After 22 years in the NHS and 11 years in Local Government I have recently moved into the HE sector – what a revelation!
The art of the possible becomes the art of the probable. The first response is a nod of the head and a positive debate. The energy to research and solve problems is tangible and most incredible of all, people are paid to think (and teach of course!).
In my increasingly senior roles within the health and care system this capability and capacity was invisible and therefore untapped – I was and remain, beside myself with excitement at the potential opportunities universities can offer to the health and care system.
We are already doing this I hear some of you cry – fabulous I say, but be in no doubt that more can be done – arguably must be done. We unintentionally (or controversially maybe intentionally) segment society, segment disease and segment solutions, often despite trying not to.
People become known by their disease or condition, they move from citizens to patients, independent to dependant, bed blockers, the elderly, the frail, NEETS, LAC and many more acronyms.
The solutions however cannot just be about the science – precision medicine, genomics, psychology, physiology and much more, but about the combinations and the interface between the elements of a person’s life – the art and creativity alongside the science in my view is what will stimulate the sustainable changes the population alongside the health and care sector need.
Universities can both challenge the system approaches to solutions which is a consequence of having your head down and firefighting, and support alternative, and dare I say radical, approaches that can influence those that are desperately trying to hold the system up.
Gold commands invoked when the health and care system is in crisis, designed to last 72 hours, are, as recently experienced, in place for weeks, these draw all attention and effort into the maelstrom of “sorting out the system” right here and right now and are to be quite frank exhausting.
Universities can, in this scenario, contribute to strategic stability, innovation space, creation of collaborations including with business, mostly invisible to many in the sector (another revelation to me – the number of businesses with solutions we need that are literally in the buildings next door).
Universities can help to clarify thoughts, marshal multiple challenges that connect, add value to the strategic debates, be independent and objective – I would urge everyone to never underestimate how the intense and unrelenting pressures in the health and care sector can impact on objectivity.
If we do not fundamentally strengthen our relationships and embrace the art and the science of both citizen wellbeing and recovering their lives following a health or care intervention, of salvaging and sustaining the wellbeing of our health and care systems and the people within it, the perfect storm we find ourselves experiencing will turn in to the tsunami some of us are most fearful of which will be catastrophic to the health and care system in the UK.
I make no bones about being a prophet of doom but the past eighteen months has seen me also become a narrator of hope – a sticking plaster won’t cut it but strengthening our sector relationships with our universities and businesses just may.
So what did Cornwall do? Well it wasn’t remotely scientific (unless you recognise the art and science of nagging). I was in a very senior role within the local authority, deeply embedded in the health and care system, having an all-age portfolio with commissioning, provider, public health and strategic programme experience.
It was strikingly clear to me that we were not investing anywhere near the time, attention or resource into technology, the digital world, innovation and system focused research that we needed. Our drive (and the national drive) was integration, integration, integration as the panacea to all our ills. Quite right of course, however, without wise use of technology, research and innovation, the integration agenda is at significant risk of failure.
So I nagged constantly, OBVIOUSLY supported by a business case and all the paraphernalia required for a seemingly small scale radical proposal – I was released on a secondment to Falmouth University to focus on innovation and technology in health and care, the combinations, collaborations, the alternative approaches aligning the art, the science and the system (and satellites but that’s another tale).
Our approach puts the merging of the digital and physical world at the centre of our thinking, optimising the potential proffered by the increasingly ubiquitous nature of the digital world. To address the pressure caused by rising demand we are exploring what the digital citizen and digital community have got to offer the health and care system in terms of self – care, self- management, predictive health, the citizen as a health and care consumer and vice versa.
To moderate the over reliance on an unsustainable people-heavy model of care and the enduring recruitment and retention challenges we are creatively exploring the digital solutions (including the unforeseen digital solutions) developed by the workforce themselves if left to get on with it, and being allowed to fail! We are also exploring system processes but from a creative and humanist perspective.
Technology-based innovation is arriving faster than health and care can assimilate and implement. When it comes to the digital world even the research backing it up is too slow and I do believe universities need to help to pick up the pace – our health and care system needs to develop the attitude and behaviours that facilitate pacey digital change.
To do this our workforce needs support, digital skills will become of paramount importance – there’s not much point investing in digital if there is not an equal investment in digital skills at ALL levels – growing the relationships with our schools, colleges, universities and businesses is of crucial importance and there is an urgency required.
So a part of my cunning plan is get academics to shadow health and care personnel in their environment and vice versa, encourage short term secondments to facilitate practitioners and leaders alike the think time that is so lacking and do so within a supportive thinking environment – and not just the odd one but as something that becomes the norm.
Facilitate shifts in care homes and domiciliary care settings, ED, medical wards and gold commands for university staff especially those who don’t have medical or care backgrounds but who have so much creativity to offer. I want to make sure the very real, enduring system challenges are highlighted within the research development processes within the university, and constantly remind people this is their NHS and their Social Care and it’s no good just thinking about it when you need it.
Expose what’s coming – it’s not our GP’s, nurses, social workers, speech and language therapist, care home managers that need to own these challenges and solutions – it’s us.
Anna Mankee-Williams is Senior Research Fellow Innovation and Technology in Health and Care at Falmouth University and a member of the NCUB taskforce on Digital Health and Care