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early health model
early health model
Biochip array technology systems could provide hospital laboratories with the next generation of analysers to help improve the quantity of information obtained from laboratory tests through the simultaneous measurement of a wide range of analytes from a single sample. Healthcare is time sensitive, of great complexity and the single most important concern to each of us in our daily lives.
The following early health model presents an overview of a philosophy for the fundamental change in the way we deliver healthcare. The World Health Organisation and more recent reports by Derrick Wanless (commissioned by HM Treasury department) have identified proactive strategies as best models for global health improvements and national health improvements. The health and wealth of our nation will depend on the will to change and the implementation of change.
There are no quick fix solutions but one thing is for sure, the largest health organisation in the world has a chance to lead again and this chance may lie inside a Cradle to Grave Philosophy for healthcare.
FROM CRADLE TO GRAVE, A PHILOSOPHY FOR HEALTH CARE
‘The test of a first-rate intelligence is the ability to hold two opposing ideas in mind at the same time and still retain the ability to function’ F. Scott Fitzgerald
Our ‘great’ NHS is a 50-year-old stressed system and no amount of new tax will mend it sufficiently well to take the strain of the population demographics, the increasing costs of treatment and the already overloaded system.
Quick fix solutions will surely flow cash through the gaping holes that so badly need plugging. There are no debates necessary on general staff shortage, equipment shortfalls and a legacy of Victorian buildings with insufficient car parks. Increased taxation or private finance will need to address these issues as quickly as possible and government is currently active in these areas.
The Achilles heel of the NHS
The issue this paper means to address is the other legacy; The National Health Service was founded to address the needs of our Nations sick and that is how it has been enacted for a number of decades. Unfortunately this philosophy of healing the sick has in the end been the Achilles heel of the NHS. The NHS is a reactive organisation that needs to metamorphosis into a proactive organisation. In this paper there will be no further discussion on how far down the NHS has fallen other than to cite the World Health Organisation’s ranking of 18th for the UK NHS. A long way away from the once proud ‘Mother’ that modelled most of the worlds’ Health Systems.
Purchasing power, innovation and value
The effect and consequences of having an inefficient health strategy is far reaching. In the 1st instance quality of life for the British citizen has diminished (waiting for delayed treatments). The staff in our health system are only beginning to emerge from the downward spiral of de-motivation caused through the frustrations of keeping pace with ever increasing workloads. The indigenous industrial infrastructure of design, research and manufacturing is suffering from oppressive shortsighted buying strategies. The same support infrastructure is weakened greatly in its ability to meet the overseas trade challenges and wealth creation.
The world’s largest employer (outside China) will surely have many areas in which efficiency measures can be introduced and a lot has been done in the last years. Nevertheless many efficiency drives have turned out to be annual rounds of budget cutting. Not bad in itself if quality management is deeply embedded in the structure to ensure cost cutting and quality cutting don’t merge into one. In fact the seemingly endless ‘budget freeze or budget depletion’ of the last decade has been directed to areas that have been the easiest to target, ‘easy number crunching’. The effect has been to polarise departments and build strategic walls between departments within each hospital. The result is seen through the treatment of patients were one department cannot effect the change to benefit the treatment/costs in another department because the polarisation is institutionalised. Department (a) cannot increase spend by 1 unit to save department (b) 3 units because Department (a) can neither increase its budget or transfer 1 unit of saving from department (b). This is the institutionalised disease of vertical budgeting or silo budgeting.
What if the patient with a specified disease could be managed for the disease with a ‘pre allocated budget’? This now becomes patient management as against budget management.