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Rethinking NHS services - and driving cost savings

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Can standards in NHS care realistically be improved while cutting out system costs?

This dual aspiration, the heart of the NHS’ modernisation plan, was never more apparent than when NHS chief executive Simon Stevens called for £8 billion in funding in 2015/16 to kick start the service’s ambitious five-year Forward View reform plan, at the same time as looking to save money on a previously unseen scale.

Whilst Stevens’ request was met with some added cash for front line services in the last Spending Review, no-one is fooling themselves for a moment about the scale of the task facing the NHS.

True, the health service must find ways to manage demand for care from an ageing population with more complex needs, but it must also use information to make smarter care interventions, and most ambitious of all, achieve a quantum leap in its ability to co-operate with its partners in the NHS, local government, and charities to de-duplicate effort and wrap care increasingly around the patient.

Redcentric has taken a closer look in recent months at how these daunting aims might be delivered.

We were struck how key elements – better harnessing of data, smarter resource sharing and pragmatic technology investments – are already present in important care and efficiency improvements being made by different types of NHS primary and secondary care bodies.

This sort of careful change won’t always meet the deadline of a reformist Government but it does show the quiet improvement of care services – what the Kings Fund has called the aggregation of marginal gains  ̶  are being achieved in tandem with system economies.

In a clear case of how information sharing can change service delivery, doctors, consultants and nurses at a large hospital trust now get instant access, wherever they are across the trust’s 22 different sites, to the patient data and images they need, following a phased systems upgrade. Clinicians are better managing patient rounds and dispensing medication with information delivered to the ward or individual device – and all done more cost-effectively.

Better sharing of resources ‘across boundaries’ in the future will come from planned NHS-and-partner collaboration but this could equally be achieved by say, a cool-headed rethink of a trust or CCG’s computing networks.  In an unusual example, a social enterprise delivering out-of-hours primary care, increasingly constrained by its host CCG’s ICT, outsourced its infrastructure.  Yes, it has resilient N3 connectivity, but now it also has predictable computing capacity that can be rapidly scaled up and down in response to peak demand: in this case, imaging or record applications being accessed by clinicians (and better supported by technicians) during night-time hours.

No headlines are being made, but we are seeing a steady but striking renewal of trusts’ and partners’ ICT. And while sceptics will shake their heads at, as they see it, hard-pressed NHS organisation being encouraged to run before they can truly walk, we are witnessing a quiet determination by NHS clinicians, nursing staff and technology teams alike at the local level to achieve that elusive outcome of better care improvement and lower costs.

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