Denis Campbell Health policy editor
Wed 5 Jul 2023 07.00 BST
The NHS must undergo radical change or it will continue to decline and lose public support, Tony Blair has argued on the service’s 75th anniversary.
It must embrace a revolution in technology to reshape its relationship with patients and make much more use of private healthcare providers to cut waiting times, the former Labour prime minister says.
The prevalence of chronic health conditions, long waiting times, the NHS’s stretched workforce and tight public finances in the years ahead mean the service must transform how it operates, he said.
“The NHS now requires fundamental reform or, eventually, support for it will diminish. As in the 1990s, the NHS must either change or decline,” he writes in the foreword to a new report from his Tony Blair Institute thinktank, which sets out ideas for safeguarding the NHS’s future.
He adds: “Change is never easy and requires brave political leadership. If we do not act, the NHS will continue down a path of decline, to the detriment of our people and our economy.”
Every patient should be given a new online personal health account, hosted by the NHS app, Blair proposes. That would let people see a record of every test, appointment and treatment they had had and would collate personal health data, including from wearable devices such as Fitbits. It would also allow the NHS to send information designed to make people more responsible for their own health, as well as details of services on offer from private healthcare firms.
On six occasions in his foreword, Blair backs the private sector playing an expanded role, including in the provision of high-volume, low-complexity services, such as dermatology. When in No 10 Blair used independent sector treatment centres, run by private companies, to help tackle long waiting lists.
But Dr John Puntis, the co-chair of the campaign group Keep Our NHS Public, urged caution on Blair’s ideas. “Caring is about people, and although technology supports healthcare it can never be a magic bullet and replace the need for staff.
“The Blair years demonstrated that with increased investment, NHS performance and patient satisfaction improved. On the other hand, use of the private sector undermined NHS services, and independent sector treatment centres pushed up costs,” he said.
More people will resort to private healthcare unless the NHS banishes long treatment delays, Blair predicts
This reminds me of the current arguments about ticket offices, smart ticketing etc on the railways. Modernisation in these regards - ticketing on the railways, online results and monitoring for the NHS - are exactly the steps we should be taking. I've had similar experiences with recent health scares and only the current NHS locks away test results behind appointments and paper-based systems.For the past three years I’ve had some health issues.
I’ve experienced NHS [poor], Cleveland Clinic (American private) [Amazing] and Circle Health Group (British private) [quicker version of NHS].
The American firm has a web portal. You can manage appointments, see test results, send messages to your doctor, view and download letters & your medical record.
I love it because the moment a test result is in you get a notification. You can instantly see what is normal and what isn’t. Then Google and prepare for your discussion with the consultant.
View attachment 381935
That trends bit is a graph of all your previous tests so you can see if it’s gone up or down etc.
It’s frigging amazing. I can’t see why the NHS can’t have this. It exists. It’s not impossible.
I hate the way the NHS baby you through test results. Receptionist can’t tell you, must speak to the doctor, there an appointment next week if you phone before 8 etc.
Keep Our NHS Public (KONP) have various events around the country.
I had a full blood panel run on the NHS last week, said they would contact me within a week if anything was concerning, heard nothing. Can get the results but have to phone in as you said, does seem daft if I have to make an in person appointment and use up time for someone to hand me some test results. Do have some kind of private healthcare through work but I have never bothered yet.For the past three years I’ve had some health issues.
I’ve experienced NHS [poor], Cleveland Clinic (American private) [Amazing] and Circle Health Group (British private) [quicker version of NHS].
The American firm has a web portal. You can manage appointments, see test results, send messages to your doctor, view and download letters & your medical record.
I love it because the moment a test result is in you get a notification. You can instantly see what is normal and what isn’t. Then Google and prepare for your discussion with the consultant.
View attachment 381935
That trends bit is a graph of all your previous tests so you can see if it’s gone up or down etc.
It’s frigging amazing. I can’t see why the NHS can’t have this. It exists. It’s not impossible.
I hate the way the NHS baby you through test results. Receptionist can’t tell you, must speak to the doctor, there an appointment next week if you phone before 8 etc.
This does mean, however, that those without smart phones, or whatever hardware and software become necessary in the future, will be left behind with a second rate service. The money will be spent on the new fashionable tech. Those with learning difficulties, mental health problems, no money, dementia etc etc, in other words those who may need the service most, will gain the least or lose out.This reminds me of the current arguments about ticket offices, smart ticketing etc on the railways. Modernisation in these regards - ticketing on the railways, online results and monitoring for the NHS - are exactly the steps we should be taking. I've had similar experiences with recent health scares and only the current NHS locks away test results behind appointments and paper-based systems.
I work in medical records and know that increasing numbers of Trusts are going digital, only not far or fast enough. If Fitbit can provide more detailed health results, in an easier to access format, than the NHS, something has gone wrong.
I can see my test results via the patient access website. Not all of them, but most and it tells you if they are in normal range. Also graphs plotting results over timeFor the past three years I’ve had some health issues.
I’ve experienced NHS [poor], Cleveland Clinic (American private) [Amazing] and Circle Health Group (British private) [quicker version of NHS].
The American firm has a web portal. You can manage appointments, see test results, send messages to your doctor, view and download letters & your medical record.
I love it because the moment a test result is in you get a notification. You can instantly see what is normal and what isn’t. Then Google and prepare for your discussion with the consultant.
