Can the UK Fix its Health Service?

 The NHS (National Health Service) in the UK is regarded by many British people as ‘he jewel in the crown’ - by far the most important public service.  Over the last decade, though, there has been increasing disappointment with the state of the service - with the COVID pandemic putting a large nail in the coffin.  Though people still value the NHS for its convenience and its ‘free of charge at the point of use’ status, it is generally reported as, and regarded as, ‘broken’. Demand for its services is rising with an increased demand (and lengthening waiting lists) for, in particular, mental health related services.

So what can be done to fix the NHS .  ‘Throwing more money at it’ is the usual political solution - but a solution that never works … and almost certainly could never work.

Increasing, and improving the use of technology is one partial solution - and AI certainly seems to offer some potential to help. (The NHS uses and produces vast quantities of data and carries out a large amount of data analysis.)

Certainly it seems to an outsider that  the NHS has to change the way it does things, rather than simply attempting to do more stuff…. but the NHS should be looking for specific, focused technologies rather than trying to squeeze and mould existing or mainstream technologies to fit its own environment.

The NHS should be, and is, looking at developments elsewhere in both public and private health arenas - and in different contexts.

For example, many developing nations have been unable to copy western, high functioning, high infrastructure health services due to the very high set-up costs.  Yet they often construct services which meet many of their needs at far lower costs - often by using staff with shorter, cheaper qualifications.  (Despite recent trends in the use of ‘paramedic’ staff, the NHS still uses expensive, well-qualified doctors to diagnose and treat low level ailments.)

So, the NHS can be wholly or partially fixed but it may need to be  further (intentionally) broken to end up with a streamlined structure, a wider range of staffing levels and skills, more appropriate use of specialised technologies - and this will take  a massive political will to ‘attack’ the beloved NHS before rebuilding it.

The size of the NHS complicates the situation but such ‘turnarounds’ have been undertaken by failing, commercial organisations to show  that this is a difficult, though by no means impossible, mission.

What is the Point?

Reading documents and even blog posts about productivity would lead one to believe that the only purpose of improving productivity is to raise profits.

That is true at the level of the firm … but sometimes we need to take a wider view.

At the national level, raising economic performance  by improving national productivity is clearly important  but only, fundamentally, because its allows a government to improve the social well -being and quality of life of its citizens. 

The productivity improvements should also be in sustainable directions so that those changes in well-being and quality of life move only in one direction - upwards.

So let’s place less emphasis on profitability, on GDP, and start to work out a well-being index that more clearly reflects our longer-term aspirations and societal goals.  Then we can know if we are being successful.

Such an index has even discussed in the past but further work is necessary on an international basis to try to reach a consensus that allows international comparison and benchmarking.

America Leads

Even though productivity has been rising slowly in the last few years, America still tops the international league table for productivity.  Why is this?

Well, possibly the most significant reasons are:

Firstly, America is a high-tech country.  It leads the way in software development , and probably still in hardware design.  America therefore implements new technologies as an early adopter and other countries have to play catch-up.  This early lead means that America gets the real first-mover advantage for most significant technologies (though countries like South Korea are fast catching up.)

Secondly, America has high quality universities which provide an effective pipeline of new talent.

Thirdly, though linked to the technological advantage, is America’s commitment to capital investment, both physical (infrastructure, equipment) and intangible (software, patents). 

This  sets it apart from, and above,  many other economies. Non-residential investment has run at about 17 percent of GDP in America since the mid-1990s, consistently higher than the share in large European economies, according to John Fernald of INSEAD, the leading French  business school.

What’s more, public and private R&D spending of 3.5 percent of GDP is surpassed only by Israel and South Korea.

Fourthly, America has a high turnover or churn rate  rate for companies, with nearly a fifth of companies being created or dissolved annually. Thus fosters innovative firms can rapidly emerge and obsolete ones can gracefully exit.   Start-ups find financing easier than do their counterparts elsewhere.

None of this is rocket science.  (Actually, some of it is ... see reason one above).  Other countries can learn the lessons but would have to invest over a number of year to reach the same point - and this would, in many countries, be mitigated by a reluctance to take risks.

No Secretto Improved Productivity

 There are thousands of articles, book - even blog posts - promising you the Top 5 (or 6 or 21) secrets to productivity.

However, I have disappointing news..  There is no one secret, no magic bullet, no productivity panacea.

Improving productivity takes real commitment - from the leaders of the organisation and infused throughout the organisation - a commitment to asking searching questions, examining systems, processes and working methods and to getting all staff to buy-in and participate in thinking up new ways to do old things.

Forget the promise of the ‘productivity revolution’.  Get the organisation thinking hard and working hard to ask - and then answer- all the difficult questions that need to be asked.

Is this the big success area for AI?

I am slightly sceptical about the great productivity gains suggested for AI.  I hope I am wrong but I think it may take quite some time before the ‘intelligence’ of AI gives solid results.  That is not to say that AI will not bring benefits, such as productivity improvements, only that we should not expect too much too soon.

There is ,though, one area/industry that seems ready for AI - healthcare.

Healthcare has a lot of bureaucracy and many medical and para-medical staff spend far too much of their time filling in forms, recording data and generally keeping the vast bureaucratic machine fed.  If we can reduce this feeding frenzy, we save time and increase job satisfaction (or at less reduce dissatisfaction and frustration).

We have also seen advances in areas such as diagnostic analysis resulting from machine learning (which is what a lot stuff we now call AI really is). Analysing large MRI and other scans is faster and more reliable using AI.  AI isn’t perfect at such analysis and subsequent diagnosis but tests suggest its success levels match or exceed those of most doctors.

The next stage is for AI to make recommendations as to further tests or even potential treatments.Such processes will improve over time as AI ‘learns from its mistakes’ and learns from actual outcomes.

AI is unlikely in the near term to take over any ‘hands on’ work of doctors and nurses.  But if it can reduce the ‘side load’ of bureaucracy and speed up diagnosis and determination of treatment, we could see quite large productivity gains in the relatively short-term future.

Healthy Employees Are Productive Employees

Many employees, when asked in job satisfaction surveys, express the view that they are constantly tired and often under stress. Even in organisations with standard work hours, employees are increasingly expected to be available during evenings, weekends, and vacations.

Now a degree of stress can be helpful in motivating and focusing employees but too much can result in tension and ill-health - both mental and physical.

Progressive employers recognise this and take measures to control stress levels, knowing it is good for the employees and good for the business. 

Workplaces should embrace a culture of self-care and relaxation, which enable employees to enjoy reduced stress, better rest, and an enhanced work-life balance, ultimately boosting overall well-being and productivity.

Of course, employees must know that any measures taken are genuine and based on appropriate values and respect for employees’ well-being.  They can recognise ‘lip service’ and inauthentic approaches and messages.

Rather than opting for time-consuming training programs on self care, leaders can benefit from training that focuses on creating an environment and culture conducive to well-being. The organisation can seek to  use technology to increase employee freedom without sacrificing productivity.

Employees can be encouraged to set realistic rest regimes both at work and at home - helped by a consistent bedtime regime.

Employees must realise that a major part of the solution to their problem lies in their own hands.  

The company helps and supports.

How Was The Pandemic for You?

It is apparent that many people gained a fresh perspective on their own lives during the pandemic.  They now want the mix of home and work life they enjoyed when forced to stay out of the office.  

I have written enough about my view of home and hybrid working - and its impact on the productivity of an organisation.   (Spoiler for those who did not read those posts : I think it is not helpful.)  

This time I want to approach the experience of the forced seclusion from a different angle.

Truly successful people constantly develop themselves alongside working for an employer - or they turn to running their own business.

How many of you during the pandemic:

- [ ] Learned a new skill

- [ ] Acquired new knowledge

- [ ] Planned a modified future for yourself and/or your family

If you did none of these, what were you doing?  Why were you wasting this glaring opportunity to improve your future? 

Of course, you can still do all of these -  but it is more difficult while holding down a full-time job.

Seize the day!