A long time ago, in a land not very far away, you couldn't shop after 6 pm, nor at all on Sundays. When you did make it into the shop, you had to ask the grocer for what you wanted and wait for him to hand it to you. The selection was slim, and cost a large part of the weekly wage.
British retail has come a long way since then. Today, supermarkets import a dazzling array of produce from all corners of the earth, at prices 1950s housewives couldn't imagine. Meanwhile metropolitan luxury retailers attract destination shoppers from half a world away, and our fast fashion retailers are a byword for urban cool.
What's more, without leaving my sofa I can now check my bank balance, order my groceries and send a birthday present to my sister in New Zealand.
But some things I still can't do. For example, I can't email my GP. I can't see my personal health records online. I can't order a postal STI test from my local NHS. I can't Skype my obstetrician to get my test results. And sometimes it seems easier to get hold of sold-out Glastonbury tickets than to get an appointment at my GP surgery.
It's as if Britain's retail revolution passed our healthcare system by completely.
Of course, healthcare services are complicated. Getting diagnosed and treated is not like buying a packet of crisps. But we shouldn't let the complexity of healthcare stop us from asking how we could do it better, from streamlining it, or from taking inspiration from other industries.
Here are four things the NHS could learn from British retailers:
1. Segmentation of the front end
Retailers know that customers want different brands, store formats, and sales channels. They know that different lives have different rhythms and need different ways of buying at different times. That's why we have restaurants, cafes, take-aways, ready meals, and street food, in countless variations.
In healthcare, on the other hand, there's often a single option for all comers. A local hospital. A sexual health clinic. A GP surgery open 9-6 pm on weekdays. Take it or leave it. Many people 'leave it' - which in the long run often turns out to be bad for their health and everyone else's wallet.
Healthcare traditionalists often point out that great care is available, if only people would make more effort to go and get it - at a time and place suiting the provider, of course.
Retailers would never say that. Retailers know that people aren't stupid but they are easily distracted. Retailers know their job is to make it really, really, really easy to be served.
2. Industrialisation of the back end
The most successful British retailers work with large-scale, efficient suppliers, driving down their own costs and passing (most of) this saving on to customers.
In contrast, much of the NHS is sub-scale cottage industry, especially in primary care. Aside from a few bold pioneers, little is automated. Patients who need a diagnosis are processed in the same way as patients who already have a diagnosis.
There is tremendous scope for increasing efficiency, allowing more people to be diagnosed and treated at lower cost while improving the journey for those who already know what they need.
3. Customer service
This builds on the previous lesson. If the NHS saved more from industrialising the 'back end', more could be spent on personalised attention and great customer service.
In the best of British retailers, the phone always gets answered before the third ring.
British retail is now reinventing itself again, this time online. The NHS should take up the baton. For example, public health campaigns can be highly effective online. Dr Thom, a provider to the NHS (full disclosure - I am the CEO) has managed to bring down the cost of diagnosing HIV patients from up to £19,000 per positive patient to under £300, using careful online targeting and home testing by post.
That means that many more people can be diagnosed with HIV early on, saving years of their lives and reducing the chance they might unwittingly infect others.
There are some truly excellent healthcare providers out there doing all of this already: segmenting to reflect patient preferences, industrialising where possible, tailoring services to individual patients, and experimenting online. But not nearly enough of them. It all needs to become standard. (More platforms for innovators, such as the Women of the Future awards in association with Shell, would help spread the good ideas.)
In short: there needs to be a healthcare retail revolution.
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