NHS Efficiency

Dean Russell Excerpts

Tuesday 2nd November 2021 Westminster Hall

[Dean Russell (Watford) (Con)]

It is a pleasure to speak under your chairmanship, Sir Gary, and an absolute honour to follow the excellent contribution of my hon. Friend the Member for Peterborough (Paul Bristow). I refer to my registered interests and, in particular, I raise the fact that I am the chair of the all-party parliamentary group on digital health, which very much informs some of my points today.

I will be brief, as I am conscious that this is a big debate to have in a small period of time. One of my passions for looking at efficiencies in the NHS comes from my own experience. About 12 years ago, I was asked by the Department of Health to do a strategic review of every NHS website in England and Wales. I will cut to the punchline: there were more than 4,000 live sites. I did the financial calculation and worked out that between £87 million and £121 million a year was being spent on websites, many of which people did not even know existed. That highlighted that one of the challenges for the NHS is that, because of its immense scale, even though people want to do the right thing, duplication inherently causes extra costs on a scale that one cannot really comprehend in a normal business, or even in a global business.

This highlights various points. First, if we want to improve efficiencies, we need to make sure that patient experience and patient care is at its heart. There were 4,000 websites at the time, of which several hundred were about how to stop smoking. It would probably have been more efficient to have one really good stop smoking website, rather than 200 average ones.

Patient experience is not just about the outcome but about how patients find the right information, how they get to the source and how we make sure they are not having to repeat the same thing every time they go for an appointment, which is where technology is so important. We often think of technology in the NHS as big, expensive, lumbering IT systems that are hard to comprehend, but the world has changed. We now have a consumerised approach to healthcare. People have watches that can track their heartbeat. They can go online and book appointments by email. They can use apps to do so much more, even track their covid status.

We need to look to the future, not just on efficiencies for cost savings but on patient experience. Thinking about the sort of experience we want patients to have over the next 10 or 20 years, it has to be seamless and efficient. Seamless in the sense that if a person breaks their arm, they do not have to say that they have broken their arm every time they see a new clinician, go on to a new website or use a new app. Their broken arm might mean they need additional wraparound care or it might affect their ability to work, so what will be the impact on social care? If we start to put patients at the heart of what we do, we can create efficiencies around them, rather than requiring them and the NHS to duplicate their efforts.

There is a great opportunity to look again at patient experience, given the technology that is available not just in the NHS or in social care but generally. We are now used to using social media, apps and phones for so many different things. If we can start to bring that into how we look at the future world of health, we would have a powerful opportunity to say to patients, “What would you like your health system to look like?” Rather than imposing variations of the health system of the past 40 or 50 years, we could ask, “What is it that you, as an individual, would like to see in how we look after you, your children and your parents, not just now but for decades to come?” We could then create an efficient and effective system that has patient outcomes at its heart and that ultimately creates a superior patient experience that helps everyone and, as I always say, is free at the point of use so we can make sure that the NHS continues to live up to its values as it always has.

Let us look to the future and let us see what is available, rather than just relying on what we had in the past.