Our vision: to transform access to medical care.

A bad Apple or a better Swiss Railways

I finished up in the “Goldfish Bowl” at the HSJ Innovation Summit this week, being quizzed about the trials of innovation.  With me in there was the amazing Neomi Bennett, a nurse who invented the Neo-slip for helping to put a pressure stocking on a DVT patient.  She got me to demonstrate her product and instantly we saw the complete change she had made to a difficult and troublesome task for nurses and patients.

It made me think again about a picture for the NHS as an innovative organisation.  We’d heard about leading edge device technologies now coming available which at lightning speed can measure your body functions and transmit them via an app to your personal record for analysis.  Apparently we’ll be covered in wearables, stickables, implantables and improbables.

The tech companies are aiming at exponential growth, and after the inevitable bubble and crash investment cycle, some of these may have an impact on our health and healthcare systems.  Apple has ambitions here of course, and some say the NHS with its million strong workforce, wealth of ideas and population coverage should join in.

I don’t think so.  The NHS is not and cannot be a global consumer brand.  All the talk among the delegates was about good ideas which have never been adopted and exploited at scale by the NHS.  Let’s not expect this to change, because it’s an operational business where managers must avoid risk and keep their heads down. People in the NHS can germinate, maybe incubate great ideas, but they can’t disseminate them.  It’s like trying to grow a tree inside a house.

Innovators know that most ideas fail, and those that succeed are driven by uncommonly tenacious people covered in scars.  Rather than be a bad Apple, the NHS could nurture ideas and spin them out as fast as possible, letting people and companies take them on, whose day job is to innovate and grow.  If Prof Tony Young’s innovation role in NHS England achieves this, it will multiply the success with Neo-slip.

So what legendary organisation should the NHS emulate?  I propose the Swiss Railways.  It’s a much loved national institution, a state owned monopoly, and it knows its business is to provide universal coverage at an affordable cost.  It doesn’t do exponential growth, but it’s high tech and highly innovative, specifically in the direction of its core values of predictability, convenience and safety.  The resulting performance is pure delight for passengers which only the Swiss take for granted.

Their health system compares poorly with the NHS on value for money by the way – they are addicted like no other country to staying in hospital.

We believe that the NHS is the best system design in the world.  But its performance could be so much better.  We must stop the frippery, the hand wringing and the demotivating target & inspection regime.  We need a laser focus on efficiency.

Harry Longman
Founder, Chief Executive
GP Access Ltd

PS  We’ve just published full data from Rydal practice on their first two months with askmyGP, analysing 1735 patient submissions as over 30% of demand shifts online.  Full of surprises.

PPS Perhaps I thought of a railway thanks to a lifetime first for me this week, on a train from Edinburgh.  I only dropped off for ten minutes, but woke as we pulled out of my change stop at Warrington. “I’m going to a funeral” I protested to the guard.  “I think you’ll find,” he graciously pointed out, “that you’re going to London Euston.”  Well, the best I could do was to write an extra psalm, 23 and a half.

Comment on this blog – what frippery would you stop?


One response to “A bad Apple or a better Swiss Railways”

  1. John Havard says:

    Hi Harry,

    Whilst I agree with much of this, I am not sure about the Swiss railways comparison. The NHS ‘passenger’ demographic is changing much more than Swiss passenger demand so we have a greater need for innovation and new ways of working. Change is the only way to survive.

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