John Appleby: the NHS productivity challenge

We need to stop concetrating on supply side issues which usually focus on the centralised repair shops aka hospitals.

We should go hell for leather to transfer care into people's homes thus shifting the cost of accomodation and 24 hr staffing onto the patient and their kin folk.

The capital cost and fixed cost savings at the hospital will more than compensate the additional cost in primary care. In reality hospitals will shrink in bed numbers. Oddly enough the citizenry say they want to be treated at home if at all possible. Sounds like a win win to me!

To achive this level of shift we will need to use technology e.g. body worn monitors and AAL equipment etc.

Fortunately the tech cupboard is full of kit we can use and rely on from a safety / efficacy point of view. The only problem we have is lack of experience in using the technology - too many people of a certain age are in charge of the system may be?

Money saved can be reinvested into demand reduction facilities. Stopping and or delaying people getting sick or acquiring long term conditions is the only show in town in my opinion if we want:

A. Happy healthy citizens who can enjoy an active health ageing process and work for longer.

B. Reduce the size of the Health and Social care realestate and if we are really lucky the H&S care labour force.

In the US, the 2000s marked the first citywide bankruptcy in our nation (i.e., Detroit in Michigan) and the world saw the first nation bankruptcy in Greece. We support your initiatives on responsible cost improvement targets, investment funding, and income generating activities in a broad sense. Look forward to working with you in the 2014-2015 period on the use of health care financing in the community.