In order to optimise efficiency gains, it is vital firstly to understand what needs to be made more efficient, secondly to decide where resources should be deployed to realise the greatest gains and thirdly to confirm (or otherwise) the delivery of those gains. Key to this is the new “gold”, data, and, more importantly, its assessment and interrogation.
Not just in the NHS, but across all businesses, measurement is key and the more “real-time”, the better. It allows management to better understand and actively optimise operations, generating gains and enhancing value. Importantly, measuring and recording the right metrics also means that an owner can evidence trends and data within the business to support the strong valuations so helpful when looking for investment or a buyer.
Data is a commodity that is ubiquitous and relatively easy to accumulate. The important trick in terms of generating real value is identifying the problem you are trying to solve and then ensuring you collect the right data to allow it to be addressed. In the NHS, with multiple systems recording, collating and processing data, data uniformity and inter-operability are key if efforts are to be focused in the right areas, even at a fairly local or regional level.
Consideration of efficiency has risen in profile off the back of Covid, as necessitated changes in remote working drove higher take up and adoption of new technology and an associated improvement in willingness to consider new methods.
Clearly Polestar could write a very long blog on the opportunities in the NHS and the link with measurement. However a couple of specific examples perhaps give an idea of, not only where focus could be improved within the NHS, but also how measurement metrics can be used in different ways from different sources within a more general business context.
Firstly let’s look at using data for long term change. It is well recognised that lifestyle is a strong contributory factor in general health. Insurance companies routinely use such data to price insurance policies for risk – an active individual with good levels of fitness is less likely to suffer a heart attack than somebody smoking 20 cigarettes a day. Equally, data shows us that early identification of problems generally result in better outcomes at lower cost.
As a result, remote healthcare services and efforts to move to a more cost effective, proactive rather than reactive, health regime are both high on the agenda of various cross party committees.
We would all like progress to be quicker. However, the reality is that this is a long term project, where improvements will build over time. Much like an investment in a new property or new machinery for a smaller business, it should therefore be considered independently of (though in tandem with) the undoubted improvements that can be considered on a day to day basis.
Since accumulated health problems will continue to rely on reactive healthcare, probably for decades, financing such change does need to be seen as an incremental investment in future-proofing the NHS, rather than a measure to restrict short term budget pressure.
However, though long term, it does need monitored. Approved expenditure can be reallocated and, though funding from the public purse is sometimes treated as though it is nobody’s problem, it is of course everybody’s. Cost implications will filter through as new methods are sought, trialled and either rejected or rolled out more widely. Not letting costs overrun is not typically a strength in large organisations, especially in the public sector and better accountability is required in this respect (of which no doubt more will come in the Incentivisation article).
Secondly, like all businesses, the NHS needs to put its best foot forward. It is inconceivable that there is not strong expertise in different areas across an NHS staff of 1.3 million. Unfortunately the risk in any large organisation is that data and expertise become siloed. Where regional teams have had success in the North-west may not be understood or have a sufficiently strong advocate in the South-east. Since human nature is to try and minimise negative publicity, this disconnect is likely to be even more substantial where errors have been made, hence the opportunity to make gains from the learnings and avoid similar mistakes elsewhere is lost.
Consistency across the NHS across the full remit of treatment, efficient buying, education etc is lacking and where comparisons are drawn, too often they are based on inconsistent data – even fields that are supposed to be measuring the same thing are not, in reality being calculated the same way. Innovation of course comes into play and we will look at a few initiatives in the separate blog on Innovation.
Three takeaways for business from measurement: