The IoD Jersey Debate: Healthcare in JerseyOctober 12, 2015
Following an extremely fruitful IoD debate concerning digital healthcare in Jersey, I wanted to share my reflections and continue the conversation with Jersey’s community about this most pressing issue.
In common with developed countries round the world, Jersey faces challenges from a growing and aging population; more chronic disease, rising demand and expectations from the population, new treatments and technologies, increasing scrutiny on quality and safety, and rising costs of care. Indeed this issue of rising costs was a recurring topic of discussion at the IoD debate.
The call for more investment in health is a common refrain heard from many individuals and sectors, but securing this investment is much easier to do when you can prove that the way you are using current funds is providing value for money.
So how can we provide this value for money? Firstly, we need better synergy between GPs and the hospital. Clinicians in primary, community and secondary care settings need to change their models of care to be more effective. Encouraging the public and patients to take responsibility for their own health as a form of preventative care is by far the best strategy to reduce costs and improve the performance of our healthcare service.
There are many international examples of new models of care, with patients being cared for outside hospital settings, which Jersey can take its lead from. Changing the traditional behaviours of the public, patients, professionals and organisations is key to delivering sustainable health and social care.
This is where technology has a really big part to play. It can be a disruptor of the status quo, and will enable many of these much-needed new models of care to emerge.
Virtually all of the current and future technologies have relevance to Jersey, including patient wearable and self-controlled technology to enable the individual to self manage; patient:clinician technology allowing easier and remote interaction between the two; clinician:clinician technology bringing specialists and generalists together in a virtual context and enterprise:enterprise technology enabling inter-organisational exchange. Remote controlled robotics are increasingly being used and one could envisage invasive procedures being undertaken on a patient on Jersey by a surgeon based off-Island. Above all, using, sharing and developing information of all types, with appropriate safeguards, has to be a priority.
While important however, technology will not of itself deliver success; that depends on the human dimension taking advantage of technology to realise its benefits.
Another key thing to consider is Jersey’s scale – as it makes care relatively more expensive and requires, as is currently happening, good partnership links with other systems to maintain clinical skills and provide care in more highly specialised services. There are good examples of remote care being successfully delivered for similar or smaller populations, and it is in this that technology has a distinctive role to play.
All this considered, there are several key steps that need to be considered when thinking about the new hospital. Firstly, staff members are absolutely critical; they must be included in every step of the process. Secondly, the hospital must be designed around what it’s actually going to provide. This means clearly defining, or in some cases redefining, the services and procedures that will be provided – and also the ones that won’t.
Optimising the use of scarce resources is vital. e.g. running a three session theatre day six days a week could halve the required number of theatres needed compared to a more traditional five day two session practice. A similar approach to outpatients reduces the number of clinic rooms required. Reducing length of stay by proactive patient management and pre-planned recovery and discharge practices will reduce the number of beds required.
Beyond this however, there is also an opportunity to export our services if they are good enough; for example, commissioners in the UK are buying specialist services from Calais, so why not from Jersey? Currently in Jersey there is a law against profiting from health services, and that is one thing that would need to change.
The third sector was strongly represented at the debate and contributors demonstrated why they must have a role in the future delivery of health and care services. They have a well developed, expert understanding of specific conditions they operate outside many of the constraints of public bodies giving them flexibility, nimbleness and efficiency in responding readily to need. Many are volunteers whose commitment, energy and empathy make them a priceless resource. The trick for public bodies is to know when the third sector can do it better and then finding the way to support it happening.
Jersey has a tremendous opportunity, with new investment pending, to demonstrate leadership and make a reputation for excellence in innovative healthcare delivery. The level of interest expressed about digital healthcare solutions at the IoD debate was a real cause for hope for all those looking to move Jersey’s healthcare provision to where it needs to be for future sustainability.