Understanding the Cost Per Patient in the U.K.
As a speaker at a recent Healthcare Strategy Forum, it was my great pleasure to converse with a broad cross-section of the U.K. National Health Service (NHS) community. What was evident is the stress on these organizations from the competing factors of improving patient service—driven by the strong and genuine desire from health professionals to deliver the best outcomes for their patients—vs. the pressures of ever-increasing demand for their services in an age of austerity.
While health is a “protected department” from a budget-cutting point of view, they are not protected from the rapidly aging demographic. This is causing ever-increasing numbers of patients to come in for care, which is pushing the system to its limits. Never has the motto “work smarter, not harder” been more apt. 
It was pleasing to get a positive reaction to some of the new concepts I presented on patient experience management. Currently, a normal distribution of best practices exists between NHS Trusts – the engine rooms of secondary health care within the U.K. However, many are grappling with a common problem – how to gain better visibility of their patient interactions as a pre-requisite to understanding the overall costs to serve each patient.
The root of this problem lies with traditional patient record systems that are – quite rightly – focused on the clinical needs of patients. However, these systems inadequately document the interactions a patient has with the organization and the interactions that health professionals have with each patient. They also fail to effectively implement cross-disciplinary workflows, where patient-centric processes need to straddle departments, each with their own processes, clinical systems and contact points.
For a typical NHS Trust, this all looks like an enormously high peak to scale. Agreed, but a useful project to start with is the Trust’s external patient interactions. While a minority of Trusts are implementing ‘proper’ (i.e., non-email-based) digital self-service channels, most are still struggling with the issue of having numerous patient contact points into the organization.
For example, organizations often have dozens of externally facing phone numbers, resulting in distributed staff across the organization handling the interactions in a non-optimal way. While many differences exist between the two sectors, the learnings from local government indicate that providing an omnichannel environment to centralize the process for customer contact could provide substantial benefits for patient satisfaction and operational Trust savings.
However, this project is just a means to a lucrative end. The approach allows a patient relationship management model to be constructed that shows a single transactional view of each patient. This allows a cost for those interactions to be assigned per patient. Furthermore, with this model established, additional touch points with consultants, general practitioners, etc. and the costs of supply provision through these routes can be added, providing that crucial unified view that most Trust chief executives are missing today.
Yes, this is a substantial transformational job, but one with significant benefits that can accrue. With the right unifying infrastructure in place, it can be accomplished one step at a time.
The issue arises as to where this patient model best resides. At a Trust level, it adds great value but only goes so far, missing patient interactions at a general practitioner and local authority level. The obvious answer is a national scheme, but the legacy of too many failed national IT projects should give pause. Delivery at a Clinical Commissioning Group (CCG) level makes much more sense, but while CCGs own and distribute the budgets, many seem unwilling to consider the provision of an infrastructure in their own right. A CCG beacon project, successfully delivered and then rolled out more widely, makes most sense.
Who’s up for it?
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