TECHNOLOGY
Doctors now routinely consult with patients remotely, diagnose conditions, review scans in high definition, and collaborate with clinical experts, in remote locations.
environment would create a system for technologies such as medical drone procurement and deployment to bridge existing and future key coordination and supply chain gaps, and inefficiencies in the emerging place-based model. The Chancellor’s focus on place, technology, and prevention, calls for a fresh approach to transformation. While efficiency, cost-effectiveness, and performance, remain core principles in delivering services, the emphasis is now on ‘system’ performance, optimal use of collective resources, and leveraging technology to offset staff shortages, reduce dependency on high-cost facilities, and optimise access to increasingly costly medical expertise and equipment. Reducing demand, rather than gatekeeping to control demand, is the new watchword. In this new context, we propose a new perspective on transformation:
a shift in the problem statement, moving upstream towards prevention. This involves orchestrating change across partners through a maturity framework, and recognising that change is challenging – and choosing which challenges to embrace and how.
Change the problem statement ICBs and Trusts are forecasting a potential NHS deficit of £4.5 bn for 2024/25, and collectively restricting spending by £8 bn to stay within budget and increase productivity by 2%.5
They also need to
reduce a growing waiting list. Changing the problem statement seems at odds with such pressure, but is logical. Rather than chasing solutions to ‘reduce the burden’ on the NHS, we should change the question to ‘How do we reduce the need for health and social care?’ Same agenda – different lens. Immediately, we are asked to look outwardly to partners as collaborators across the system to design pathways and actions that seek to empower individuals, shift the focus towards early intervention, and reduce the risk of lost wellbeing and independence. This approach encourages more self-management, the use of remote technology to advise and reassure, and more reablement therapy. We know that this preventative lens triggers a focus on health-positive
choices and actions by both individuals and clinicians. It encourages collaboration and multi-professional co-design of patient pathways. It shifts the focus of clinicians towards early intervention and reablement to reduce the risk of disease progression, and stimulates innovation and creativity. When presented with a bottom-up resource model of what they collectively designed, teams self-adjust roles, skills, grades, customs, and practices. They configure models that promote independence, self- management, and empowerment. Including service-users in the design ensures that their experience and needs are central to shaping and streamlining services. Without fail, this approach reduces both costs and
March 2025 Health Estate Journal 73
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