Innovation: the holy grail of QIPP?

One of the most well-known developers of healthcare innovations, Philips acknowledges that technology, alone, is unlikely to meet the Department of Health’s objectives on QIPP – there is no ‘magic bullet’ to solve the complex problem of ‘how to do more for less’. Nevertheless, advances in medical technology have a role to play in meeting rising demand for healthcare, with limited resources. In order to establish how advances in medical technology can be harnessed successfully, research projects are currently underway focusing on improving patient engagement, home healthcare and optimising quality of care and productivity. Some of these projects were highlighted at the exhibition and involved collaboration between Philips, healthcare providers, universities, medical research institutes and other stakeholders. “The health service in its current form is unsustainable,” commented Neil Mesher, managing director, Philips Healthcare UK and Ireland, as he introduced the agenda for the day. “We need to do things differently.” A panel of speakers from medical and patient communities, as well as industry, discussed the role of advances in medical technology in ensuring a more sustainable healthcare system – highlighting the challenges, opportunities and potential pitfalls. They considered the question: “Are healthcare innovations the holy grail of the UK’s QIPP agenda?” Providing a voice for patients, service users, carers and their representatives, Jeremy Taylor, chief executive of National Voices, commented: “QIPP, as an acronym, does not mean anything to ordinary people. Patients and consumers of healthcare care a great deal about quality; but they are probably neutral about innovation. “What people want is good care. If innovation delivers this, they will want it, but it is fair to say that they tend to be wary and don’t like change. People are suspicious of innovation – particularly if they feel they are forced to use it, so the context in which innovation is provided is very important.” He pointed out that prevention is also important: “In the UK, some people die 15-20 years younger than others because of their social circumstances; they may be unemployed, live in poor housing or smoke. Technology cannot fix this, although it may help. The health benefits associated with technology that allows people to connect through social media may be even greater than the innovations being developed here today – by building social capital and overcoming isolation. We cannot ignore prevention and health inequalities – technology may be able to help with this part of the QIPP agenda.” Although technological innovation is not the ‘holy grail’, in his view, it still offers a valuable contribution: “More than anything, we need innovation in the way services are designed and delivered – as well as innovation in terms of the culture of the health service and the way it interacts with the public. Technology has an important role to play in this respect, but it is one aspect. Innovative technologies will not work unless they are also part of a chain of change in the way health services are provided,” he commented. Jeremy Taylor emphasised that patients should not be viewed as ‘consumers’. “Healthcare is not like shopping”, he cautioned. “People want choice and to be in control, but they also want to be looked after. Technology works if it enables individuals to be more in control. However, one of the dangers is that we may unwittingly enslave people to technology that they do not really want – it becomes their master rather than their servant.”

New ways of working

Malcolm Hart, commercial and customer service director, Philips Healthcare UK and Ireland, pointed out that, faced with the QIPP agenda, along with the Nicholson challenge of delivering ‘efficiency’ savings of £20 bn by 2015, the initial response by the health service has been to “freeze pay, cut the workforce to the bare minimum and increase task loads to breaking point”. However, the next level of savings will be much harder to achieve. At this second stage, technology will become the ‘enabler for service transformation’ and new ways of working – not just on a local level but on a large scale. “Healthcare is not like insurance or banking, where technology has played a major role in the way services have been transformed. However, we do need to find a balance between the industrialisation of processes and services and ensuring that, locally, these services are tailored to the requirements of healthcare professionals and patients,” he commented. Malcolm Hart pointed out that informatics solutions need to deliver real benefit to patients, carers and healthcare professionals, across health and social care boundaries – in a way that is cost effective and at scale. “Building a business case for investment in technology will be assisted by its ability to help avoid hospital admissions; significant progress can be achieved in this area,” he asserted. “This is only the beginning of the solution, however. If we can enable the sharing of information across boundaries, we can work in a more collaborative way. We have seen this through the Department of Health’s 3millionlives and the ‘DALLAS programme’ (delivering assisted living lifestyles at scale).” The Department of Health believes that at least three million people with long-term conditions and/or social care needs could benefit from the use of telehealth and telecare services. The initiative 3millionlives is about transforming service delivery by enabling millions of people to receive the benefits reported by the UK’s Whole System Demonstrator trials (the largest randomised control trial of telecare and telehealth in the world). The trials resulted in: