Charteris partner Stephen Hewett discusses the urgent imperative for constructive and efficient collaboration between healthcare providers
Mrs Smith, aged 78, falls over at home and badly bruises her right leg. She is in a lot of pain and calls an ambulance that takes her to the local hospital. But even when, after a week, the bruising subsides she’s kept in the hospital for a further week because she isn’t very mobile.
Only after those two weeks does a social worker who knows Mrs Smith hear about what happened to her and hurries to the hospital. There, the social worker explains to the hospital staff that Mrs Smith isn’t too mobile anyway, but is perfectly happy at home with her limited mobility and her friends and relatives visiting her and her regular help from social services. The social worker takes Mrs Smith home from hospital, but her unnecessary week in hospital has given her bedsores and has actually made her less mobile now than she was before. Her health takes a long time to recover.
The lack of information costs the NHS tens of millions of pounds every day
This kind of scenario isn’t a fantasy but is played out thousands of times every day in the UK today. It’s caused by different healthcare providers not having centralised access to the same information about particular patients. The lack of this information costs the NHS tens of millions of pounds every day, deriving from unnecessary hospital stays and from other inefficiencies in the care system.
The consequences of this lack of inter-provider sharing of information can sometimes even have disastrous consequences, if some crucial patient information is not readily available at the right time.
A dream in the healthcare profession - a dream for patients, anyway - is that every entity they interact with, whether a GP practice, hospital, ambulance service, social care department and any other provider of heathcare, has instant access to a computer system that integrates all the information gathered about a patient into a single source of reference. All the different providers would be able to access this at will.
Achieving this dream, while not without some challenges, is attainable at a technological level. What prevents it happening - and in fact in the UK today, no group of healthcare providers in any particular county has properly achieved it - is, in the final analysis, a lack of willingness to take the steps that would turn this dream scenario into a reality. This lack of willingness appears to derive from established cultural perceptions among different kinds of healthcare providers that concerted and systematic collaboration between them, to the extent that they should work together to share patient data via a computer system, is not an initiative they want to foster.
It’s difficult to fathom this logic.
Within the healthcare profession today, patient care is, of course, the most vitally important aim and objective, and a criterion against which the likely effectiveness of all initiatives need to be assessed.
The NHS is a wonderful organisation and something of which we can, in Britain, be deeply proud. To an American healthcare professional, for example, the idea of a national health service that pioneers many of the world’s leading medical techniques, is especially renowned for the calibre of its accident and emergency treatment and which, in almost all cases, offers its treatment free of charge, would seem close to sci-fi. The superb treatment offered by the NHS is a superb example of patient centricity in action.
Lack of effective collaboration between different healthcare providers. isn’t only a cause of patient care often being less good than it could be. The problem also makes the NHS less effective than it could be at prevention of illness and in planning for patients holistically by looking at all aspects of their health.
The problems of collaboration stem partly from the way the NHS is structured, with different healthcare providers operating as individual ‘silos’ where they have little contact with other types of heathcare providers. Instead, what’s needed is a smooth, patient-centric journey across the various entities, with each seamlessly making its contribution to that journey.
Different types of healthcare providers (which include local community health organisations and voluntary and charitable organisations as well as GP practices, hospitals, health trusts and ambulance services) need to get together and talk. And the time for this to happen is now. The need is pressing, and urgent.
Yes, individually they do look after patients well, but they need to collaborate and share information efficiently and effectively, making full use of the tools technology provides, in order to ensure that patient care can truly be all it can be.
Stephen Hewett, partner, Charteris plc