The NHS Crisis: Transform or Die

2022 ended terribly for me. But I’ve decided to write about this because I see parallels between my experience and that facing our industry.

On the 30th of December, I had to rush my dad to the hospital.

My nerves were shot. He was diagnosed with throat cancer at the end of November. He’s doing okay considering the circumstances. It’s been a tough time for us all, as perhaps some of you might be able to relate. But this particular hospital trip turned into an exceptionally strenuous one.?

I sat in A&E for 12 gruelling hours before my 87-year-old dad was seen.?

I looked around at the handful of staff struggling to keep together a broken system as best they could.

I could see nurses filling out paper admission forms and then moving on to other documents as they moved patients slowly along the process while hundreds of people anxiously waited for their turn, each in a different state of agony, pain and illness.

My dad eventually received help. But it didn’t get him a bed in a hospital ward.

Instead, he slept on a bed in the corridor for 4 days.

Exit that ordeal and I got struck down with a particularly nasty strain of COVID-19. I picked it up whilst waiting in the emergency room for my dad to be seen. Ours is just one of the many stories illustrating mounting frustration against the UK’s National Health Service.

This is just another example of an institution that requires transformation.

In fact, that’s not strong enough. Let me rephrase.?

The NHS’s entire existence DEPENDS on it!

NHS: Britain’s Crisis Hotspot

Issues with the NHS existed before Brexit, before Covid-19 and before supply chain crises shook the world. They have simply been left to develop unchecked. But now, those issues are getting fatal.

Bleak warnings from the Royal College of Emergency Medicine report that 500 avoidable deaths could be our reality each week with continued delays in emergency care. I don’t think that’s been fully registered.

What’s more worrying is that nobody seems to have answers. There isn’t an actionable and effective plan in place. The issue isn’t being resolved. It’s getting worse and multidimensional factors are compounding dangerously to bring the NHS into the historic decline we see today.?

Here are just a few of them.

Chronic Understaffing

There has been a near decade-long mismatch between supply and demand.?

Currently, in the NHS there are 133,446 vacancies. That’s the extent of the labour crisis, which amounts to a whopping 9.7% of the entire NHS workforce . Nurses - the backbone of healthcare - account for 47,496 vacancies alone. I have flashbacks of sitting in an emergency ward where it felt like the patients outnumbered staff 20:1. I wish that was an exaggeration. But it’s not.

The problems seem to stem from a diverse cocktail of factors:

• Higher absenteeism and burnout reports
• Poor retention and high staff turnover rates
• Labour strikes over salaries, care and workloads
• Healthcare professionals leaving the industry
• Staff opting to work in the private healthcare sector?
• Negative public image around the treatment of staff
• Relative pay erosion as the cost of living increases
• Excessive working hours and limited remuneration
• Poor investment in training infrastructure & facilities

Outdated Technology

Now this one really gets on my nerves.

80% of NHS trusts are considered digitally immature on account of dated technology and insufficient IT provisions. Staff - limited as they are in number - are stuck in tedious loops of completing long, inefficient and clunky admin tasks such as paperwork, data input and filing. Time is being stripped from customer care due to repeated failure to invest in upgrading outdated software.

Inefficiencies aside, the lack of a cohesive, digital structure seriously undermines cross-functional collaboration, meaning patient records are harder to track, parts of the system are duplicated or laced with errors and sharing data between practices and facilities is immensely time-consuming.

A digital-forward NHS would drive a better service for patients, reduce waiting times and enable more timely treatment. It would also improve the employee experience by minimising time spent chasing referrals, scheduling appointments, managing patients and recording data.

(Excruciatingly) Long Waiting Lists

It’s been a barrier to entry even before the pandemic.

But after a 12-hour wait in A&E, I’d say the barrier has become insurmountable. There isn’t sufficient capacity to house the demand for emergency short-term care, let alone sustained hospital treatment. With jammed waiting rooms, month-long waits for GP appointments and an admission process that doesn’t guarantee incoming patients a bed, the NHS really is stuck in a place of crisis.

The graphs below show the severity of the decline. My experience sadly isn’t an exception.

Transforming the NHS

I’ve worked in the supply chain and logistics industry for over 20 years. I know that our response to emergencies can prevent significant economic, social, and even political upheaval.

The NHS is holding on for dear life. If we’re not already in it, another national health crisis looms. This time not due to a killer virus. Instead, it’s down to a failure of senior management, leadership and governmental bodies to build a resilient, digital-driven and well-funded healthcare system.

The problems I see in the NHS are the same ones facing the supply chain industry.

• Addressing the talent gap
• The need for digital transformation
• Deprogramming from old models
• Cross-functional collaboration
• Stakeholder accountability

I remember holding my father’s hand while waiting for the next nurse to run by. Counting the long intervals between the moments when skeleton staff actually showed up, showing clear signs of fatigue and burnout. I can’t imagine that scene incentivising the role to new talent. God forbid!

It begs for a solid revamp. One that properly trains and compensates staff for work instead of taxing their pockets and their well-being. After hours, I finally filled out an admission form only to notice the stack on the reception desk that hadn’t been touched since we dropped in. Another symbol of a hopelessly antiquated paper model of working that mounts even more pressure on staff.

The system stands to benefit from the most minor upgrades. Centralised platforms, digital recording of data (instead of clipboards and pens) and more funding that tackles real on-the-ground problems that healthcare professionals face day-to-day. It could literally save lives.

I recall looking around the emergency room at people whose faces mirrored my own emotions… an entire community failed by a chain of operations that seems stuck in the stone ages.

I was frustrated. I still am. Frustrated that promises have been made time and time again to change an old and unsustainable model with no actions and results to show for it.?

The lack of transformation in the NHS could cripple it.

Human complacency is about to cause the biggest healthcare emergency the UK has seen.

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