Dr Mahmood Adil looks at the move from quantity to quality of services and talks about how value-based healthcare will be the key focus in the future.
To me the economic downturn is an opportunity not a threat. The NHS has been through a number of different eras since its inception. We have moved from quantity (access/waiting list) to quality in this journey so far. In particular, over the past decade it’s been mostly about quality and clinical effectiveness – but the next 30 to 40 years will be about value. ‘Value’ in healthcare is defined as ‘patient outcomes (not outputs) relative to inputs/cost i.e. patient outcomes/£ spent’. Since value is defined as outcomes relative to costs, cost reduction without maintaining or improving outcomes may lead to false savings and potentially to the detriment of effective care.
Financial challenges in the NHS have created an unexpected opportunity for clinical and finance colleagues to develop effective partnerships and co-create value in our health system. Value-based healthcare bridges the cost and quality chasm and motivate clinicians and finance managers to be the key partners to achieve the best outcomes with the same or less inputs. Therefore, clinical and finance engagement is an area very close to my heart.
Yet, in order to seize this opportunity, we need to have the right knowledge and tools – rather than just the passion! Both professional groups are data/evidence savvy and therefore tools which could measure and show variation in cost and quality data may provide common ground and a shared desire to work towards a common goal i.e. to create the best value for our patients in the NHS.
I often see that the dedicated efforts of many organisations do not bring fruits. This is because these professional groups either don’t have the opportunity to share their ideas or are unable to access the right tools to collect and analyse cost and quality data in order to understand the root cause of variable and costly care, leaving them unable to find a solution together.
Have you used any such tools which have helped clinicians and finance managers to work together effectively to co-create value? If so, it would be great to hear about your experiences and ideas in this regard.
Dr Mahmood Adil