Section 1: The challenge of service innovation
Let's innovate!
‘If we do what we’ve always done, we’ll get what we’ve always got.’
‘To focus relentlessly on improving the quality of care patients receive.’
‘To move away from cost containment and seek to harness innovation.’
(Lord Darzi, 2007)
What might be driving innovation and change in your clinical practice and the way services are delivered to patients?
This question is likely to trigger a wide range of thoughts, depending on where you work and what you have recently experienced. You may be thinking about, for example:
- the financial constraints linked to the current climate of public sector austerity
- an increasing focus on standardising aspects of ‘patient pathways’
- complex multiple long-term conditions and desires to bring care closer to home
- the impact of technology and the potential of telemedicine
- the changing nature of clinical roles and their redesign.
The context for innovation
Let’s take a more in-depth look at some of these drivers for innovation and change in healthcare, many of which apply globally.
 
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Activity
Read the report on Fixing Healthcare from the Economist Intelligence Unit. You may like to read the whole report. But if you have time constraints we suggest you concentrate on the Executive Summary, Chapter 3 and the Conclusion.
As you read, ask yourself how far some of the local drivers for innovation that you can identify for your own clinical service area are reflected nationally and even internationally. Perhaps reading about pressures on health systems internationally has triggered further thoughts about the nature of local pressures on your own service.
In particular we want you to think about the current and likely future impact of:
- demographic changes – in particular the ageing UK population
- patient expectations and behaviours
- medical research and development – new medical or surgical technologies, techniques and medicines
- new information and communication technologies, including the internet
- rising total costs in comparison to the financial resources available.
Make some notes on your reflections in your MyStuff learning journal. Summarise the pressures your service is currently under and how these pressures are likely to develop in the coming years.
- Which pressures do you consider will be most significant?
- How far do you also share the frustrations of clinicians in western economies, documented in the report, in terms of whether the health system you work under is able to respond in a positive way to the pressures it is facing?
Reveal discussion
Discussion
You have probably been able to identify how your service is affected by the broad themes underpinning the challenges facing healthcare systems around the world. Shifting demographics combined with rising expectations and the impact of lifestyle choices on long-term conditions are placing increasing pressure on health services at a time when financial resources are tightening. Your service may be one where there are definite new techniques or new drugs on the near horizon, which you are aware may have significant implications for the way your service is provided and what you can offer patients. Or you may have identified how access to web-based information for clinicians or for patients can make your service more effective.
Whilst your reading may have highlighted the opportunities to deliver improved quality whilst reducing costs, you may also have reflected on the importance of recognising the 'people' dimensions of the innovation and change required, in particular the concern of many clinicians to move to a more patient-centred form of care. This has been increasingly reflected in NHS policy, and has been further emphasised by the new coalition government's Secretary of State for Health. See this press release: 'Equity and excellence: liberating the NHS' (Department of Health, 2010a). |
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