TECHNOLOGY
Transformation in the era of systems, place, and AI
Michèle Wheeler, International Health and Life Sciences director, and Karen Bryson, Transformation Expert adviser, at healthcare and life sciences consultancy, Lexica, delve into ‘the evolving landscape’ of the global health and care sector, with a look at ‘the pivotal part’ they believe technology and AI will play in future healthcare transformation.
This year promises to be both exciting and challenging for the global health and care sector. Governments worldwide are grappling with increasing healthcare demands, a shortage of skilled professionals, and rising treatment costs. Traditional efficiency and gatekeeping programmes have fallen short, prompting a shift towards integrated care models, localised and decentralised care, and a stronger emphasis on prevention. Technology and AI are set to play a pivotal role in this transformation. Economic growth and a healthy workforce are
intertwined, with universal healthcare seen as a key influence. However, it is a costly endeavour. While industrialisation and globalisation may have improved living standards, and medical advancements have extended lifespans, we are not living in better health. We have eradicated most transmissible diseases, such as polio and TB, only to replace them with diabetes, heart disease, dementia, and cancer – diseases associated with ageing, modern lifestyles, and widening income, social, and health inequalities. These factors affect where we live, our access to affordable food, housing, heating, education, jobs, support networks, and services. This results in an additional 17 years of living with a disability for those in the lowest 5% of neighbourhood deprivation, on top of their already shorter lives. If unchecked, this trend will continue, as evidenced by soaring obesity levels globally, even among pre-school children. Research and innovation in medicine, AI, and ‘medtech’ to predict, diagnose, and treat poor health are remarkable, but costly. While treatment is essential, it is not the solution. Care systems are seeking ways to contain both rising costs and increasing demand.
The UK scene Like other countries, the UK is grappling with this conundrum. The NHS has attempted several reconfigurations in pursuit of greater efficiency and better gatekeeping to manage demand and cost pressures. These efforts have failed primarily because they did not address the root cause of demand – health inequality caused by the social gradient linked to income. Therefore, the challenge is not simply about cost and demand control; it’s about reducing health inequalities. The latest and most strategic response likely to succeed
is the introduction of Integrated Care Systems (ICSs). Introduced in 2022, ICSs bring together health sector providers within a geographical area. Their mandate is to plan, shape, and deliver health services to meet their communities’ health needs. This decentralised, place- based model for healthcare is an exciting and long-
awaited step in the right direction towards the holistic partnerships needed to reduce health inequalities. The UK Chancellor’s (2024) Autumn Statement suggests
that this place-based systems approach is here to stay, with significant fiscal support accelerating its pace and impact. This includes a £13.6 bn capital increase, and a clear signal of fiscal headroom to embrace technology, AI, and data, and to invest in the estate to increase capacity and performance. The future is there to shape.
The focus ‘on place, technology, and decentralisation’ Rather than reiterate well-rehearsed principles and imperatives of the need for greater efficiency and performance, we thought it would be useful to explore the Chancellor’s focus on place, technology, and decentralisation, and what this means for how we approach transformation. We do not offer answers – that is up to individual organisations. What we do offer is a challenge to perceived wisdom, custom, and practice, and encouragement to ask different questions to solve the pressures on the health and care system. The Chancellor’s 2024 Autumn Statement clearly
Figure 1: Three evolving entities are coming together in a vortex shaping the concept of ‘place’, the authors say. The Chancellor’s 2024 Autumn Statement promotes a decentralised economy with strong public, industry, and community partnerships. Key elements include Integrated Care Systems, local government reconfiguration, and regional mayors, all aiming to enhance efficiency and wellbeing through technological advancements.
March 2025 Health Estate Journal 71
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