Putting a plaster over the crisis to fix the problem.
It’s not too late to improve the care system. Too much time is being wasted trying to fix the problem at the top of the funnel for the benefit of those in power.
The reality is that the problems lie further down the funnel, on the front line with the amazing people who deliver the day-to day care, resulting in a massive disparity between those that govern and those that do.
But before you attempt to implement any policy wizardry, a question. Have you tried playing chess without pawns? It’s difficult right? It’s almost impossible to win.
That’s pretty much what the government will be doing if don’t fix the following problems:
- Nursing
- Junior doctor
- Care worker
Post Brexit it’s estimated there will be a shortage of 380,000 care workers, this is in addition to the 35,000 deficit of nursing staff.
With an aging population these numbers are going to keep growing and the longer we wait the less likely we will be able to fix the problem. You might ask, isn’t it too late already?… I don’t think so, however, drastic changes need to be made in order to re build the system and start delivering the standard of care that this country needs.
The problem is the current processes, system, infrastructure and ways of working haven’t adapted to the changing times. Think of Kodak holding onto film and not adapting to digital when everyone else was.
Technology has advanced over the last few years. Technology has been implemented to create efficiencies and reduce user effort rather than just replacing paper processes.
Based on firsthand experience most technology updates that come out of the government are just replacing paper process, real innovation is coming from start-ups and those with on the ground industry experience trying to make their lives a little easier while working in a constrained system.
One of the issues I have seen is down to the procurement process of the NHS which doesn’t allow for the time, flexibility and agility that will come with change needed for a startup to show value. A good example of this is the NHS failed patient record system that has cost over £10bn, yes TEN BILLION, which after many set backs was scrapped.
This money could have been better spent working with startups. We can’t be the first to think that the way forward is to work with startup and high growth companies, hence why we are seeing the rise of health specific accelerators such as Digital Health, Med City working with startups and championing some of the great work they are doing. The largest to come out of this is Babylon.
So back to the headline, how can we solve the problem today and prepare for the future?
Nurses and care workers are overworked and underpaid which means that a career in this sector is perceived by many to be as appealing as making Anthony Joshua angry.
This perception needs to change — however, what are the practical ways of changing this, some quick notes,
- 10% of all nurses left last year according to NHS Digital and there are now more nurses leaving the NHS than joining.
- The average churn rate for a care provider is over 30%,
Stats like this doesn’t make anyone want to jump to join these professions.
The ability to hire an adequate workforce will also give the new and existing staff support as the workload is spread more evenly, and you can have a lot of knowledge sharing, learning from experience and new techniques.
Nurses are at the frontline of all hospitals, without them doing the fantastic job that they do the entire system crumbles. It doesn’t matter if you have the world’s greatest healthcare plan that will revolutionise the NHS, you simply cannot implement it without nurses. Imagine, walking into a hospital with no nurses? Yeah, exactly.
We need to drive health education as well as patient and staff engagement by creating efficient processes that reduces bureaucracy whenever possible.
Why do we squeeze the salary of a nurse but pay over the odds for the same medication you can get from any pharmacists for cheaper?
The NHS spent over £87million handing out paracetamol last year — with the average prescription costing 20 times the price of a packet in the supermarket. Spending like this causes staff to not just lose trust but also be resentful to a system that they love and want to see work.
Let’s try and understand why the NHS under so much pressure?
- An ageing population. The UK population stood at 65.6 million in 2016 with 18% being over 65, that amounts to almost 12 million people, more than the population of London, and it is increasing every year.
- Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11% in the last five years. This has caused record levels of “bed blocking”; elderly people with don’t need to be in hospital but haven’t been discharged due to avoidable administrative delays.
- Staff shortages. 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice.
- Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue
The government needs to relieve the pressure of the NHS which will go a long way to regaining trust and create advocacy from existing staff and recruit and retain more nurses, Care workers, and Junior Doctors.
I believe this can be done by:
- Support — Nursing bursaries were scrapped in 2015 with promises being made to reinvest the money saved (£800m) into nurse training schemes to attract more nurses, this clearly hasn’t been successful. The bursary previously helped to cover tuition fees and other education related costs is now available as a student loan, putting nurses into more debt. Suggestion would be to bring this back to allow more people to train.
- Better pay — The average starting salary of a NHS nurse is £23,000 rising to around £36,000 for more experienced and specialist nurses, in some cases it can rise up to £69,000 but this is for advanced level nurses only. Starting salaries for care workers start from £7.83 with most care workers in London on zero hours contract due to the nature of care it’s neither sustainable for the provider or the worker. Pay a fair wage for the work that is being done. LLW is great start, but we need to go further.
- Put more effort behind Advertising & PR — Raise awareness of positive side the day-to day job of those in care to allow transparency, all we ever see is the negative side of these professions, but rarely ever see the positive side.
In chess, you can’t underestimate the value of the army of pawns that allows your bishops, castles, knights and queen to move.
In part 2 I will try to tackle the social care crises and how innovation can really disrupt this industry — for now, it would be great if they started with these.
- views here are my own, and do not necessarily represent that of my current, or any past employers.
