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Embracing change: paving the path for a more resilient NHS

As the NHS reaches its 75th anniversary, Dr Karen Kirkham, Chief Medical Officer at Deloitte, writes for Hospital Times about why the NHS must embrace change and innovation to build a resilient healthcare system for the future.

The road to recovery for the ‘NHS at 75’ in the wake of the pandemic, has been, and will continue to be, long and difficult. This pivotal ‘post-pandemic’ moment calls for bold decisions and transformative measures, as evidenced by numerous reviews, reports, and inquiries. The fact of the matter is – no health system, no business, no institution can, or should remain the same.

Dr Karen Kirkham, Chief Medical Officer, Deloitte
Dr Karen Kirkham, Chief Medical Officer, Deloitte

The foundational principles laid out by Aneurin “Nye” Bevan in 1948 – universal care, free at the point access, and funded from taxation – are principles most people, including my fellow clinicians, uphold, value, and want to maintain. Once lost, these principles would be difficult, if not impossible, to reinstate. However, what is required right now is a new healthcare narrative and an agreement on the roles and responsibilities of clinicians, and patients too. Transparent public discourse is vital to align expectations with the funding and infrastructural limitations faced by healthcare services.

Health systems have a unique opportunity to influence the provisions laid out in the Health and Care Act of 2022, which can enable them to develop models that foster genuine integration and use data to understand the specific needs of local populations and address healthcare inequalities.

Alongside this important change, there remains the need to ensure each integrated care system (ICS) provides good value for money; develops incentives to improve outcomes; creates meaningful and trusted partnerships; modernises using technology; learns from other industries and invests in the development and retention of staff. The move to service integration at place level across multiple providers, and the focus on population health, also provide ICSs with greater freedom to respond more effectively to the needs of the people and places they serve.

Envisioning the future of health

An ideal vision for the future of UK healthcare foresees a shift from reactive sick care to a proactive wellness model, with data sharing, interoperability, and analysis playing a pivotal role in driving this transformation. Equitable access to care will become an unwavering focus, while empowered consumers will drive change through predictive, preventive, personalised, and participatory approaches. Technology will facilitate behaviour change and encourage individuals to take responsibility for their own health. Furthermore, exponential advancements in technology and scientific breakthroughs will continue to disrupt the healthcare landscape.

UK public health should anticipate a surge in the adoption of technology-enabled care, including virtual healthcare services, necessitating a shift towards smarter working practices empowered by technology. Clinical teams are eager to embrace these changes and adapt swiftly.

Crucially, a robust health service relies on a well-supported workforce. While the UK faces evident workforce challenges, this issue is increasingly prevalent worldwide, highlighting the urgent need for substantial workforce investments. Our Time to Change research has identified the aspects of current working practices that should be retained, actions to re-engage the workforce, and areas that require reimagining to improve work-life balance of workers.

Deloitte’s Time to Change study of nearly 1,300 healthcare workers revealed that a sense of fulfilment/making a difference and work-life balance are key to job satisfaction in healthcare – in stark contrast to a 2017 study, when work-life balance was the lowest driver. Another key take away was how the use of Electronic Health Records, e-prescribing and at home diagnostics/monitoring were among technologies healthcare workers viewed as key to quality of patient care. While healthcare workers know that technology-enabled care models, systems and processes can improve outcomes and safety for patients, simplify tasks and reduce the significant administrative burden for clinicians, adoption remains fragmented. Healthcare leaders need to modernise and unlock better ways of working that improve the employee – and employer – experience.

Navigating macro market dynamics for the future of health

The ongoing pandemic and global events have accelerated the impact of key drivers shaping the future of healthcare, but they can also undermine progress. Inflationary pressures are pushing more people into poverty and compromising their health. The climate emergency exacerbates the prevalence of communicable and non-communicable diseases, placing immense strain on health systems worldwide. However, these challenges also present opportunities for partnership and collaboration across the healthcare landscape. The changes unfolding in the UK provide a chance to adopt fresh perspectives and establish a long-term plan capitalising on the potential offered by ICSs.

Learning and sharing on a global scale

The UK can learn valuable lessons from countries that have successfully improved health outcomes for their populations. These lessons include investing in prevention and promoting healthy lifestyles, addressing housing and education disparities, prioritising individualised care, embracing technology and digital services, and fostering a culture of innovation.

As the nation prepares to celebrate the 75th anniversary of the NHS, it is only fitting that we reflect on how we can facilitate its recovery and prosperity. While these reflections on current challenges and the future of healthcare are intended to stimulate discussion and debate, the reality of transformation is within reach and will impact all stakeholders, including providers, staff, patients, and citizens.

Right now, providers and their staff are rightly focused on addressing the pressing healthcare challenges brought on during recent years. However, for the sake of the workforce and patients nationwide, this opportunity to embark on a transformational journey must be seized, to position UK public health for a future where the country can celebrate the NHS’s centenary.

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