Politician Aneurin Bevan, the founder of the National Health Service (NHS) in the UK, famously asserted at the service’s birth in 1948, “If a hospital bedpan is dropped in a hospital corridor in Tredegar, the reverberations should echo around Whitehall.” Southeast Wales is less than 260 miles from London; it would have to be one very noisy reverberation or a very heavy bedpan to be heard that distance away!
As the NHS reaches a milestone birthday it is quite rightly a time to celebrate all that is good about one of the few global services that continues to deliver on its original promise, “Meet the needs of everyone, free at the point of care and based on clinical need not the ability to pay.” The NHS is a survivor; political upheaval, boom times and bust times, the speed of innovation and a mixed investment cycle have not stopped the NHS delivering the best healthcare it can; pound for pound, day after day.
For the NHS to be here delivering on its promise in 2088, it has to take the reverberating bedpan comment and use it, not so that Whitehall knows but so the whole system can benefit from the lesson learnt. The healthcare system we have today is a series of islands, archipelagos of excellence, and yet the system is a national solution to a series of moving problems. We need to be better at sharing, we need to remove the last remaining fiefdom attitudes that exist and stop the ‘not invented here’ attitude from prevailing. Circumstances have forced and enabled this to happen in the last three years more than ever before.
Take the application by NHS Improvement of the Virginia Mason principles to five trusts across the NHS, a successful initiative with longevity. The reason this has been so successful in all five trusts is they have been enabled to share, to learn from each other and to have a unified and yet locally configured goal. The implementation of an improvement method that delivers in a locally defined culture has seen huge success for each of the trusts involved and now these trusts are asked to share across the NHS.
If I look at my own area, digital, and I look at my own geography, West Yorkshire and the city of Leeds, our key success that makes a difference to patient care is the delivery of a shared record across the city. We have taken down the care setting walls throughout Leeds and created a platform where information about the patient is carefully shared for us to ensure we support the patient through their healthcare journey and not the restrictive organisational boundaries and funding principles of the system. Now with the advent of Local Health and Care Record Exemplars we have the opportunity to share this more widely.
The NHS will adopt digital solutions to facilitate sharing, new funding will allow us to do that and new attitudes that have been created more recently with successes like the NHS Digital Academy and the networks of CIOs and CCIOs enable us as digital leaders to make the delivery of digital to the NHS system successful.
In 2088 the key principles though will have to be to share and to learn. The catalyst that enables that is the adoption of digital as the fourth utility of healthcare. In 2088 Bevan’s original principles will still be here but with a digital fabric rather than bricks and mortar ensuring that at its 140th birthday the NHS will still be a national
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