A 10–15 year vision for person-centred healthcare in a technology-enabled 21st Century
In 2018, the NHS will celebrate the 70th anniversary of its 1948 founding. Originally set up primarily to deal with acute care, the vast majority of its efforts (and as much as 70% of its costs and rising) are now focused on caring for people with long term chronic conditions, the majority of which are to some extent preventable.
The system as currently configured is unsustainable and a new approach is needed. This much is known and there is an enormous amount of work going on in many areas to address the need for change including major structural initiatives geared around integration (Strategic Transformation Plans) and developing incentives to keep people healthy (Integrated Care Systems); behavioural initiatives to drive prevention; entrepreneurial activities that change the way people interact with their health and wellness; digital-led changes in how people interact with the health system that drive efficiencies and improve experience; and scientific advances in, for example, genomics; among many others.
This project, commissioned by the Royal Free Charity, which itself reaches its 190th anniversary in 2018, takes a different starting point.
Rather than working forward ‘from here’ to fix the current system, dealing with the difficulties of reconfiguring what exists today and the uncertainties and risks inherent in change, this report paints a picture of the potential destination, based on extending forward the transformative trends in personalised medicine, prevention, AI & digital health and setting out a 10–15 year future vision for person centred healthcare which will require a strength and clarity of ambition on a par with 1948.
We have not identified new trends, nor offered completely new ideas in any individual field. The value of this report is in thinking through what might happen at a system-level bringing the trends together and describing it in a person-centred way.
If we can see more clearly what is possible, then it may be at least a little easier to galvanise change to achieve it.
This report is intended as a provocation — a stimulus for discussion and debate at a system level; a story about a possible future for public healthcare if we can get it right.
Over the coming months, we will continue to engage with stakeholders across healthcare ecosystem to further develop the vision, to make the lighthouse burn as brightly as possible in the distance and illuminate the activities we are engaging in as we move ‘from here’ in a shared direction.
If successful, the ambition is that the report will provide a basis for discussion at a series of events jointly organised and funded with stakeholders in the wider health sector.
In a year when there will be much debate about the future of the NHS in particular and the sustainability of publicly funded healthcare in general, we hope that this will provide a longer-term — beyond the typical planning horizons — and positive context for ambitious thinking.