Health and care systems facing increasing difficulties, reports PwC

CCIO, IT
Mike Fisher, CCIO and Consultant Cardiologist at the Royal Liverpool and Broadgreen University Hospitals NHS Trust, said: “If you actually want to make a difference to the health of the nation, you’re not going to do it in a hospital.”

PwC analysis puts emphasis on population health and prevention

[Liverpool, UK] A new report published by PwC emphasises the current state of health and care systems throughout the world cannot keep up with pressures posed by escalating demands, an ageing population and strained budgets.

At the beginning of April, BJ-HC went to visit Royal Liverpool and Broadgreen University Hospitals NHS Trust, one of NHS England’s 16 acute Global Digital Exemplars (GDEs), where Mike Fisher, CCIO and Consultant Cardiologist at the trust, explained: “If you actually want to make a difference to the health of the nation, you’re not going to do it in a hospital.”

Fisher went on to clarify that out of 100 people that have a heart attack, about 35-40 of them die before getting to the hospital, diminishing his chances of saving them as a interventionist cardiologist; out of the 65-60 that actually get to the hospital, only two or three might die in the next 30 days: “So you could actually prevent all the deaths that occur in hospital and you’d make almost no difference to the big picture and that’s the same with lots of conditions.”

However, the ‘willingness of the general public’ to take ownership of their health seems to be growing, facilitated by increased ‘ubiquity of the Internet of Things’.

Further analysis carried out by PwC shows funding is being invested into ‘facilities and equipment’ that cannot meet current demands. Fisher added that most of what clinicians ‘deal with these days’ are chronic conditions, with the NHS just ‘patching people up’ to get them out of the hospital, which in turn ‘increases their lifespan but not their wellness’.

“The NHS is not a health service, it’s a disease service and it always has been and maybe in 1945 that was appropriate. Certainly, when our current hospital model was designed, it was definitely appropriate. Today, it’s not. If we’re going to do something with that, we have to take the experience and expertise of secondary care into primary care and we need to focus more on prevention and population health, so we need to look beyond hospitals,” Fisher explained.

New innovation unit in Liverpool

That is one of the projects he is looking into through the establishment of a new innovation unit in Liverpool.

“We also have a stream which relates to sensor technology; so, for instance, we’re currently developing a novel patient tracking sensor which will allow us to build mathematical models of patient flow through the hospitals so that we can try and optimise those and spot in advance when it’s going wrong.

“We’re also interested in implantable or injectable monitoring systems, things that haven’t even been thought about before, really,” he added; the unit will also include an educational aspect, looking to build on the work that the NHS Digital Academy, expected to be launched later on this year, will carry out.

“So there’s a number of different strands to what we’re doing, but I think the message I want to give is that it’s not just about the trust,” Fisher concluded.

PwC also emphasises healthcare professionals have to understand how to use AI and robotics in a transparent and secure manner, not only in the ‘medical setting’, but ‘throughout the healthcare eco-system’, along with encouraging them to become ‘open to change’: “If clinicians will not be as good at monitoring, diagnosis, decision making or surgery, then what is the unique role for the human, and how can they prepare for it?”