Cross Talk on Lord Darzi’s interest in innovation
Mike Cross reflects on Lord Darzi’s interim report on the NHS, which calls for a new emphasis on innovation. This, he argues, should be a great opportunity for the NHS IT community to prove their worth and drive change.
So, if the headlines are to be believed, we're a nation of obese, trans-fat-riddled, drunkards. As usual, the boring statistics tell a different story.
Here's one fact: in 1998, a woman's life expectancy at birth was 79.8 years. Today, as long as she doesn't die from infections acquired during treatment for injuries sustained in falling through a pub floor, it's 81.2 years. The relentless upward trend suggests that in combination with other factors, the NHS is doing something right.
The fact above comes from the interim review of the NHS published this month by Lord Darzi (Professor Ara Darzi). It's an unusually good read. While the professor’s tone is upbeat - he is now a health minister, after all - he pulls few punches in pointing out room for improvement. "The real change needs to be in mindset - away from a culture of containing costs and towards one of harnessing innovation."
For details, we'll have to await his final report. But in the meantime one message shines through the various political inflections: we need to stop treating innovation as a dirty word.
Innovation stalling
As a practising surgeon, Lord Darzi says that he has seen new technology transform his working life. "The operations we carried out used to be highly invasive – most of what we do now is keyhole surgery, developed with the help of NHS investment in technology and training," he reminds us.
Across the NHS, innovations in pharmaceuticals, medical devices and clinical care have improved the quality of patients’ lives vastly since 1948. Today, however, Lord Darzi detects a worrying change in the climate, observing an NHS that "does not always make best use of innovation.”
There have been increases in funding for R&D, including a recent commitment to invest £15 billion over the next decade in medical research. Good progress has also been made in the uptake of innovative, cost-effective technologies appraised by the National Institute for Health and Clinical Excellence. But "more needs to be done.”
Institutions matter
One way forward is through institutions such as the new National Technology Adoption Hub for healthcare, which is promoting innovations in areas such as telemedicine. But the real change needs to be in mindset - away from a culture of containing costs and towards one of harnessing innovation.
"To encourage this change in culture”, says Lord Darzi, “there needs to be better demonstration of the benefits of innovation in terms of improved safety, effectiveness, personalisation, fairness and value." "This means the NHS has to stop treating IT as an embarrassing overhead, and to start treating it as an exciting enabler."
People matter more
For the NHS IT community, this is great news. We need to get involved at all levels. Most obviously, healthcare informatics can provide the means of evaluating new technologies.
Lord Darzi observes that, for all the information available on the NHS, data on outcomes is not benchmarked in a systematic way and "this is a significant hindrance to progress."
"The NHS has a great deal of data, but a paucity of information,” he adds. “Much of the information we do have is available to limited numbers of people, is often inconsistent with that held elsewhere, and is frequently not available at the point of need."
IT also provides the essential glue for holding together many innovations in areas Lord Darzi sees as priorities; the long-term care of people with diabetes, for example. Here, electronic records are fundamental to patient-empowerment and joined-up multidisciplinary care.
A great opportunity
But there's another, more important, role for the NHS IT community. If the NHS is to change its attitude to innovation, then we need to be at the heart of that change. This means the NHS has to stop treating IT as an embarrassing overhead, and to start treating it as an exciting enabler.
This, in turn, means allowing innovators to experiment with IT, to take risks, to celebrate successes and disseminate them - and to admit failures, too.
Doing all that would require a certain political nerve, given the bad press that government IT projects attract (sometimes deservedly – not always productively). We shall see.
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About the author: Michael Cross is a freelance journalist specialising in healthcare informatics and e-government. He is a member of the British Computer Society.