North Yorkshire Primary Care Trust on a remote patient monitoring system that helped to reduce A&E visits by 15 per cent and emergency admissions by one fifth.
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Then we discuss two commercial challenges facing the health sector: how to make best use of the land and buildings that the NHS owns and, how to exploit its extraordinary skills and services. EC Harris recently estimated that 2.1 million square metres of NHS property was either underused or empty space — nearly one twelfth of the total.
But that is only one side of the commercial story. The NHS is constantly discovering new ways of working and new products. These give it real opportunities to create additional value for itself and generate revenue for taxpayers. For instance, if the NHS can create new services that help to keep people at work, we should look to private businesses to help to pay for them.
We expect the BBC to exploit commercial opportunities on behalf of payers of the licence fee. Why shouldn’t the NHS do likewise?
None of these should or need compromise the core role of the NHS as a free service that meets patient needs. Indeed, they will all help to ensure that we have a health service we can be proud of in the 21st century.
These interventions help to raise the quality of patient care and reduce costs. Organisations that want to change frequently draw on external expertise, skills and knowledge; the NHS should be no different.
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• Alan Leaman is chief executive of the Management Consultancies Association