The NHS is a nightmare, says Gillian Bowditch in the Sunday Times. It isn’t national (there is no single UK standard for everything). It doesn’t appear to be much concerned with health (it is more in the business of “crisis” provision”). And it isn’t much like any other service we know (“in a toss up between protocol and what is in a patient’s best interests, protocol wins every time”).
Bowditch has plenty of anecdotal evidence to support these thoughts (as do I, and, no doubt, you). But the OECD report out last week has added grist to her mill. It tells us that we are short of 25,000 doctors, that our NHS staff “have too little time to care” and that we don’t even do the basics particularly well. There are some “really disturbing failings”.
Most of us assume that this state of affairs is destined to, at best, carry on as it is, and, at worst, to continue to disintegrate under the weight of its own ineptitude and our overweight/ageing population until it is gobbling the nation’s entire tax take, while being so useless at its supposedly core tasks that we are all obliged to go private anyway. That might happen.
As Bowditch says, change doesn’t come easily to the NHS – in England or Scotland. “Even simple cost-free ideas that could be quickly and easily implemented meet a level of resistance that would have impressed General de Gaulle.” But it really doesn’t have to happen. Technology can stop it.
A friend who recently spent a few days in hospital told me about how boring and time consuming all the routine nursing tasks appeared to be. Nursing, he said, seems to be mostly about checking (temperatures, blood pressures, blood sugar levels etc) and counting (pills) – both things that could surely be done better by technology.
How hard would it be to create an automatic dispensing system for medication? And how hard would it be to convert the Fitbit on my wrist into a diagnostic wristband sending and storing the vital signs of every patient for consultants to see when they eventually appear on each ward (or even for a computer to analyse in advance of their appearance).
That reminded me of a talk I went to recently (which I mentioned on our podcast) where the speaker pointed out that it would be entirely possible for us all to wear similar devices all the time so that our health data was always available when we needed it (on our smartphones or automatically transmitted to our GPs). That way, when we went to the GP there’d be no time wasted on basic tests and fuzzy questions (how long have you had temperature?): all the information would be there already – note that the Apple watch can store 60 types of data already.
Think of the cost saving, the time saving and the human saving: nurses freed of this stuff could think more about the actual care of patients, for example, and diagnosis could be both quicker and more accurate.
Here’s a little hint of things to come: Fastcompany.com reported this week on the new Vivi headset for surgeons in the US. It is small simple plastic device that clips on to a headband or pair of glasses and delivers the crucial bits of medical information (breathing, heart rates etc) direct to the doctor via a Bluetooth connection with other equipment. The ideas I discuss above are just an extension of that, both in and out of the hospital.
The first problem with all this, of course, is privacy – people don’t like the idea of their data being “out there”. The second is persuading the NHS to do anything about it.
The first may not be a problem for much longer – as Gillian Tett noted in the FT last week, consumers in the US are “increasingly comfortable with the idea of managing their own health in cyberspace”. They are also less concerned with privacy than activists like to think: the chief executive of AT&T tells Tett that it is perfectly easy to get people to drop the privacy restrictions on their mobile accounts just by offering to take $20 off their bills.
The second is obviously more of a problem (particularly given that the NHS has history with technological meltdown). But the news isn’t all bad. The Cambridge University Hospital Trusts gets it, and there have been various announcements from the NHS about its intention to use wearable technology properly in the future – there’s a good summary of the possibilities here
This is something to watch: if the NHS can get it right it might be on its way to claiming back the right to use at least one of its initials.