Health Chat – Matthew Gould talks with Roy Lilley

Just in case you missed it – this is my take on the health chat. I was away, but caught up via Periscope Live Streaming. You can too by clicking here.

With some of the front line…

I had to look up NHSX. I know most organisations like their acronyms – but I do get a bit lost! The web site is a good place to start. Click through here. “Driving forward the digital transformation of health and social care by giving people the technology they need”. They work with and alongside Department of Health, Social Care, NHS England and NHS Improvement. And every one another acronym. I suppose it saves ink…

This was the 70th Health Chat (congrats to whole team and sponsors). So, I’m not just going to report here. I’m going to try to pick out the essential questions. Roy was more chatting than usual. I think this is one of his favourite areas – if we can crack this then we save a lot of time and effort.

One of the problems with anything tech focused is we tend to do the “if you can imagine it, it will happen” mode of thinking. There was a bit of that through the whole chat. We started with Artificial Intelligence – AI. Again, you can go around in circles arguing whether something is machine learning or actual AI. That doesn’t realistically get you anywhere. If we think what we want it to do instead – as Matthew said, we want the tech to release some time and space to be more efficient and effective with the patient. So we could save loads of radiographer time (and we don’t have enough of them) to sift mammograms, retinopathy screens, and X -rays, to mean the clinical staff save a good percentage of brain and prep time and have more patient time? I suppose that’s the same as Babylon and the like. If 70 or 80% of consultations can work just with the algorithm then we have primary care able to give a better service to those who need it most.

I suppose we are now getting to the core problems here. The soft squidgy bit of the equation – the people. And the environment. Let’s list the issues. You will realise that Matthews back story as a senior diplomat in the foreign office may be more useful than anything else in his C.V.

• The Health and Community Care act of 1989. Trusts and Foundation Trusts – 157 trusts – like herding cats
• Lansley Reforms
• GP and all other payment for services systems in the whole health economy
• Not invented here syndrome
• Lack of interoperability
• Contractors over promised and under delivered
• GDPR fears
• Ethics of AI
• “Now we have the funding in place, we will build it here”
• It takes 15 minutes to log on to a patients notes on a ward.

And that last one is the nub of the problem. Let’s be honest. Some people seem to have fixed this already. My local pub can do it, with personal key fobs. I would guarantee that somewhere in some trusts this has been cracked. But the majority of noise on Twitter on the night was about front-line frustrations. Loads of anger.

I’ve got a feeling we don’t need “to facilitate the system so tech people feel supported, and we all feel part of something that will make a difference.”Yes, we need data driven peer reviewed proof of concept. Then to make it scaleable, and to check that out too. Then to make it all inter-operable.

Heads need to be knocked together. This feels like it needs central leadership and direction, not softly softly facilitation. If people will not use some tech because they would then get less income, then change the way they are paid. If GPs are fearful of Babylon (or similar) will be stealing their patients, then change the way it works, and make them compatible and supportive of each other. If someone has the answer already, steal it with pride and scale it up. Make the contractors do the trials in a competitive framework. Why not start with the 15 minute log on? Have 5 potential solution providers who then compete to create the two that go forward to scaling up trials.

Amelia Tickell took over Roy’s seat to ask youth centred questions. As she said, the future is over in a year. Who knows what will happen in 20 years time, as Matthew said. We need the youth to just follow their star, what they are interested in, and be very flexible, he said.

That’s what NHSX needs to be too. But it needs to provide central leadership, and sort some of the crap out first. They may find there are more solutions out there, and in other countries, than we can possibly hope.

We have self adhesive postage stamps nowadays. The Royal Mail researched it for years. Then an exec saw them already being used in France. They bought the technology. And now we think nothing of it.

Let’s have a bit of leadership. Not just lovely words. Talk and plans don’t change things.

Actions do.

We just need to share more and get on with it. With a bit of diplomacy!