Lord Darzi's Assessment of the NHS

Independent Investigation of the National Health Service in England

This is a sobering, but honest assessment of the current state of the NHS by Lord Darzi. People will debate what exactly led us to this point, but we must put political finger pointing aside and come to terms that the conclusions in this report are accurate, and the time now is to find solutions.

A few thoughts from my perspective:

“…the NHS is in the foothills of digital transformation”, I thought was an interesting analogy. The report speaks to the opportunity for digitising parts of the health system to empower patients and make the delivery of care more efficient. The NHS has recently made some large investments in digital health, but a key challenge that we see is that the NHS will provide central funding for a limited period of time, and Trusts are often reluctant to take on the cost beyond the period of funding. This doesn’t bode well for long term sustainability and integration of digital solutions. The report also points out that sometimes digital tools can add more burden on front line workers. This is often because systems and tools are not integrated or interoperable which requires duplication of work. This is a solvable problem.

In commenting on major themes for the upcoming 10-year health plan, Lord Darzi stated: The best change empowers patients to take as much control of their care as possible. I couldn’t agree more. However, I’ve also observed that system leaders, operating managers and clinicians are sometimes reluctant to give patients too much control because it can cause operational challenges. In my view, there are cases where giving patients more control can actually reduce operational burdens (e.g.: let them book their own appointments within a defined set of parameters)! As an industry we must come up with solutions that helps find the right balance between patient empowerment and retaining operational control.

I was THRILLED that Lord Darzi commented: While a top-down reorganisation of NHS England and Integrated Care Boards is neither necessary nor desirable, there is more work to be done to clarify roles and accountabilities, ensure the right balance of management resources in different parts of the structure…” I’ve been in health care for about 20 years, and I’ve seen too often a new government come in and think restructuring the health system is the answer, to only find leaders distracted for 2 years sorting out new jobs rather than focusing on making front line care better. Let’s work with the structure we have and focus our energy on making it better for the benefit of patient care.

Finally, the report highlights that only 65.8% of cancer patients are receiving treatment within 62 days of referral (the NHS’s target). There are a multitude of factors that contribute to this, one of which is the manual nature of getting these patients through from referral to treatment. Right now, a lot of the steps in processing the referral, getting appointments booked, getting diagnostic tests booked, getting the results back, and then getting patients into treatment, are quite manual. Patients get missed. We can digitise this through the NHS App and make it more efficient for patients to get through the system, which also has the benefit of empowering them to take more control over their care!

I agree with the conclusion that while the NHS is broken, the fundamental building blocks are there to make it better. With renewed energy, as an industry, we can solve these big problems!