The calm before the storm - delivering patient-centric care more efficiently

The temperature has dramatically increased in the health sector debate; with initiatives such as GP led clinics, Polyclinics Express LIFT and new groupings of GPs, hospital consultants and private equity providers forming new partnerships to compete for work.

Seasoned entrants have been joined by more speculative ventures with an apparent competitive advantage in terms of service quality and the ability to quickly establish a response to newly emerging markers such as ‘self paying’. New GP companies are also forming that will have a greater control on operating services than arms length Primary Care Trust (PCT) providers have done to date. The new organisations will control the strategic direction and provide the opportunity to grow new, alternative or specialist services if the market or their investor partners sustain it.

Clinics that fit this model are beginning to gain momentum in many neighbourhoods such as Creswell Medical in London and traditional PCTs, acute trusts and GPs will need to adapt quickly to the changing market.

A new generation

The days of GP’s and hospitals being able to dictate appointments or provide only rudimentary preventative care is long gone. Citizens working lifestyles and consumer expectations have moved on considerably. New generations want a more ‘personal service’ to use government mantra.

In other sectors such as banking and retail we increasingly demand continual access to services. The new speculative and equity based organisations recognise this and are tapping into shifting consumer needs. The new competing organisations, such as Virgin and Primary Asset, recognise this consumer voice and are responding accordingly.

Services will be increasingly delivered from hotel standard buildings with proper patient choice on access and better client engagement. The danger from the perspective of traditional providers is that patients will simply vote with their feet and move across to providers that meet their demands as consumers. The opening up of new equity and clinician led developments in the next year, highlights that initiatives from the centralised system such as ‘choose and book’ are a weak response in real consumer terms.

A need for change

The current market structure is no longer sustainable from within the types of GDP the UK has been used to applying to the health sector or by applying the current centralised systems. Current providers are facing the final chance to radically change or see future business become very unstable.

Many still hold to the view that the UK NHS is ‘best in class’ but this is not supported by the indices such as the 2008 European - Canada Health consumer index¹. Our UK ranking of 17th out of 30 is below virtually all of the major European countries. Canada’s system that is similarly regulated and mostly publicly operated comes out at 23rd overall. The best performing are Austria, Holland France, Switzerland Germany and then the Nordic countries with Sweden top for medical outcomes. When adjusted for value for money the UK health economy gets pushed even further down to 26th with Estonia, Austria, Holland, Finland and France as the top ranking.

Better intergrated services

It will only be market sensitive providers working together on a care pathway based model that is in line with the 10 principles published for co-operation and competition that are likely to deliver the service standards that are the norm in other industries. The focus will need to be on establishing better integrated services that are patient-centric not organisation centred with wider access and opening. There is also increasingly a need to group together not only allied services and tests but other health and ‘social wellness’ services with access to gyms and alternative therapies an obvious example.

The pace of change

The NHS does lots of things incredibly well. However it has been less than fleet of foot in looking beyond the UK and adopting the best performing ideas and enabling their circulation quickly into general usage. Health is now a global industry where international companies can rapidly enter the market. UK health expenditure has experienced growth from some £35 billion per annum in 1997 towards £110 billion expenditure in 2010. It is now time for the payback period to accelerate dramatically to both meet the demands of today’s consumers and to ensure efficiency savings create the headroom for ongoing growth. As the consumer voice gets louder a personal NHS service will mean just that, with the client in particular and the public in general, dictating his or her choice.

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