- Our Work
- The Reformer Blog
Reform publishes new research exploring how patients can be more engaged in their health and more involved in their healthcare. The report argues greater patient engagement could both improve outcomes and reduce costs.
The exam question facing the NHS at the beginning of the next Parliament is to save £22 billion by 2020-21. According to the NHS England Five Year Forward View, savings at this level will enable the NHS to manage without a deterioration in quality or a demand for emergency funds which, in the current fiscal climate, may not be available. The NHS should embrace patient engagement as a key means to achieve its £22 billion target. In recent years, a considerable range of evidence has shown that patient engagement can improve both outcomes and use of resources. At a time when services are stretched, helping patients to manage their own conditions can reduce demand on traditional services:
This report presents four case studies of successful patient engagement:
The NHS has launched several initiatives to improve patient engagement but the impact has so far been limited:
This report estimates that stronger patient engagement could lead to savings of nearly £2 billion by 2020-21, i.e. around 10 per cent of the NHS England target saving.
The savings would comprise more self care, improved public health, and greater patient contribution to their care, such as a diabetic measuring their own blood sugar levels.
The £2 billion saving is consistent with the findings of the last landmark government review of NHS funding. Sir Derek Wanless’ review, published in 2002, also found that greater engagement would contribute to lower costs and better outcomes. (Sir Derek Wanless estimated that the NHS would spend around 2 per cent of GDP more under a “fully engaged” scenario compared to a “slow uptake” scenario, or around £30 billion per year by 2022-23. The majority of this saving would come from higher NHS productivity.)
More than a decade later, however, improvements to public health remain marginal and in some areas, such as obesity, are in decline. The NHS is now paying the price. The involvement of private providers in the NHS is controversial for some. However creating an NHS fit for “full engagement” will require the use of outside expertise.
Industries such as banking and retail have used technology to put the customer first, such as loyalty cards, and harness the consumer’s own contribution to services, e.g. self-checkout. Leading NHS hospitals are already bringing in private sector expertise to improve customer service. NHS organisations, from hospitals to primary care to commissioners, should go further to bring this outside expertise into the NHS.
Innovators outside the NHS are already giving patients the opportunity to engage in their health and care. Private and third sector organisations are going direct to the consumer to offer services not typically offered by the NHS. Social networking sites such as IWantGreatCare and PatientsLikeMe give patients a forum to give feedback on services, learn from other patients and track their own conditions. Apps such as Babylon are giving patients access to “virtual” primary care. These disruptors will help the “expert patient” to emerge more quickly outside the NHS than from within.