In love with the future: NHS 2088

2 July 2018

As the NHS turns 70 this month, our Chief Operating Officer Jo-Anne Wass considers the exponential acceleration in medical technology innovation, what its impact might be on health and care services in another 70 years, and the importance of having a vision to help us get there.

Around 70 years ago, we began various new love affairs. From plastic and fossil fuels to sugar-laden delicacies and labour-saving technologies, we smothered love on these amazing innovations. But somewhere along the way, they each started smothering us.  Now, our seas are choking on plastic; sugar-saturated foods and sedentary lives are much to blame for today’s obesity epidemic; and we’re desperate to escape our reliance on so-called unrenewable energy.

We also fell in love with our new National Health Service, the like of which the world had never seen. An opinion poll 68 years later showed that the NHS still topped the list of things that made people most proud to be British.

As the nation celebrates 70 years of amazing NHS achievements we are reminded daily of the challenges it faces.  For example, last month it was announced that attendances at outpatients cost more than £8 billion last year and it was suggested that, as a mode of speciality support for long term conditions, this is an obsolete approach.

The King’s Fund’s 2013 – 2033 timeline on the future of health and social care weaves foreboding with fascination. It predicts trends in ill and diminishing health that seem insurmountable in scale, alongside innovations in healthcare that seem plucked from science fiction.

Theirs is a 20-year timeline. But what if we were to jump forward from the NHS’s 70^th birthday to 70 years hence? What might our health and care services look like in 2088? Will treatments such as surgery and chemotherapy be seen as primitive and archaic? What will the role of hospitals be and – as the King’s Fund predicts a possible 2,000 surplus of doctors by 2020 – what will the NHS workforce look like?  Will E.M. Forster’s eerie, fictitious ‘machine’ be in charge?

The convergence of technologies (when two or more different types of technology come together into a single therapy to achieve one solution) is already demonstrating the likely obsolescence of so many familiar health and care conventions.

Computer aided surgery (CAS) using robots is already allowing procedures to be performed that would not be possible with conventional surgery.

Medicines can now be administered using wireless monitoring devices which can analyse and communicate patient test results to clinicians; and mobile apps and wearable devices are transforming health and care services.  A recent study suggests that artificial intelligence is now better than clinicians at detecting cancer.

The Leeds City Region medtech sector is being increasingly recognised nationally as a leading platform for growth, with its world-class research and its excellence in medical engineering and manufacturing of medical devices.  As noted in the Government’s Industrial Strategy Life Sciences Sector Deal:

“Partners across the Leeds City Region, including universities, local authorities, the NHS and industry, are establishing a £350m investment programme in the Leeds City Region’s leading medtech hub, including, as part of a new Innovation Quarter in Leeds city centre, Nexus, a £40m Innovation Centre driven by the University of Leeds, which will actively incubate and grow start-ups…” [1]

As well as advances in medical technology, research also points to completely new approaches to preventing ill health. For example, in one study, people who consumed fewer calories, slowed their metabolism, which researchers suggested could prolong health in old age and even extend life.

Similarly, personalised medicine is enabling the prediction of a person’s propensity to develop specific illnesses and therefore the opportunity to prevent them.

Alongside these technological and scientific discoveries, the importance of connectivity, between professional disciplines and across health and care services, is increasingly being recognised as crucial for population health and wellbeing. We are seeing a national drive towards formal partnership working, as is happening here in West Yorkshire.  More widely, as acknowledged in Leeds’ Inclusive Growth Strategy, local economies, physical environments, employment, communities and even our mental and physical selves are all interconnected. As we touched on in our previous blog about childhood mental health, the Swedish Youth Policy Bill makes childhood mental health a responsibility of ‘all decision-making agencies’.

So in 2088, will we be reproducing organs, limbs or even whole bodies in seconds, as is already emerging via 3D printing? Will there be a global panacea for accessing patient and population health data? And will predictive and preventative measures have made ill health an anomaly?

The pace of innovation across most industrial sectors is accelerating often beyond our ability to test and adopt new products and interventions. It’s vital then that we have a vision of where we are going. One which holds us steady and focused. One which is anchored in but not consumed by current reality. Therein lies the privilege and challenge of health and care innovation.

The vision of the Leeds Academic Health Partnership is that people will live healthier lives for longer. As we explain in our strategy, our overarching approach to realising this vision is to help people to prevent ill health and to care for themselves more effectively.

As one of the biggest academic health partnerships in the UK, our partners are navigating together through the undergrowth of very real, difficult current challenges, being careful not to be consumed by them, but to see beyond and plan for the future. And perhaps help shape a 2088 National Health Service that might seem as unimaginable to us today as the internet was in 1948.

So we’re embracing change and innovation, as we must. But whatever the future holds for the NHS, let’s hope above all its founding principles and values endure for at least another 70 years. They bind together the communities and people it serves – patients and public – and the staff who work for it. As the NHS Constitution for England states:

“The NHS belongs to the people.

“It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.”

Jo-Anne Wass is Chief Operating Officer at Leeds Academic Health Partnership.

[1] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/650447/LifeSciencesIndustrialStrategy_acc2.pdf