KayHill have been fascinated by the issues that trend on social media and have often paused to think why that might be. Around the winter period, amongst the more predictable themes such as who was cool in 2016 was #NHScrisis, discussing the rising demand for A&E services and the consequences of this. Healthcare organisations attempted to use social media as a means of communicating to the public about utilising their NHS services more effectively. Messages included choose well campaigns to infographics demonstrating use of A&E and what service they could have accessed as an alternative.
These seem to have had at best, a mixed effect. It made us think how well the NHS get these important messages across. For the public who need access to healthcare, A&E is easily the most signposted and recognisable healthcare resource in what is a very complex system to navigate. The key is striking a balance to ensure those who need urgent care can access it easily but also preventing unnecessary attendance for things that are neither an emergency nor an accident. Why is it that the public don’t use healthcare responsibly? Could the NHS messaging, signposting and advice be confusing?
Kayhill have supported NHS systems in redesigning their urgent care systems and we understand the complexity of why demand is increasing in A&E. People are living longer with more complex and chronic conditions that consume 70% of healthcare resource. 8 out of 10 contacts with the NHS take place in general practice but it isn’t coping. The current model of healthcare (and indeed social care) delivery is unsustainable, and the NHS need to reconfigure services. The Catch-22 is that the NHS has a shortage of doctors and nurses in primary and community services to achieve the shift in models that are required and there is a shortage of doctors in A&E with the skills to manage people with chronic and complex long term conditions.
The Five Year Forward View emphasises the need for new models of care. The FYFV stresses there isn’t a one size fits all option, nor a “thousand flowers bloom option” but that there are a number of new care models that can be deployed in different combinations locally across England. However, it is possible to transform urgent care systems. We know because KayHill has supported a number of healthcare organisations to transform their urgent care systems. The key ingredients to the changes that took place were:
- Understanding the system and its issues- not just using reliable information but from the users perspective.
- The creation of & buy in of a whole system vision of what would be different
- Clinical leadership- developing new models of care bottom up and clinically led
- Strong patient engagement in design and execution of the strategy
- Strong collective leadership
“Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.”- Atul Gawande