Health Service Focus

Change is on its way

One of the key messages at this year’s NHS Expo was that change is on its way, especially in the form of technological advances for creating greater personalised care. NHE’s David Stevenson reports.

Sir David Nicholson, the outgoing chief executive of NHS England, says that the NHS must change if it is to survive and remain sustainable.

From what NHE saw at the two-day Health and Care Innovation Expo 2014 (widely known as the NHS Expo) in Manchester, there seems to be a great deal of innovation, technology and support available that can make this happen across the UK.

The Expo, hosted by NHS England for the first time, was held at the Manchester Central conference centre, and featured hundreds of speakers across multiple stages.

“We are at a fork in the road,” Nicholson said. “Those who say we can muddle through for two or three more years as we are and sustain the NHS are wrong. The old ways will not sustain it and we will only see a managed decline.”

Nicholson was not being defamatory towards the NHS; instead he was highlighting the importance of NHS Expo 2014 as he stated that the event had been focused on innovation in its ‘broadest’ sense as the health service looks for new ways of working to deliver a culture shift leading to “genuine and lasting” improvements for patients.

Feeling at home

Many of the more than 3,500 visitors attending the two-day show praised the organisers for designing it with a ‘working from the bottom up’ mentality – rather than top-down. This is what made the show a real success, they said.

There was also a feeling of integration within the conference centre, with technology innovators, carers, NHS organisations, scientific networks and others all being meshed together, creating a very mixed and diversified atmosphere. Even the seminar platforms – named Community and Living Room – were designed in a way to make everyone in attendance, be it an NHS manager, campaigner or technology guru, feel more relaxed and comfortable.

On stage

One of the most eagerly anticipated seminars was the discussion on care.data, the patient data sharing initiative that has been generating controversial headlines in the national press in recent weeks. Among the guests discussing NHS England’s approach, thrashing out the arguments on privacy, the benefits for medical researchers, and the communications challenge, was Tim Kelsey, national director for patients and information at NHS England. Our full coverage of that debate is on page 63.

Another interesting seminar, chaired by Sir Muir Gray, chair of the Health and Social Care Digital Service (HSCDS) Board at NHS England, focused on the development of patient-centred personalised care.

During the session, it was stated that the NHS will soon experience a ‘digital revolution’ future, with more and more people using social media, technology and knowledge to develop personalised care packages. More from this session on pages 42-44.

Telehealth was also thrown into the spotlight at NHS Expo 2014, as a panel of experts discussed its potential and asked the question – has it been too focused on technology? Beverley Bryant and Dr Martin McShane, NHS England’s director of strategic systems & technology and its domain director for improving the quality of life for people with long-term conditions respectively, were joined by Ian Dalton (president of BT Global Health) and Dr Richard Pope (clinical director at Dynamic Health Systems). The panel agreed unanimously that telehealth has been too focused on technology and more needs to be done to break down the barriers to its use, and to demonstrate the benefits.

Talking about the opportunities of telehealth, Dr McShane said putting people in control of their own care could be transformational.

Attendees at the exhibition also explored the challenges for healthcare in making increased use of digital channels to engage with patients.

Going digital

A panel session entitled ‘Is digital healthcare increasing or decreasing equality?’ brought together leading experts to discuss how the healthcare sector can turn things on their heads and deliver digital accessibility for all.

Dr Arvind Madan, a GP and the CEO of Hurley Group, presented his experiences of working with patients and making use of digital channels. He surmised that the use of digital technologies may increase inequality in the short term, but it will improve access for all in the medium to long term.

NHS Expo 2014 wasn’t just dedicated to seminars, as it featured a number of events and initiatives at several stands throughout the exhibition hall. For example, delegates were encouraged to add their own pledges as NHS Change Day was launched.

The attendees helped push the total number of pledges to improve care for people towards the target of 500,000, joining the thousands of staff, patients and supporters of the NHS who have already made pledges in what is the largest display of collective action in the history of the NHS.

This was the second year Change Day has been staged, and the number of pledges of action has outstripped the 189,000 made in 2013 by individuals, teams and whole organisations. Pledges can still be made until the end of March.

Compassion

Looking at compassion as a topic within the NHS, one discussion featured Jane Cummings, chief nursing officer at NHS England, and Dr Kate Granger, specialist registrar, cancer patient and the ‘hello my name is’ campaigner, who talked about the need – from a patient’s point of view – to have personalised and compassionate care. There was also the presentation of the first Kate Granger Compassionate Care Awards during the same session. (More on pages 42-44)

During the Expo, the list of the first 75 NHS trusts who will get a share of £30m from the Nursing Technology Fund was announced. This first round of investment from the £100m fund was announced by Beverley Bryant. And money from the fund, which opened for applications in December 2013, will be used by trusts to buy technologies such as digital pens, tablets and clinical software to support nurses and midwives to develop modern practices allowing them to do their jobs with greater ease, while offering improved patient care.

Changing mindsets

As well as looking at care, compassion and innovation, doctors and patients during NHS Expo 2014 called for fundamental changes in the way people think about mental health, and the way psychological issues are managed as part of the wider NHS.

In a session at the exhibition entitled ‘Is the term ‘mental  health’ doing more harm than good and what can we do about it?’, NHS England’s national clinical director for mental health, Dr Geraldine Strathdee, national clinical director for diabetes Prof Jonathan Valabhji, consultant liaison psychiatrist and Royal College of Psychologists spokesperson on suicide and self-harm Dr Alys Cole-King, and mental health campaigner Georgina Wakefield, called for an end to the stigma surrounding mental health, both inside the NHS and in the wider public.

All four agreed that current services and attitudes are resulting in fragmented services, a lack of understanding and a lack of support for clinical specialisation, leaving people at risk.

Dr Strathdee said: “We are at the same stage in terms of mental health as we were in medicine when I was a student. We used to talk about general medicine and general surgery but we never do that anymore. We have specialist diabetes, nephrology, urology – but we still have mental health as a single blob.

“We still have people who say mental health issues are just part of life, but I can show you the brain scans, the genetics and the viruses that impact on, and cause, mental health problems, influenced by people’s experiences, lives and relationships.”

On the cusp of change

Jeremy Hunt, the health secretary, closed the two-day event by saying “technology is bringing costs down and I believe we are on the cusp of one the biggest changes in the NHS’s history, especially in our lifetime”.

He concluded that technological innovations, so far, have “only scratched the surface” in helping create more tailored and personalised care across the NHS through the upcoming ‘data’ revolution.