Forget what the newspapers and media are saying about a dispute over working hours and patient safety. The NHS, like every other healthcare system in the world, is facing rising costs. In a government funded healthcare system revenues into the healthcare system are mostly fixed, and in the present age of austerity are unlikely to increase to keep pace with the rise in demand for healthcare. With no mechanism at present to increase revenues, the only other way to meet the challenge is to cut costs.
There are only two ways to cut costs:
1. Innovate to increase productivity – do more with the same resources.
2. Cut costs directly – lay off staff, close wards, rationalise healthcare.
For the last 5 years we have been told the NHS needs to make x billion pounds of savings in order to be sustainable. So what has the progress been to date on that ever-shifting target?
The new junior doctors contract is an exercise in management 101 – reduce the costs of labour by reducing pay. The overall effect of the contract is a reduction in pay. Junior doctors pay is being reduced in order to reduce NHS costs. If this is true, then it is also true that the NHS has failed to realise sufficient cost savings through the only other method of reducing costs – innovation. The pace of innovation is too slow to keep pace with rising costs. The NHS has failed to innovate fast enough to achieve sustainability. Therefore it has reverted to the easy option of reducing labour costs by reducing pay.
Innovation is not an easy process. Innovation is an unpredictable force driven by creativity and ingenuity. There are no quick fix solutions. The good news is that innovation is an unstoppable force in an age of exponential technological advancement. We are on the cusp of a revolution in the delivery of healthcare via the digital health revolution. All it needs is a helping hand to deliver the changes we need to make a better, faster, cheaper, safer healthcare system.
The NHS is an innovative organisation. The recent NHS Innovation Accelerator program is one such example. The UK has led the way in several initiatives. However, innovation tends to happen in pockets where local champions have pushed hard for change. What is needed is a more systemic approach to innovation at the organisational level. The Chief Executive of NHS England Simon Stevens has put innovation on the agenda in the five-year plan, but more needs to be done at every level. We need more experimentation, more pilots, and a greater contribution to the formation of ideas from frontline staff. Innovation is the responsibility of all healthcare staff at every level.
If we can accelerate the progress of innovation successfully in the NHS, we can ensure the system is sustainable. This in turn will ensure that our doctors and nurses get paid adequately for their hard work in providing world-class care for the British public.