12 Mar 2019
Could digital innovation save the NHS?
The future of the NHS relies on it embracing technology and the transformative impact that can bring. But how can old meet new within the scope of the current NHS system? Lantum CEO Melissa Morris may have a prescription for success.
When I decided I wanted to start a healthcare business, people told me I was mad. I was working in the NHS as an external consultant and everyone – work colleagues, NHS staff, friends in the pub – said much the same. The NHS is set in its ways, they told me, it never changes. It wouldn’t work, it couldn’t work.
There’s this perception that the NHS loathes change – and that change, when it comes, arrives as a one-size-fits-all Whitehall decree designed more for political than practical purposes. But that’s not really true. I know because during my time as an external consultant I gained a very high-level view of the way the NHS works. I knew I wanted to figure out ways to make it work better – and that if I was going to improve it I should work for the NHS.
So, that’s what I did, joining in 2010 as a strategy analyst for NHS London, the capital’s strategic health authority at that time. What turned out to be my most formative experience was seeing the National Programme for IT (NPfIT) being wound up. This was the project that was designed to finally bring the NHS into the digital age. Instead it was an expensive and wasteful failure. Its chief legacy was that the NHS became even more risk averse than it already was.
The NHS is by nature wary of risk – and quite rightly so given it’s in the business of saving lives. If you take reckless decisions in the NHS, doctors can lose their jobs, politicians can lose elections, patients can even lose their lives. It means the fear of negative outcomes outweighs the potential for the best results.
And that encapsulates the problem. So, when the NHS does innovate, it’s often done in a piecemeal way or by biting off way more than it can chew, building a behemoth and assuming it’ll work. The NHS simply doesn’t have the capabilities to build things itself in an agile and lean way. That’s one thing I learned from witnessing the end of NPfIT. The other was how much waste there was on that project – money and time. It created a shockwave that stopped people from wanting to take such a bold approach again. It was a very public failure and there was a lot of blame to go around.
The NHS England Innovation Accelerator has created lots of very effective pilots. Three years since its foundation, it has supported 37 different ideas. Between them, they have raised £40m of funding, created 114 new jobs and won 29 awards.
It’s not that the NHS can never change, but that it needs to draw on creative thinking at a grassroots level. The NHS England Innovation Accelerator (NIA), which has supported my company Lantum, is a perfect example of what we should be doing. This incubates and helps to finance small tech-based healthcare start-ups. Under the NIA’s auspices, entrepreneurs have the freedom and incentive to trial projects in lower-risk environments – a handful of GP practices and hospital departments rather than nationwide. If it fails, the downside is limited. If it goes well, they get paid on the upside.
What’s more, these NIA start-ups are all heavily vetted by NHS England. That’s an invaluable stamp of approval because it’s very difficult for anyone in the NHS to purchase a new technology if they don’t know if it’s any good or not. This approach has created lots of very effective pilots.
Three years since its foundation, the NIA has supported 37 different ideas. Between them, according to figures in The Times, they have raised £40m of funding, created 114 new jobs and won 29 awards. However, the NHS is not so good at seeing these pilots through to scale. The NIA lacks the funds and organisational clout to make this a standard way of sending new ideas out into the NHS. Pilots will be run in really small pockets and data on their performance is patchy – either it’s not collected properly or it’s not disseminated effectively.
If the data was properly tracked and stored somewhere, then it could deliver the message that this project is a go, that one is a no-go. There’s lots of great stuff happening but there’s just no formalised process to scale up innovation.
That’s where we are at the moment. And an example of that situation is my own company. The NHS spends around £3.5bn on recruitment agencies – money that leaves the NHS. Everysingle month GPs and hospitals go through the same process of entering their rostering into Excel, printing it out on paper, people penning the differences, putting it back into Excel, emailing it to the doctors and nurses. Then they may not reply, so you have to ring them…
I decided I could redesign the process. That’s when I came up with Network Locum, which is what my company was called when we first started. It provided a software tool to help hospitals find doctors, nurses, pharmacists, anaesthetists – whoever they needed to fill shifts. We created a sort of marketplace where if you needed extra cover for your shift you could go on Network Locum and find high-quality cover, without giving a penny to the middle men of a recruitment agency.
Far from us being backdoor privatisation, we’re effectively protecting the NHS from privatisation. We’re selling the NHS software tools so it can provide better services itself, rather than rely on private companies to provide those services.
But we were only solving part of the problem, not the full issue. The company has evolved since then. We now work more in workforce management. The idea is to empower the NHS to better connect with its own staff first. So, in addition to the rostering, we do communications with freelancers’ lists, automatic invoicing, diary planning, tax returns, payroll – you name it. Last year we changed the name to Lantum to reflect what we are, which is an end-to-end software provider.
There’s a bit of a phobia about private companies working for the NHS. But Lantum is a software provider – and the NHS isn’t good at building its own software, any more than it would be at manufacturing its own computers or developing its own drugs. Far from us being backdoor privatisation, we’re effectively protecting the NHS from privatisation. We’re selling the NHS software tools so it can provide better services itself, rather than rely on private companies to provide those services.
An out-of-hours service run by GPs is unlikely to have the tools or infrastructure to match large corporations. With our software, they can connect with staff more efficiently, reduce their spend on agencies and provide services better and more efficiently.
We currently have a client base of around 1,000 GP practices, but only 13 hospitals. If our software was used throughout the NHS we could save this national treasure around £1bn a year. Far from being a threat to the NHS, digital innovation could be its saviour.
Melissa Morris is the CEO and founder of Lantum, and a Fellow at NHS Innovation Accelerator. Beginning her career in financial services, she joined US management consultant specialist McKinsey before going on to work for NHS London, the former strategic health authority for the capital.