Clarity in Conversation: Q1 2023 HealthTech Dinner

At Clarity, we run regular Clarity in Conversation events where we bring a selection of industry leaders together to discuss the critical issues of the day. It’s a space to share ideas and challenges, and network with like-minded executives in different sectors. 

In late March we were proud to host a UK HealthTech focused Clarity in Conversation dinner featuring an impressive lineup of guests including health technology titans, digital health visionaries, and experienced NHS leaders. We brought them together to discuss how money is flowing around the UK’s National Health System (NHS), where the power really lies in health, and how essential it is to communicate all of this simply and effectively. Central to this conversation is the NHS’s 75th anniversary, which is taking place on the 5th of July this year, with all recognizing its future existence should not be taken for granted. 

In this article we’ll provide an overview of the conversation at the event, along with any key takeaways impacting healthcare and HealthTech as a whole.

The HealthTech funding dilemma

The event kicked off by addressing the funding dilemma facing the UK’s HealthTech sector and NHS in 2023. The single grant of money  that the UK Government provides to the NHS, known as “The Vote”, cannot be exceeded. The money that flows around the NHS is not considered to be “real” or tangible until it is actually spent on staff, goods, and services, so only is it clear how much of ‘The Vote’ has been spent and is remaining for the health system.

There were clear frustrations around the room at the focus of short-term spending budgets. HealthTech solutions are ready, available, and relatively inexpensive to implement, with proven long-term cost savings and improved outcomes. Yet, the system’s inertia has prevented change happening as quickly as it could or should. The group agreed that if budgets are viewed longer than through a one or three year spending term, then the value proposition for HealthTech has the potential to sky rocket, saving the NHS money, and improving patient outcomes. 

However, while official statistics show other countries spend more on healthcare per head of population, which is consistent with more recent studies, the group acknowledged that “more money” was not the silver bullet. A change in culture at the center of the NHS, a change in patient behavior, and change management of the NHS’s structures, including a redesign of pathways and funding methodologies, would all play a necessary role.

Restructuring the NHS

The attendees had all heard that the reorganization of the NHS, including the absorption of NHS Digital within NHS England, and the launch of 42 regional Integrated Care Services (ICSs) replacing Clinical Commissioning Groups (CCGs), has created a seismic shift in power. This, combined with changes in purchasing philosophy, a new Medtech Directorate, and growing centralisation at NHS Supply Chain looks likely to shape the future of healthcare for years, if not decades, to come.

Whilst ICSs have been in existence for almost a year now, there is still a difference of opinion around what an ICS is, including around the room at the dinner. It was unclear whether an ICS is a direct replacement for a CCG, or whether it acts as a partnership facilitator to the provider (an individual or organization providing healthcare services). The room was in agreement that a lack of consistency across the UK is making it difficult for industry to engage and offer solutions to problems ICSs are facing, with their priorities differing from region to region.  

As the above makes clear, there is skepticism about the current potential of ICSs, with attendees believing that Trusts (organizations across the UK which provide hospital services, community services, and other forms of patient care) still hold the power locally, particularly with ICSs not yet having centralized data to manage patient flow and treatment demand. It was recognised that ICSs need to prioritize having more of a transformative impact on elective recovery, and that they will need to embrace digital systems to harness and analyze centralized data.

Overcoming the NHS’s communication challenges

The group discussed several dichotomies and challenges faced by the NHS. Many argued that  the NHS is in reality a “Neighbourhood Health Service” rather than a “National” one, and the aphorism of, “once you’ve seen one ICS, you have only seen one ICS” may well apply for sometime to come. 

We heard that telling the NHS’s story could be a powerful way to describe how improvements should be made, while tapping into the clear emotion people feel for the UK’s beloved health service. The 75th Anniversary is potentially a useful hook to tell this story. 

The perennial battle of “Clinical versus Clerical” needs addressing, whereby doctors and nurses provide sole NHS credibility, while managers suffer the ire of our politicians, media and the public. A fully functioning NHS needs both to work in harmony. 

The final output from the communications-focused discussion turned to how we might learn from the pandemic, where clinical pathways were explained in clear terms on prime time TV, meaning prioritization and prevention messages achieved the necessary cut-through. 

The role of data

Last year’s policy paper, Data saves lives; Reshaping health and care with data strategy (2022), committed the NHS to modernizing its data architecture with a Federated Data Platform - where every Trust and ICS have their own data platform but are able to connect and share information. The group considered how the Federated Data Platform might tackle the NHS being “data rich and insights poor”, and offered the following insights around how data could be used to solve critical healthcare challenges:

• Using data will prove cost savings and improve patient outcomes.
• Language should be modified from data “ownership” to “held by a Trust”.
• We should use virtual data prior to conducting real world data trials, because the data is more efficient and provides a basis for the real world data trials. It means that the trials will be more focused, faster, and build up useful clinical evidence. 
• Risk scores around data usage need to be clearly evaluated and communicated, including the benefits of data sharing, who it is shared with, and why.
• Incentivizing data sharing will go a long way, as incentives are the ultimate driver of behavioral change.

Insights into the Care.data farrago included ‘the reality behind the headlines’ that GPs were not innocent in the policy failure ten years ago that allowed the NHS to share people’s health records. It was agreed that we need to learn from the past to not repeat mistakes which might further delay the benefits of responsible data sharing, which has considerable scope to improve patient outcomes.

Opportunities for HealthTech to support the NHS

The NHS, it was felt, is in a perilous state due to poor engagement with the public, services being capped and under-funded, long waiting lists, low workforce morale, and private healthcare subsequently growing in popularity. The old view that the NHS delivered more with less money is being challenged. Is new investment the answer, or is it time to rethink the NHS? Could technology still be its savior?

There was a clear mix of views in the room. The HealthTech evangelists felt money could be saved, and patient outcomes improved, in the short-term through digital health and remote monitoring which prioritize keeping people well long-term.

HealthTech that addresses the current Conservative Government’s singular focus on reducing the elective care backlog is most likely to be prioritized, but doubts were expressed as to whether this would translate into actual investment before an election.

Conclusion

The adage that technology’s take up and impact is overestimated in the short-term and underestimated in the long-term seems as apt for healthcare as it is for every other sector. However, as HealthTech’s ability to support the Government in overcoming some of the health challenges faced by the NHS is so clear, the group agreed that implementing the necessary transformational change should happen without further delay. 

Clarity thanks all those who attended and participated in the dinner; it was an excellent and lively conversation! If you are interested in joining another Clarity in Conversation dinner, or are a HealthTech firm looking to learn more about Clarity and how we can support your market access activity, then please get in touch here.

 

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