Getty Images/BBC
The English government is planning the biggest restructuring of the NHS in its history.
It follows a damning report by Lord Darzi, the surgeon general and an independent peer, which warned that the health service is in a “crisis state”.
The prime minister said the new 10-year plan would be based on three concepts: greater use of digital technology, greater emphasis on community care, and preventing ill health in the first place.
There are already several innovation initiatives across the NHS and these localised schemes have the potential to benefit the whole NHS over the coming years.
Inspection and scanning in shopping centres
Local people can now get x-rays and bone density scans at The Glass Works shopping centre in Barnsley.
The NHS carries out around 2.5 million tests and scans every month, including for cancer and heart disease.
The NHS is struggling to carry out diagnostic tests quickly enough, with ageing and shortages of equipment and some hospitals difficult for patients to access.
More than a fifth of patients are waiting longer than the target period of six weeks.
Part of the solution is to provide new centres in community places, including one at The Glass Works shopping centre in Barnsley.
The NHS diagnostic centre is due to open in 2022 and will offer everything from ultrasounds and x-rays to breast exams and bone density scans.
The center’s impact was immediate, reducing wait times for bone density scans from six weeks to one week and increasing breast cancer screening uptake by approximately 50 percent.
The center is one of 165 community diagnostic centers, with others located in downtown areas, college campuses and football stadiums.
The goal is to increase testing capacity by 9 million tests per year, but a shortage of key staff, such as radiologists who can interpret the results, could make this difficult.
Virtual Ward
The virtual ward aims to provide hospital-level care in the comfort of your own home.
Using apps and remote monitoring, patients with respiratory, cardiac or frail conditions can remain at home under the care of hospital consultants, and home visits by nurses can be arranged if needed.
Over the past few years, NHS England has encouraged local services to adopt them for those deemed suitable for the service – patients whose condition is not rapidly deteriorating.
England currently has more than 11,000 virtual beds, compared with around 100,000 physical beds. Scotland, Wales and Northern Ireland are also investing in virtual beds.
Some studies suggest that for every two to three patients treated in a virtual ward, one hospital admission is averted.
But because it was rolled out so quickly, there were some initial problems.
Research by the Health Foundation charity has found a mixture of successes and failures, with some areas struggling to access the right technology and one study finding that a virtual ward bed can cost twice as much as a real hospital bed.
Surgery Hub – with patient video diaries
PA Media
Then-Prime Minister Boris Johnson visited the surgery centre in south-west London in 2022.
Alamy
The South West London Selective Orthopaedic Centre in Epsom is offering non-urgent treatment with the aim of tackling NHS waiting lists.
South West London Selective Orthopaedic Centre’s five operating theatres are among the busiest in the NHS, treating patients six days a week, often late into the night.
The unit is dedicated to non-urgent treatments such as knee and hip surgeries and is staffed by a specialised team of surgeons, nurses, physiotherapists and other medical staff, with over 5,000 treatments and surgeries carried out annually.
The idea is to eliminate waiting lists at facilities that don’t need beds or operating rooms for emergency care, which often delays surgeries.
Patients are discharged quickly (around 60% are discharged the same day) and report back to the center’s staff via video diary, allowing them to monitor their rehabilitation progress.
It’s a model that is now being implemented across the country: there are over 100 surgical centres in England that specialise in high volume, low complexity surgery.
The NHS Confederation, which represents health authorities, believes such centres could play a “vital role” in helping to clear waiting lists of 7.6 million people and has called for the number to be doubled.
So far, the results seem promising: studies have shown that in areas where the hubs have been introduced, treatment volumes have increased by more than a fifth.
The problem, however, is that these units require up-front investment to build new operating rooms and renovate hospital buildings.
This was a problem Lord Darge recognised when he published his report: “Often you have staff but no theatre. It’s very unproductive.”
Emergency Discharge Team
About one in eight hospital beds are taken up by patients who are medically fit to be discharged but cannot because they need support at home.
In some areas, hospitals have gotten around this problem by forming teams made up of caregivers, therapists and nurses to help discharge patients quickly and help them return home.
Rather than a lengthy full assessment on the ward, patients go home with the peace of mind that the team can quickly attend and arrange support.
What’s interesting is that because patients are in the familiar comfort of their own home, they often require less care than hospital staff initially anticipated.
Oxfordshire launched integrated ‘discharge to assessment’ teams late last year.
Over the winter they were asked to help 105 patients get discharged from hospital and were in a position to help 91 people.
Karen Fuller, the city’s director of adult social services, said she’s pleased with how the initiative has worked, but it’s not without challenges.
Fuller said the team is currently “working seven days a week.”
And this is the main obstacle preventing further progress: these schemes rely heavily on local governments, which have tight budgets.
The government has committed to reforming the social care system alongside new plans for the NHS, and local authorities say extra funding could hold the key to making more hospital beds available.
Lung cancer screening vehicle
National Health Service
Mobile lung cancer screening trucks are testing people in supermarkets, sports centres and football stadiums.
Invitations will be sent to local people identified as most at risk, primarily smokers and ex-smokers aged 55 to 74.
People will have a lung health check and if there are any concerns they can get a scan on the spot or at their local hospital.
Lord Darge warned that the high death rate from cancer was a major concern.
Catching cancer early, at stages 1 and 2, makes it easier to treat and increases the chances of survival.
The track identified more than 3,000 cases of lung cancer, three-quarters of which were stage 1 and stage 2. Some people were also diagnosed with respiratory diseases.
The initiative started in Manchester and Liverpool but has been gradually rolled out to other parts of the country over the past five years.
This is just one of many ways cancer tests are being developed.
As the age at which people are screened for colorectal cancer has been lowered, screening for colorectal cancer is now available to an increasingly large number of people.
Dance and Art Prescription
The NHS isn’t just there for people with health needs, it’s also a support for people struggling with other elements of their lives.
Walk into any GP practice and, alongside people with illnesses and conditions, you will encounter many people seeking help for the consequences of wider social issues such as debt, stress, loneliness and lack of exercise.
In fact, it is estimated that around one in five general practitioner consultations are for non-medical issues.
To help solve this problem, the NHS is investing in social prescriptions, where patients are referred to activities and supports such as volunteering, arts, gardening, making friends, walking schemes and dance classes.
This type of “social prescribing” not only helps people with non-medical problems, but also benefits those with chronic conditions such as mental illness, diabetes and heart disease.
The British Association of General Practitioners has described social prescriptions as a “vital lifeline” for patients, particularly as the cost of living continues to rise, and think tank King’s Fund has previously said there is evidence that social prescriptions can have a “range of positive outcomes for health and wellbeing”.
The concept was promoted in the 2019 NHS Long Term Plan, which led to investment in link workers to help GPs co-ordinate access to activities and services provided by local authorities, community and the voluntary sector.
