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Tackling Andrew Lansley's £100 Billion Pound Shortfall

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Originally posted on HaCIRIC website: 23 June 2011 by James Barlow

In the next 10 years the UK must spend perhaps £1.0-£1.5 trillion on health and social care - just to stand still. If we want to deal with aging and create a truly world class care system, it will cost at least £2 trillion. The future looks even bleaker in the longer term. In 20 years, according to Andrew Lansley, real terms health spending could more than double to £230 billion a year, if things carry on unchanged. That's more than £100 billion a year on top of today's already large NHS bill.

So we must think far more radically in all these areas. But this is generally in silos and the links between them are poor. Architects are often unaware of the potential impact of new technologies. Meanwhile, health service and management researchers overlook how buildings influence what can and can't be done. Health technology researchers tend to miss wider organisational or service delivery issues.

This is where HaCIRIC comes in. We sort out this disconnected thinking. And, in our second phase, the Centre is focusing on some big questions around innovation. We are studying how to reconfigure the way services, infrastructure and technology fit together so that the location of care can be shifted. We seek affordable solutions, including disruptive innovations or 'reverse' innovations from health systems outside the developed world. We want to assure change is sustainable by exploring how to design innovations so they can be scaled-up from the outset.

The need for this work is clear. Innovation may be the answer to the problems of healthcare. However, so far, we have not got that answer right. In fact, innovations are often part of the problem. For a start, they generally increase costs, partly because they allow more people or problems to be treated. And healthcare suffers from all the issues that typically trouble complex systems, such as the non-linear and often counter-intuitive behaviour it displays.

Second, in the UK, the overwhelming focus of policy and public support is on the development of new technologies. There is far too little attention devoted to their adoption. So there are big problems around spreading and sustaining innovation in the NHS.

It is clear, therefore, that all of HaCIRIC's skills and knowledge will be needed to help tackle the £100 billion a year problem that Andrew Lansley has identified. Calling form more innovation is not enough anymore. At HaCIRIC, we are trying to make sure that it is affordable, scalable and adoptable.

I have suggested that the UK has a £2 trillion healthcare challenge for the next decade. If HaCIRIC can help to deliver just 10 per cent of that challenge we will have made a serious impact.

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