The future shape of global healthcare provision is a major issue that we all need to grapple with. Its importance is highlighted by the depth of divisions when health care reform becomes the centre of political focus.
Obama-care currently divides a nation and was one of the key differentiators between the presidential candidates in the USA. The future of the Health and Social Care Act is a political minefield in the UK as successive governments have tried to reform the NHS and met with mixed success. Meanwhile China is facing the complexities of increasing healthcare provision, while tackling issues of access. For those of us involved in finding solutions to global health care challenges, it is all too easy to get bound up in the technocratic details of policy and implementation. However we need to get back to first principles and be clear about priorities. At the top of my list is that the most valuable asset in any health service is its staff - its people.
In Value Walks, a report on healthcare across the globe, KPMG estimates that in developed countries, health systems may be facing a workforce shortage of over 20% by 2022, as populations age, patient demand increases and the health workforce shrinks because of retirement. Some people say that "cost walks on two legs", but this is a negative, damaging and short-term view. In fact value walks on two legs. This report takes this idea forward by highlighting five approaches that successful organisations have adopted to create a value synergy in which staff productivity improves, work attractiveness increases, and professional motivation blossoms.
Buurtzorg, an aged care provider in the Netherlands, is an interesting example of an organisation taking a strategic view of health provision. The Buurtzorg team placed more power in the hands of well trained nurses, encouraged the use of the latest techniques, and let them organise care and place the patient at the centre of their efforts. These moves have dramatically increased productivity while improving clinical effectiveness and morale.
When managing a healthcare provider real differences to the quality and cost of patient care result from the design of the clinical care process, the degree of innovation in the business model and the motivation of staff. Working with trade unions and professional bodies can further enable organisations to take a strategic view of their collective position. Having spent 20 years working for the NHS in the UK, I truly believe that successful healthcare organisations are those that have a strategic and long-term focus on patient value; consciously empower healthcare professionals and give them greater autonomy; systematically apply leading-edge business and care process redesign methods; improve clinical and management information so it is routinely used in day to day activities; and have unambiguous staff performance management and accountability frameworks.
People are the beating heart of healthcare provision. Patient value is created by dedicated staff caring for patients. To address the potential workforce shortage we must empower staff, motivate healthcare teams and care for those who care for us.
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