Working collaboratively to drive new models of care

28 May 2018

It is well known that the NHS faces a number of challenges in meeting the growing demand for healthcare within its available resources. With life expectancy increasing, the rising trend in prevalence of co-morbidities, and the expanding expectations of the public for convenient and personal care, NHS costs are becoming unmanageable and the pressure to reduce costs is ever growing. Demand is rising at a rate of 4 per cent, whilst current funding growth remains at just 1 per cent. In order to achieve the £22 billion efficiency savings of the NHS Five Year Forward View by 2020, the momentum to drive new models of care must gain pace.

The Accountable Care Systems (ACSs) play a key role in delivering the changes necessary for a sustainable future for the NHS. Implementing these, however, can only be achieved if the government, the NHS, the third sector, industry and patients can shift their thinking and work collaboratively.

The radical changes required to ensure the NHS remains a world-leading organisation can only be made if, at the same time as the commissioning of new care pathways, we have the courage to de-commission services that are no longer fit for purpose in order to free up capacity.

Out of hospital care offers significant opportunities to both generate efficiency savings and improve quality and safety of care. Home therapies can empower patients to take control of their own treatment, drawing on clinical and other support to assist their choices. However, budgetary silos between different NHS organisations and local government often act as a barrier to enabling increased out of hospital care.

A joined-up, system-wide budgeting model must permit long term settlements for new treatment pathways whose benefits may be realised in the longer term but require an initial investment. This can only be achieved where the ACSs are accompanied with an appropriate payment system and there is alignment between commissioning and provider incentives.

Baxter is a leading supplier of products and services to the NHS, supporting patients at all stages from hospital admission to managing a long term condition at home. There are evident examples of how Baxter can help the NHS deliver the out of hospital care agenda set out in the Five Year Forward View and articulated in many ACSs. An outpatient parenteral antimicrobial therapy (OPAT) service we set up in partnership with St. George’s NHS Healthcare Trust to enable a carefully selected group of patients to receive intravenous antibiotics at home has saved the hospital up to 2,700 bed days. OPAT allows patients to continue their treatment at home or can completely eliminate the need for hospitalisation. Baxter provides the home delivery of medication as well as the nurses to infuse the drug as often as required.

Home dialysis is another incremental innovation that offers patients better clinical outcomes and improved quality of life. Baxter’s cloud-based communication platform that connects home dialysis devices to Renal Units enables clinicians to monitor their patients daily. This simple technology is a step change in innovation and has the potential to increase both patients’ and clinicians’ confidence and reduce avoidable and costly hospital visits.

Luella Trickett, Senior Government Affairs and Public Policy Manager, Baxter Healthcare

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