Time to act 'out of the box' not just think



In a recent report the World Economic Forum states that there are 6 key issues facing global healthcare for 2022.

  1. Health equity

  2. Environmental resilience

  3. Mental Health

  4. Digital transformation

  5. Medical science advancements

  6. Reimagining of Public Health

You don't have to be a futurist to pick out these priorities as the pandemic has signposted them very clearly. None of these are likely to be solved in a year but we can establish solid foundations for the future and make headway in these areas.


For me it is about questioning some of the problem solving and risk aversion we see related to these big challenges and asking tough questions about how we tackle them in the future.

  1. Health Inequality is a massive challenge for our NHS. You do not have to be a scientist to understand the direct correlation between poverty and health inequality. Where you find fuel poverty, poor housing, unemployment, low income, poor educational attainment, you will find health inequality. The reality is that care is more expensive to deliver in these areas and life expectancy and quality of life is markedly lower too. The challenge for strategic planners is 'has the universal service approach failed to deliver?' and if so, are integrated care systems the answer and how exactly will they address inequity. Time to think outside the box?

  2. Environmental Resilience is an ongoing challenge that faces every healthcare provider but when you throw into the mix escalating energy charges, the high cost of sustainable energy and the related environmental pressures of getting that off the ground it really isn't straightforward. The will and the ethical justification is there but in a cash strapped NHS it is difficult to see how they will achieve their energy targets when the service is under such demand pressures. It is time to examine the small stuff. If you want to make savings in the long term then you redevelop the operating infrastructure (can take up to 5 years). If you want to make quick savings (to give you a fighting fund) then look at the small stuff, the habits and norms in an organisation and make changes there. Not sexy but very effective is creative ways to reduce waste or changing to local suppliers where possible to reduce the length (and emissions) of the supply chain. Time to act outside the box?

  3. Mental health has been the poor relation for years the NHS with a 'breadcrumbs off the table' approach to funding in many areas. That is changing now but it is the attitudes and stereotyping that also need to be challenged. The Nations mental health has taken a beating during the pandemic and easy access services like talking therapies were already under pressure. It is recognised that early diagnosis and access to low level treatments/therapies can slow the deterioration of some mental health conditions yet in some areas waiting lists have grown to 12 months before someone can be seen. This may be an area where personalised budgets should be explored. There are a wealth of qualified, private practitioners who are in a great position to help with talking therapies if people had the funds to access them. Time to act outside the box?

  4. Digital transformation is the most hopeful of all of these priories. Famously, we saw the NHS adopt 5 years of digital developments in 9 months during the pandemic and we must guard against losing that momentum. The reality is that if the service is ever going to catch up with the backlog it currently faces and manage a general increase in demand, then it has to look to technology to do that. The service has to face the undeniable truth that the lack of progress in this area does not lie in available technology (or even money) but in the cultural resistance of some of its staff and patients. Integrated care records were first trialed in 1997 and we are still not able to boast universal coverage of this foundation stone of digital transformation. Definitely time to ACT out of the box!

  5. Medical Science advancements is not just about new treatments, earlier diagnosis and wearable technology. A big part of this is the empowerment of patients to take responsibility for their health and wellbeing and co design healthcare solutions. A key element of this is developing health consumerism in the NHS (a public service). Making terms like this distinct from the age old fears around privatisation are critical if we are to understand the psychology of patients and how they want to be involved/shape the care they receive. The more we know and understand about conditions and the earlier we can educate people about prevention. This way we stand a real chance of reducing demand on the system to achieve the ultimate goal of being a health service rather than a sickness service. Time to think outside of the box.

  6. Reimagining of Public Health is a little trickier. Over the last decade it has undergone a range of makeovers and when the pandemic struck, it was left wanting (to a degree). The things that people thought it would and should deliver were sometimes at odds with each other and it was swamped with expectations it simply could not deliver. For me, this is an area where we really do need to go back to the drawing board and be crystal clear about its remit, its scope, its authority and its agency. Public Health practice operates on the core principles of equity, fairness and inclusiveness, empowerment, effectiveness and evidence-based practice, but the pandemic has also required them to focus on protection and safety of the population. For this service to be truly effective it needs clarity around the outcomes it wants to achieve and the financial support to achieve that. My question is "Is Public Health so important to our population that should be completely independent and free of political influence?" Time to really think outside the box!

I am a futurist without a crystal ball. I ask the questions that challenge the status quo and hopefully get decision makers and strategic planners to think outside the box but if we are to truly learn and move on from the last two years we need to ACT differently. That will require courage and the ability to inspire followership. One thing is for sure, if we continue to let the box we are in define us then we will do what we have always done and we will get what we have always got!

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