Transcript Trends with a high potential impact, which are more certain are

Future Challenges
Nigel Edwards
Policy Director, NHS Confederation
Visiting Professor London School of Hygiene and Tropical Medicine
2 sets of challenges
• Challenges from changes in healthcare
• Challenges from workforce change
Some trends will have greater impact than others
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High Impact
Low Uncertainty
“Wild Cards”
High Impact
High Uncertainty
Low Impact
Low Uncertainty
Low Impact
High Uncertainty
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Trends with a high potential impact, which are more certain are:
– Rising patient expectations
– E health and the use of IT networks
– Widespread use of intelligent devices and expert systems
– Miniaturisation of diagnostic tools
– Ageing population and increase in chronic disease
– Common use of remote consultations and home monitoring for patients
– New ways of working and changing health professions
– Major pharmaceutical innovation reaching market
– The widespread use of genetic screening and mainstream use of
pharmacogenomics
Trends with a high potential impact, which are more uncertain are:
– Expert Patients generating a significant increase in self care
– Emergence of new infectious disease
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Trends with a lower potential impact, which are more certain are:
– Further use of Minimally Invasive Surgery
– Use of robotics
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Trends with lower potential impact, which are more uncertain are:
– Use of stem cell technology to regrow body parts and repair injury
– (Re-) Emergence of infectious disease
Technological & communications advances
Information for the professional
Information for the patient
Isolated care
Integrated care
Slow communication
Rapid communication
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New patterns of service delivery
Industrial age medicine is transforming into information age healthcare
Individual self
Tertiary
Professional
Secondary
Care
care
Friends &
family
Self help
networks
Primary
Professionals as
facilitators
Professionals as
partners
Professionals as
authorities
Source: Jennings, Miller and Matema - Charging Healthcare, Santa Monica: Knowledge Exchange, 1997
Other changes in healthcare delivery
• Patient centred and consumer driven
• Growth in chronic disease means a need for co-ordination
and integration between traditional interfaces
• Safety and Healthcare acquired infection
• Systemisation
• More multi-professional teams
• More of a population focus
New skills
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•
•
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Relationship with patients
Team work
Communications skills
Safety and systems design
Information management skills
Knowledge management and assessing
evidence
• Managerial skills
Attitudes to work
• New Roles
• Working environment
• Affiliation and attachment
– Feeling valued
– Job satisfaction
– Resources and pay
Global threats
• Aging workforce
• Increasing demand from China and India
• Impact of the USA on the rest of the world