Could better use of patient data be the key to solving challenges facing the NHS?
In this three-part series, Qa Research explore how critical challenges facing the NHS could be addressed by more effectively using high-level patient data and meaningful public engagement.
Part 1 explores current healthcare issues
We all need and value our health over almost anything else. In the UK, we rely on the NHS to look after us and we take pride in the institution that’s been running for three-quarters of a century. However, with Labour’s recent landslide election victory, Keir Starmer’s government is inheriting an NHS in dire straits, needing to adapt to evolving healthcare needs such as advancements in medical technology and changes in disease prevalence, all the while dealing with historic cuts to NHS funding.
This series looks to explore how the NHS can tackle these challenges through using patient voices and data to really make an impact where it matters.
Public satisfaction with the NHS is at its lowest ebb
The Labour government’s starting point with the NHS is not a positive picture. The British Social Attitudes survey reported the lowest level of satisfaction with the NHS on record (in the 40 years since the survey began). In it, less than a quarter (24%) of Brits were satisfied with the NHS, an unprecedented 29% drop in satisfaction since 2020. Indeed, a staggering 52% were actively dissatisfied with the health service, citing inadequate healthcare spending as a major concern. In a survey that we at Qa Research recently conducted with Understanding Patient Data, a similar picture emerged, with 85% agreeing ‘I am concerned with the state of the NHS’ (representative sample of 1000 UK residents). The healthcare system’s current challenges significantly impact public satisfaction, which only serves to emphasise the need for improvements.
But where are these concerns coming from?
In the BSA survey, the top reasons for dissatisfaction with the NHS were ‘waiting times’ (71%) and ‘staffing shortages’ (54%). These two major issues are prominent in the media and resonate with past projects we at Qa have carried out with regional NHS and health system partners. When it comes down to it, it’s quite simple; people want quick access to healthcare when they need it and enough high-quality staff to feel safe and cared for, ensuring timely patient care.
What are the major challenges facing the NHS today that need addressing?
The current picture of the UK’s health and care system is one of immense pressure, heavily influenced by health economics, including financial challenges. For a more detailed look, publications such as The King’s Fund, The Health Foundation and the Economics Observatory have done an excellent job of laying out the challenges facing the NHS.
In this article we have picked out four of the key pressures we have observed over the years.
1. Care backlog and patient flow
A major factor in current NHS issues is the sheer backlog of elective care built up during Covid-19, meaning that waiting lists for treatment are stacking up. Recent research from the University of Edinburgh suggests this backlog is not likely to be cleared by 2025. Delays in providing care to patients, including emergency care, further exacerbate the situation.
On top of this, in the UK we don’t have the flexibility other European countries do in terms of hospital beds; in the EU there are on average 5 beds per 1000 people, but only 2.4 in the UK. This is only compounded by issues with social care, as hospital beds are ‘blocked’ due to delayed discharge. Combine this with the NHS’ limited scope to invest in preventative care and tackle health problems ‘upstream’, it means patients are living for longer but with more health conditions.
These NHS challenges mean many patients are now struggling to get the right care at the right time.
2. Partnership and integration of health services
Newly-founded Integrated Care Systems, most of which are working with significant budget deficits, are considering how to best collaborate locally all the while being assessed under new ‘capability’ ratings.
It is a challenging time for the fledgling Integrated Care Systems and their governing bodies Integrated Care Boards, many of whom are considering significant restructures in order to balance the books. On top of this, all different partners in the system may have different structures, different ways of working and different IT systems, which only makes things more difficult.
3. Widening health inequalities
Health inequalities are avoidable differences in life expectancy, health conditions and qualities of life between different groups in society. These have been widening in recent years, despite being a priority of the NHS Long Term Plan to tackle it. NHS services are working to close this widening gap in health outcomes which are affected by wealth, geography and other factors.
Combined with a population that is living for longer, people living with multiple health conditions at once (known as co-morbidities), this means more complexity in the support the NHS needs to deliver. The NHS will have to adapt to this new reality, addressing health inequalities through a strong focus on public health.
4. Strikes and staffing challenges
The NHS is currently functioning in a climate of prolonged industrial action and key shortage professions, meaning Health Secretary Wes Streeting is inheriting a workforce in distress and willing to strike over working conditions.
The impact of these strikes? There are four main impacts, of course starting with patients who experience rescheduled appointments or impacts on the quality of care they receive. This can significantly affect patient outcomes. Another major impact is on the healthcare workers who ultimately have to keep the NHS running on skeleton staff, and deal with the increased backlog when the strike is over, taking a physical and emotional toll. For striking staff, loss of income or the difficult decision on whether to strike can impact them too. Stress and burnout is high in the NHS, with many opting to leave the sector, which only makes the problem worse for those who stay.
Beyond those directly involved with the NHS, public trust and opinion towards NHS staff as well as politicians can be damaged by ongoing strike action, as we found in recent work with Bradford Health and Care Partnership. And of course, every strike costs the NHS money, with consultants and expensive agency staff being drafted in to cover.
Why explore these NHS challenges now?
Through our wide-ranging research with NHS patients, communities and health sector stakeholders the issues highlighted in this article have been mentioned repeatedly. The policy and funding landscape certainly exacerbates them, as do major health incidents like Covid-19, but the issues have been bubbling for years, decades even.
2024 has potential to be a year of change in how the NHS is managed as the future of our health service formed a crucial part of Labour’s successful election campaign. Indeed, now they are in government, Labour will be looking to fulfil their manifesto pledge to not only cut waiting lists, but to work towards a ‘fairer Britain, where everyone lives well for longer’.
So what can be done to solve these challenges?
Certainly the challenges are great. In the first year of the new government, the country will be watching their progress on pledges to halve the gap in healthy life expectancy and cut NHS waiting times with 40,000 more appointments every week.
When looking to address these challenges, there is so much patient data and evidence out there to drive decision making, and patients are keen to have their voices heard and be part of the future of the NHS.
However, ‘data-driven’ and ‘patient-centred’ decisions often feel like two opposite ends of the spectrum and can operate in silos. Perhaps a united, cohesive approach could drive more efficient, impactful decisions in the NHS?
Next month in part 2 we explore how supportive patients are of having their data used to power decision-making and what this could mean for solving NHS challenges.
