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Our Scottish Future exists to make the case for better cooperation across the UK. We do so because we think that on key policy areas such as economic growth and environmental protection, collaboration leads to better outcomes. Now, a new area where this is true is emerging – in the future of healthcare.
Most politicians and policy makers now accept that the current NHS model cannot hold. According to our own research, Scotland’s rapidly ageing population means that, if we carry on as things stand, we would need to build an extra 8 mid-sized hospitals by the end of 2040 to meet demand (Press coverage, report). An extra 17,000 nurses would be needed to staff them. Even if the economy was going gang-busters, this would be completely unrealistic.
The only way forward is to reduce demand on the NHS. The best way to do that is to shift from a model which, as things stand, waits for people to get sick and then treats them expensively to one which either prevent disease in the first place or, when that’s not possible, helps people manage conditions without the need for a costly and undesirable two-week stay in hospital.
When we talk about “reform” of the NHS, this is what is required. It’s been estimated that 40% of the NHS budget goes on treating preventable disease. Even just a small dent in that will help doctors and nurses continue to do their job.
And what’s clear is that this model of a more preventative NHS is one that relies heavily on the four UK health services working together. The successful UK wide roll out of the Covid vaccine is a good analogy. A similar at-scale emergency effort is needed if the ideal of a preventative NHS is to work.
As evidence, witness a major study published only this week by Health Data Research UK , the national institute which seeks to bring together health and care data across the entire UK.
Led by analysts at Edinburgh University and published in the Lancet, the study had access to data from all 67 million people across the UK. With that level of data at its disposal, it was able to show that more than 7,000 hospitalisations and deaths from COVID 19 might have been averted in the summer of 2022 if the UK had had better vaccine coverage. At that point, the study found, between a third and a half of the UK population hadn’t received the recommended number of vaccinations or boosters. That data can now be used in real time to tackle on-going COVID cases. But the researchers at HDU UK also note that this is the tip of the preventative iceberg.
As Professor Cathie Sudlow, chief scientist at HDR UK and director of the British Heart Foundation’s Data Science Centre said: “The infrastructure now exists to make full use of the potential of routinely collected data in the NHS across the four nations of the UK. We believe that we could and should extend these approaches to many other areas of medicine, such as cancer, heart disease and diabetes to search for better understanding, prevention and treatment of disease.”
The point is that this effort to identify at risk people and to prevent disease is made much easier when working at scale. A similar argument was made just before Christmas by the Tony Blair Institute. It has proposed launching “Protect Britain” – a nationwide programme which would offer preventative vaccines and therapeutics to everyone in Britain who is at heightened risk of dying or being forced off work due to chronic illness. It proposes the scheme could be rolled out via the same successful routes that led to people across the UK receiving equal access to the Covid vaccine. This would prevent the existing doctors and GP practices from being overburdened by yet more work.
Again, the point is that, in order to work, the UK’s four health services, and the health data of the UK’s 67 million people, need to be brought together both so that researchers can better analyse those people at risk of disease and to help deliver equitable preventative treatment. Scale works.
Our Scottish Future’s Health Commission will be examining how best this is done over the coming months. We published our first blog on the issue this week here. If the NHS is to have a future, and the ideal of a preventative health service is to be realised, then we need to see the UK’s health services cooperating on a plan.