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The Future of Work in Health – Part 3

April 4, 2017

This is the last of three blogs leading up to a forum on the future of work in health. In this one, David Lye, Director and Fellow of SAMI, and a former Senior NHS Manager and Department of Health official, identifies a few key questions posed by changes in society, technology and other dynamics.

The story so far…

In his blog, David Smith, CEO of Global Futures and Foresight, highlighted the rapid and accelerating changes taking place in the world of work and technology. In the second blog, I identified a number of the key factors that will drive change in health care – social, technological environmental, economic and political.

The Overriding Question … “So What?”

We know that the world of work is changing, and we know that there are currents of change that will affect the worlds of health and social care. These factors lead us inevitably to the question of how they will change the world we know.

What We know

We can probably be sure of some things. The ageing population will drive up demand for health care. More people living with comorbidities; more people living alone; more people living with dementia.

The march of technology will drive up the number of new treatments some will be incremental improvements on current options, whilst some – genetech, biotech and nanotech, for example, will seem like miracle cures. This flood of innovation will add a further cost pressure to the pressure of the ageing population.

There is no immediate prospect of a windfall of extra funding to help the NHS to absorb these pressures, although no doubt battles will be fought in the trenches of UK politics. NHS England’s publication, “Next Steps on the NHS Five Year Forward View”, published last week, recognises the need for the NHS to change, and to look again at its priorities.

So we face the likelihood of a world of rising demand, new opportunities (at a cost) and little prospect of a financial windfall.

What We Don’t Know

The future health of our health system will therefore depend on how it can adapt to these challenges, making use of the opportunities of new technology to provide services in ways that are better and more efficient. Here are some of the questions to which we don’t know the answer, but which will determine how successful we are in the future.

The Patient of the Future

The market is awash with apps and wearables that claim to help us to keep a closer watch on our vital signs, diet, exercise, sleep patterns etc. How far will this lead to a change in lifestyles? And what proportion of the population will refuse to engage in proactive management of their health? How can health services best encourage and support the willing, and try to convert the unwilling?

The Clinician of the Future

Given the ability of artificial intelligence to absorb entire libraries of information and to diagnose more quickly and accurately than humans, what will change in terms of what clinicians need to do, and need to know? Will significant areas of the current professional training curricula become redundant? What new skills will be needed? How will boundaries between different professions change?

Will the current boundaries between primary, secondary, tertiary and social care need to shift? For example, will primary care become accessible from the patient’s home – or wherever they happen to be? Will traditional secondary care services, such as diagnostics, be centralised? Will advances in AI and robotics mean that some services will become less labour-intensive (the NHS paybill is over £45 billion)?

Research in the Future

How to ensure that different technologies and strands of research can join up and allow cross-fertilisation? And how to ensure a safe and efficacious transfer from the laboratory to the clinic. How will funding streams and licensing/regulatory systems need to change? How do undergraduate and graduate syllabuses need to adapt to produce the researchers of the future?

Managing for the Future

The NHS and social care have been very resistant to radical change. How to ensure that change can be adopted more quickly, without compromising safety and efficacy? How to persuade the public and the staff who work in health and social care to support changes to the status quo? How to prioritise the massive change agenda facing services?

As John Maynard Keynes exclaimed:

“The difficulty lies not so much in developing new ideas as in escaping from old ones’

The workshop on 6 April will begin to address how we can distance ourselves from the bondage of established dogma and start to explore the questions posed above. We will report on the outcome in a future blog. But undoubtedly there will need to be a lot more concentrated and continuing thought, and we will be looking for ways to foster and contribute to that debate.

Written by David Lye, SAMI Fellow.

The views expressed are those of the author and not necessarily of SAMI Consulting.

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