View attachment 381935
That trends bit is a graph of all your previous tests so you can see if it’s gone up or down etc.
It’s frigging amazing. I can’t see why the NHS can’t have this. It exists. It’s not impossible.
I hate the way the NHS baby you through test results. Receptionist can’t tell you, must speak to the doctor, there an appointment next week if you phone before 8 etc.
That's the thing. There are some great advances in technology across the NHS but, to take one example I know from our Trust, something like maternity departments are only just creating programmes GPs can access notes from anywhere in the country. It's still incredibly difficult to share notes from Trust to Trust.Making Appointments, sending follow up information to people, booking more appointments related to the outcome of X,Y and Z - these are all completely solved technology problems, if British Gas can do it - so can the NHS.
The challenge is that when you are implementing technology to run business processes - customisations kill you - if 5 GPs practices want to book appointments in slightly different ways - that’s 5 sets of customisations and all of them need testing whenever you change anything.
If you are running a team in a call centre in British Gas booking service appointments and you want to do it a slightly different way to the other 5 teams doing the same thing - they’d tell you to GTFO.
I rarely share my actual opinions on this forum and now look at me.This does mean, however, that those without smart phones, or whatever hardware and software become necessary in the future, will be left behind with a second rate service. The money will be spent on the new fashionable tech. Those with learning difficulties, mental health problems, no money, dementia etc etc, in other words those who may need the service most, will gain the least or lose out.
Why is closing ticket offices on the railways and shifting everything online exactly the steps we should be taking? Or have I misunderstood you?This reminds me of the current arguments about ticket offices, smart ticketing etc on the railways. Modernisation in these regards - ticketing on the railways, online results and monitoring for the NHS - are exactly the steps we should be taking. I've had similar experiences with recent health scares and only the current NHS locks away test results behind appointments and paper-based systems.
I work in medical records and know that increasing numbers of Trusts are going digital, only not far or fast enough. If Fitbit can provide more detailed health results, in an easier to access format, than the NHS, something has gone wrong.
The world is digital. We can't be an island glued to the past on every score, that's how Brexit was won.Why is closing ticket offices on the railways and shifting everything online exactly the steps we should be taking? Or have I misunderstood you?
That's a poorly worded slogan rather than an explanation of why closing ticket offices and 'shifting everything online' is exactly the steps we should be taking.The world is digital. We can't be an island glued to the past on every score, that's how Brexit was won.
When I worked for Evil American Megacorp there was a big £Billions deal signed one time. In the daily email that came round telling us how wonderful it was to work there and how lucky we were was a item saying celebrate the deal with "Breakfast on Us! Morning of Whenever". I excitedly turned up expecting something like a full English buffet to find out the breakfast consisted of one bap with a couple of slices of bacon (choice of sauces though) and a cup of tea in a plastic cup. Definitely felt swindled.Just found out staff have got to pay £2 for cake WTF?
I was on a train the other month, to Ilkley. Every passenger in my carriage had digital tickets except one, and the guard had a good laugh with them about being "old fashioned".That's a poorly worded slogan rather than an explanation of why closing ticket offices and 'shifting everything online' is exactly the steps we should be taking.
If it’s proper health care rather than one of those ‘you pay and can claim most of it back’ schemes…I had a full blood panel run on the NHS last week, said they would contact me within a week if anything was concerning, heard nothing. Can get the results but have to phone in as you said, does seem daft if I have to make an in person appointment and use up time for someone to hand me some test results. Do have some kind of private healthcare through work but I have never bothered yet.
I work with a woman who uses NHS for some things and private for others, and heard the similar thing from you, that it's sometimes hard to go back to an overrun GP surgery but that's the balance she's struck.If it’s proper health care rather than one of those ‘you pay and can claim most of it back’ schemes…
I’d say damn well bother with it.
The difference is startling and you are actually lifting some burden off a stretched NHS.
The danger is you might get used to it and find it hard to go back to plain old NHS.
I’ll admit I felt a bit of a class traitor using it at first but I can live with being a class traitor when the alternative is waiting years on the NHS on an emergency list. Yeah a two year wait and I was on the quick list!!!
Unintentionally or possibly intentionally this is just a tepid defence of the rail companies' proposals. It has nothing to do with either embracing technology or avoiding whatever turning into a heritage lines means. It is purely about saving money , reducing staff and boosting shareholders profits. It's in a similar vein to abolishing the guard on the train. There are scores of surveys from passengers on what they want, suffice to say that the closure of ticket offices is not one of them.I was on a train the other month, to Ilkley. Every passenger in my carriage had digital tickets except one, and the guard had a good laugh with them about being "old fashioned".
The customer base is already shifting from queuing for paper tickets; they expect digital tickets for air travel, gigs, even hotel bookings. Queuing up for a paper ticket works for the old fellas at the heritage railways, it's no longer how society functions.
Like I said earlier, there are ways to help people get access to tickets. There will be staff on platforms.
I don't like all the plans from the government and I sure as hell don't support them. But in some ways the railways have to avoid being themselves turned into heritage lines.
You obviously have a smart phone and the ability to use it.The world is digital. We can't be an island glued to the past on every score, that's how Brexit was won.
I do.You obviously have a smart phone and the ability to use it.
ding, dingI do.