Can We Heal an Ailing Healthcare System?
Part 1: Renaissance of the NHS as a Social Movement
By Minesh Khashu and Jeremy Scrivens
Do we have the best healthcare system in the world?
Time and again we hear that we do but to many of us in the U.K. it does not feel like it is. In relative terms, considering the resources spent on healthcare, we perhaps have the best healthcare system in the world. However, in terms of outcomes and quality of care, there is still a lot that can and should be improved.
The Mid-Staffs disaster is still very fresh in our memory. There is still significant avoidable harm in the NHS, with about 500 patients daily experiencing some form of adverse incident. While there are pockets of excellent practice, there are many untoward events happening daily and the experience of many a patient, their carer and their family is still quite unsatisfactory.
The main issues that cause significant difficulties for the NHS today are:
- Supply and demand imbalance e.g. the long waits in emergency departments,
- Fragmentation and poor coordination among different parts of the system, for example, between health and social care, between primary and secondary care,
- Very little focus on prevention,
- Inadequate learning from mistakes as well as good practice and poor dissemination of learning and good practice,
- Out of date, top down, management styles fuelling disengagement amongst staff at a time when the new social and digital technologies allow for a never possible previously level of engagement from staff by way of collaboration, innovation and social good at scale The ‘Five Year Forward View’ by Simon Stevens, Chief Executive of the NHS, provides a strategy and plan of action going forward. It highlights the financial gap going forward, the need to focus on demand, improve efficiency and most importantly shift the system to a person centred care and prevention paradigm. It, for the first time, talks about making the NHS a social movement. This, to us, is the most important legacy of this document. The so called new models of care need to be bold enough, visionary enough.
- NHS as a social movement is the start of a Renaissance for the NHS.The ‘social movementfrom the whole, not, as we see now, a series of hierarchical, siloed institutions stifling innovation, risk taking and avoiding why?
However, the ‘Five Year Forward View’ does not elaborate about how to make the NHS a social movement and that is why we are writing this open manifesto to the public of the United Kingdom who care passionately about the future of the NHS.
We propose to positively disrupt the NHS to move in the direction of a social movement beyond the boundaries of our fragmented current system. We see a significant positive impact on decreasing long-term demand, improving efficiency, bridging financial gaps and engaging the untapped potential of our staff to work in a culture of open collaboration and innovation.
We propose the development of a health and social care service akin to youth military service in some countries. But this will be a social movement which engages our millennial or GenG workforce to become members of a living NHS ecosystem where every member can contribute their strengths not only to the what and how of healthcare but to the why from the experience of wholeness at scale.
The development of this health and social care service will be a single intervention that can help overcome all the significant difficulties alluded to above.
- Increase provision of health and social care but without significantly increasing the cost,
- Provide the ‘glue’, the connectivity to improve coordination within the health and the social care system,
- Engage the youth of today, tomorrow’s Britain, to contribute the best of their strengths. This is about releasing their intrinsic needs, shaped by today’s open platform social and digital technologies, for Authenticity, Collaboration, Wholeness, Abundance and Connected together, these young kids are wired to contribute to health promotion and disease prevention at scale,
- Release untapped resources, assets, ideas, time and money previously locked in the cracks between the parts of the hierarchy and the so out of date ME job descriptions, rather than the future of work in the NHS as ‘WE’ Collaborative Charters,
- Restore ownership of the priorities, resources and decisions back to a self- regulating living community, not a third party compliance driven and separated hierarchies.
It is in our stewardship, our gift and our time to make it happen!
The earlier models of national youth service (still practised in some countries) were compliance driven; they were mandatory. Today, most of our workforce live in compliance based work cultures. No, it does not need to be mandatory, it has to be about engaging contribution, which is about voluntary choice, about being drawn to something, rather than being driven. Britain, has shown, time and again through its contribution to voluntary and charitable work globally that this is not an impossible ask of British youth.
It is about taking the time to engage people intrinsically from the heart, to contribute the best of the individual connecting with others to bring more strengths together to reshape renaissance of the NHS system as a living community or ecosystem. What’s better, a mandatory system which sees an extra million pair of hands or a voluntary system which engages 250,000 with their hands, their minds and their hearts?
This is not just about increasing capacity/capability in the system. The bigger and more important goal is to engage the younger generation to be more involved in health and social care, understand life style choices better, contribute to health promotion and disease prevention and as a nation take charge of our future health i.e. making it a social movement.
We can achieve a better balance in supply/demand of health and social care with little extra cost. We will significantly expand the voluntary sector, shift the focus of the future generation into a health promotion/prevention paradigm and increase the interest of the future generation in science and health work streams (we have been historically short staffed in these areas of work).
Above all, we will generate a social responsibility vehicle. We will give a young generation, wired for sharing, collaboration and innovation, an opportunity to learn compassion and life skills for their own health and those of others. We will see a restored and extended life-work ecosystem operating out of wholeness, not separation. We can and should save millions by dismantling our costly system of third party compliance, moving to a self-regulating living ecosystem.
See Part Two: Renaissance of the NHS as the Elevation of the Positive Core at Scale