You have no idea of the changes which are coming
covid19 future health nhs · 11 comments · 900 words · Viewed ~772 times.
I wrote this before the pandemic. I chickened out of publishing it because I was working for NHSX at the time. Some of these things have come to pass. Some are yet to come.
I'll never forget the look of horror on my professor's face when I told him I didn't think his university course was good value for money.
I was in the first cohort of UK students paying tuition fees. A massive £1,000 per year. A group of us had gathered to complain about the poor quality teaching materials on a specific course, the lack of contact hours, and decrepit facilities.
Value for money and - by extension - user choice, was an alien concept in undergraduate education. We weren't humbled by wise old men - we were paying a significant sum of money for a resource.
I went back to my old university a few years ago. The crappy computer labs have been upgraded, lecturers seem more engaged with students - rather than treating them as a distraction from research, and the students are more confident in demanding what they need.
A large part of this is because prospective students aren't choosing a course based on which campus has the cheapest beer any more. They're on social media talking to existing students, they're looking up the salaries of graduates, they're investigating the ratings of professors. If you were paying £9k, wouldn't you do the same?
That conversation was 20 years ago. Fuck. I'm old.
But the same conversation has been and gone with swapping energy providers. I was bemused when we moved into our new house to discover that the previous owners were stuck on the most expensive tariff from a company which took 30 minutes to answer the phone. Sure, not everyone cares about switching to the best deal, but within 15 minutes I saved £100s and swapped to somewhere with better customer service.
Like millions of people in the last few years, I've fired my phone provider. I recently told my bank to improve their services or I'd switch to one of those fancy app-only banks.
Nearly every service in the UK has undergone a radical transformation due to digital disruption. Users' expectations have been raised for quality and value for money.
Now the same transformation is coming for healthcare.
My local village pharmacy was crap. They were slow, inefficient, never answered the phone, and were downright rude. OK, their prices for an NHS prescription were identical to every other pharmacy - but I didn't feel like their service represented value for money.
I could have taken a bus to the nearest town and got my drugs from there - I'm lucky to have the mobility and money to do so. Instead, I swapped to an app-only pharmacy.
Echo post out my meds with no delivery charge. They send me reminders when they reckon I'm running low. If I'm away from home, they'll deliver to me. They don't shout out in a crowded shop "MR EDEN? YOUR EMBARRASSING OINTMENT IS READY!"
All I needed was a smartphone and an Internet connection.
I appreciate not everyone has these things. And not everyone trusts online services. That's fine. But most adults do. And there will suddenly be a tectonic shift when people realise that there is a better way of doing things.
The same is true of a regular GP visit. Do I want to sit on an uncomfortable chair, surrounded by ill people, waiting for hours because the previous appointments have been delayed? I might not be able to physically reach a different practice - even if their chairs are comfier - but I can swap to an online GP.
OK, a video chat isn't going to take my blood-pressure or hear my heartbeat - but it is great for a whole range of appointments. And if I don't want to look a doctor in the eye - due to anxiety, embarrassment, or even just time constraints - I can text chat.
I think every GP should have the best equipment, the fanciest chairs, the politest and least-stressed staff, super-fast computers, and plentiful appointments. They should all have amazing pharmacists who are discreet and caring.
But I'd still switch to something which was more convenient to me, better met my needs, and gave me an experience which I thought was higher quality. I suspect many people would.
This is the change that's coming. And it reveals some interesting questions:
- What happens to a GP surgery when the built-in pharmacy doesn't have enough customers to stay profitable?
- If "simple" consultations are replaced with video-chat / triage, does that leave more resources for others?
- Do certain GPs want to work in an area with low / no digital take-up?
- How many patients care about seeing the same doctor each time? Is that easier or harder via digital technologies?
- We used to have doctors which made house-calls. Now they can do so virtually, what new skills do they need?
And, the big one:
What user needs are unfulfilled?
Ten years ago, no one wanted an app-only bank. The world has changed. And that change is coming for you!
David Durant says:
Rachel Clarke says: