Healthcare Innovation: A&E For The NHS

The UK's National Health Service (NHS) is experiencing tough times. Waiting times for A&E services are hitting record highs, where the increasing number of patients and a shortage of medical staff are causing a perfect storm. According to data acquired by the Telegraph, in December 2016, only 82.2 % of patients were assisted within 4 hours, which is the lowest figure ever recorded for the whole organization.

When it comes to not-for-profit organizations, especially those directly involved in maintaining and improving a society's quality of lives, continuous innovation, in terms of new initiatives and management systems, is critical. However, unlike in the private sector, these are often harder to deliver, due to the organizational structure and limited resources, but there are still ways to ease the pressure.

The NHS consists of a large number of General Practice surgeries (GP), which join forces with hospitals across the country, as well as several charities and organizations. The functionality and productivity rates in each area depend on many elements, including the differences in demographics, differences in the range and quality of facilities provided by hospitals, the availability of trained staff and doctors, and others.

One of the challenges the health service faces is the shortage of hospital beds, particularly in cases of severe health conditions which require immediate assistance. According to the peer-reviewed medical journal The Lancet, a new study found that the average life expectancy in the UK has reached 81.5 years and is forecast to increase, meaning that a larger segment of society are now elderly. In many cases, older people suffer from chronic or terminal conditions which require permanent treatments. Currently, an overwhelming number of elderly patients with long-term conditions are treated in hospitals, so there is a decreasing number of beds available for other patients. The problem is that some elderly patients who are occupying beds do not require them for medical reasons.

The Glasgow City Council and NHS Greater Glasgow & Clyde came up with the intermediate care program, where older patients are being helped to leave hospitals, in some cases, where medical facilities are no longer needed. New discharge policies suggest that patients can leave the hospital within 72 hours, with their long-term needs being transferred outside. However, these patients are by no means abandoned.

So far, private nursing homes in Glasgow has opened 90 beds, as a result of their collaboration with the NHS. David Williams, the Chief Officer of Glasgow City Health and Social Care Partnership said, ‘We set targets to get 30% of people home that came into intermediate care beds, and we have achieved that consistently.' If a practice is successful in one region, it can be achievable across the entire country, where both patients and medical staff can benefit tremendously.

Another problem is that like many non-profit organizations, the NHS falls victim to its own structure. The dependency on the government budget, relatively low wages, bureaucracy, and a lack of infrastructure mean that the organization is forced to deal with all sorts of problems, so there is simply no room and time for innovation. In this instance, collaborations with external not-for-profit organizations are critical for implementation of new strategies and practical solutions.

Considering and reviewing the practices of other organizations can be useful to start with. For example, nothing can be more challenging than innovating in a sector related to the end of life care and hospices. However, Marie Curie Cancer Care is a good example of a charity organization that combines a high quality of service with innovative thinking. Acknowledging all the challenges associated with demographic changes and ongoing NHS and social care reforms, the organization provides nursing and hospice services to tens of thousands of people each year, where the most important mission is to provide people with a choice.

Their ‘Death and Dying in England: Understanding the Data’ report stressed the differences and advantages of non-hospital care for both families and national healthcare. In the case of terminally-ill patients and their care, the shift should be towards homes and communal support, moving as far as possible from hospital care. For example, often patients who require immediate palliative care (pain and life-support management in oncology), are often brought to A&E services, where not only do patients have to wait for relevant assistance for hours, but in the end, they are rarely offered the full spectrum of care as nurses are either unqualified for this type of treatment or are simply unavailable due to high demand. Currently, A&E nurses are offered the chance to undertake palliative care training, but this doesn't seem to be helping too much as terminally ill patients want to be treated at home, based on patient stories from Macmillan Cancer Support. Each palliative care case that is brought to A&E requires the assistance of at least one specially trained nurse, as well as a doctor consultation. If the palliative care can be transferred outside A&E on a national level, the unnecessary inconvenience for patients and additional workload for A&E staff could be avoided.

Creative approaches and innovation can resolve, if not all, but at least some of the most painful problems, where partnerships can further ease the tension. Even though many cite the current problem at the NHS as a crisis, the national healthcare system, which is free of charge and accessible by all citizens, remains one of the most advanced healthcare organizations in the world, the preservation and maintenance of which is vital.