The vision thing: at Microsoft’s annual NHS summit

NHS South Central has emphasised prevention and the need to make patients “partners” in their care. Chris Evennett, its deputy chief executive and director of strategy and reform, will be talking about its vision at Microsoft’s annual NHS summit.

He introduces his theme and how information, IT and leadership will be key to delivering the SHA’s ambitions, to Lyn Whitfield.

NHS South Central is the strategic health authority that stretches from Milton Keynes to the Isle of Wight. Within this area – “four times the size of Luxembourg,” according to its website - more than 20 NHS organisations spend £5 billion delivering care to 4 million people, while employing 88,000 staff.

The SHA has ambitions for these services. In Towards a Healthier Future, the “vision” document it published as part of the Next Stage Review of the NHS, it says it wants them to deliver a “high standard of personalised care”, in “safe and clean” settings using “appropriately skilled” clinicians – with minimal waits.

Yet it is also looking beyond them. In Towards a Healthier Future, the SHA also emphasises the need to prevent ill health in the first place by evaluating health risks and making sure that health and social care appointments are used as “an opportunity for prevention as well as treatment.”

And it emphases the need to make people “partners” in their own health and care so that patients and those with long-term conditions “take responsibility for their own health and treatment” with “guidance and help” from professionals.  

Chris Evennett, the SHA’s deputy chief executive and director of strategy and reform, sees this as key to improving satisfaction with the NHS. “I want to focus in particular on choice and patients as partners in their own care, because I think the experience of using health and social care can be a problem,” he says. “The experience is often not very good. It is often not very personal.”

Communication

Technology, he adds, has an important role to play in this. “One of our challenges is to improve communication between services and the people who work in them,” he says. “Our systems are often so complex that communicating about what is happening and where people have got to is difficult – but we need to do it so that clinicians know care is being linked up and patients feel empowered.

Now, if the challenge is to bring information together, then one way to address that challenge is IT. If you buy something from a big store online, the first thing it will do is send you an email to say what you can expect to happen next – with a number on it so you can track where your purchase is. You do not get that with healthcare. We have been very slow off the mark when it comes to using IT to deliver a good experience.”

The SHA is at the very early stages of talking about how it might use technology in this way. But Mr Evennett says some of its primary care trusts are already very interested in using tele-care services to help people remain in their own homes and modern voice and text to mobile services to deliver alerts and health information.

"We are just writing our strategy,” he says. “But I do not think this will be done by top-down initiative. That may be the right thing to do if something is shown to work. But otherwise it might be better to pump-prime the market and let people innovate from the bottom-up.”

He is also willing to see the private sector help with this innovation. “It is interesting how many companies are getting into health because they recognise synergies with their own businesses,” he points out, noting that this applies to Microsoft itself.

Personalisation

The final report of the Next Stage Review, High Quality Care for All, emphasised the need for the NHS to deliver a more “personalised” service to its users. However, it was hardly the first policy document to do so.

The report, written by health minister Lord Darzi of Denham, went further than earlier documents by calling for “choice” to be extended from acute to primary and long-term care, and for patient views to be used to drive quality. But the idea that the health service needs to adjust to patients used to being treated as consumers in other areas of their lives has been around for at least a decade.

Mr Evennett argues that at least two things need to change to make personalisation a reality. On the one hand, he says, the NHS and social services need to try and see what they are doing from a user’s perspective.

“We tend to categorise services by what they provide rather than what people need,” he says. “We talk about physiotherapy, while patients might want pain relief, for which physiotherapy is an option.”

Again, he argues that technology has a role to play: this time by allowing the NHS to get much more information about its users and their preferences. “Supermarkets, with their loyalty cards, have collected a lot of information about people and their purchasing habits and made it useful,” he says.

“We need to try to get to that level, because, at the moment, we have population level information, but not that kind of personal information.”

The other key to change, he says, is leadership; people within the NHS need to stop “looking up” for help from the Department of Health and to start “looking out” at what they can do. “In the NHS, we have 60 years of history and culture to turn around,” he admits. “But everybody can help to make this happen if they want to.”