Reimagining the NHS: A Collaborative Journey

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Published in September 2024, Lord Darzi’s report on the state of the National Health Service (NHS) in England gives a sobering account of the challenges facing the healthcare system. Increasing costs combined with rising demand for care set against an ageing infrastructure, present entirely new challenges for the NHS.

Dr Mark Davies and David Bibbs offer diagnosis and their optimistic prognosis.

However, while the report emphasises that the NHS is in a critical condition, recovery is within reach. The prime minister has pledged “the biggest reimagining of our NHS since its birth,” and digital capabilities will surely play a crucial role. In this blog post, we explore some of the key opportunities to create a fit, future-ready healthcare system.

Tackling post-pandemic disruption

The COVID-19 pandemic severely disrupted routine care, leading the NHS in England to delay or cancel many thousands of scheduled procedures, causing massive backlogs in elective care and storing up demand that is only just beginning to flow through the system.

Coping with this exceptional increase will depend heavily on the ability of the health service to improve productivity. Some of the most significant solutions will come from outside the healthcare sector, where innovation and experimentation thrive without impacting outcomes. For example, the newest thinking includes generative AI and robotic process automation (RPA), machine learning (ML), deep analytics, and design thinking.

The promise is that many of the ideas and technologies will be able to release staff from repetitive tasks and enable them to focus on their clinical specialties, helping to reduce waiting times and cut the backlog. This is about giving time back to staff so that they can focus on care.

Embracing ‘design thinking’

‘Design thinking’ is intended to focus attention on the desired end-state by understanding a process from the user’s point of view, and can bring an entirely fresh perspective to what can be seen as intractable problems.

For example, recent collaborations between IBM and University Hospitals Coventry and Warwickshire NHS Trust highlighted the value of applying a design thinking approach to healthcare.

In one study, analysis revealed that more than 30% of calls to the Trust’s contact centre were from patients asking about referrals. Tempting as it would be to build an automated answering service, the team reviewed the reasons why the calls were occuring and instead redesigned the patient’s journey through hospital processes to provide referral information proactively. As a result, call volumes declined dramatically, cutting the Trust’s costs and improving the patient experience.

In a further engagement, the team reviewed the challenges reducing out-patient no-shows, which despite reminders from the Trust, remained stubbornly high. After reviewing the patient journey, IBM suggested a simple change: provide an earlier opportunity for patients to reschedule appointments that they could not attend. This modification not only reduced the no-show numbers – patients were more likely to attend their re-booked date – but also the Trust was able to re-allocate timeslots to an additional 700 patients every week.

Improving experiences for all

Another area of Lord Darzi’s report comments that many NHS staff feel disempowered  and disengaged, leading to high levels of sickness absence and a reduced discretionary effort. At the same time, the report highlights significant issues with patient communication and responsiveness.

HR professionals in the commercial sector have long known that removing friction from administrative employment-related processes can help to deliver a significantly improved workplace experience. For example, by making the basics easy – managing shifts, taking holidays, applying for new roles, payroll checks – staff, teams, and managers have more time to consider professional development, invest in training, and encourage career development.

Similarly, in the retail industry, it is well-known that customers like to be in control of their destiny, using self-service mobile and web apps that show detailed order status and delivery progress. The same strategies can be offered to patients, providing highly personalised care with an emphasis on prevention and self-service.

For example, Diabetes UK’s Year of Care (YoC) programme found that most patients with diabetes in England prefer to use the NHS mobile app to monitor and manage their condition, spending an average of only four hours of contact time with a healthcare professional each year. Increasing the uptake of digital enablement will be vitally important to empower more people to play a positive role in their own health and wellbeing, whilst simultaneously reducing the NHS workload.

Realising the vision of integrated care

While Lord Darzi’s research provides examples of integrated, community-led care, the analysis also shows that even as the NHS has talked publicly about integration, patients have become less satisfied with how their care is organised.

Ensuring a joined-up approach that links the NHS with non-statutory and social care will be essential to future healthcare provision, which will invetivably entail data sharing across multiple services.

Moving to a neighbourhood integrated care system that encompasses the NHS, social services, hospices, community organisations and more will depend on strategic thinking about who owns patient data, how it is curated and protected, personal rights, and more. Designing unified services will lead to re-designs of the underlying systems, and again the commercial and industrial sectors have a great deal of experience to offer to help drive the digital transformation. Looking further ahead, integration will create significant opportunities to go further and make that data available for new types of analysis. The IBM Quantum System One installed at Cleveland Clinic provides just a hint of the breakthroughs that could come.

Taking the next step

Lord Darzi has given us a clear prescription for reimagining the health system, and IBM is ready to help. The IBM ecosystem of consulting, technology and industry partners brings best-in-class solutions to tackle and resolve the toughest challenges.

Click here to learn more about IBM’s offerings in the Healthcare industry.

About the authors

Dr Mark Davies MBChB, BSc, FRCGP, FRCP, is the Chief Health Officer at IBM UK. With 25 years’ experience as a clinician in the NHS, Mark’s interest in the power of health technology and system design to deliver better health outcomes has led to work in many leadership roles in the UK and internationally, across government and industry.

David Bibbs is Managing Director, Technology – UK Healthcare at IBM UK. David brings proven leadership experience in healthcare technology solutions. For almost 25 years, David has orchestrated strategic digital transformations to bolster the NHS during critical times, including the COVID-19 pandemic. He has led multiple national, citizen-facing projects that materially improved the health outcomes of people in the UK. David’s experience spans Imaging Systems, Patient Flow, Cloud Technologies and large-scale digital transformations.