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.
4. E-commerce
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.
Follow Rachel Carrell on Twitter: www.twitter.com/RachCarrell
Tried-And-Tested Wellbeing Treatment Of The Week: A Power Plates Workout
Harvard Quiz: Test Your Ability To Recognise Emotions In Eyes (PICTURES)
Kaleo Diet: Why Weight Gain Can Be Good For Your Body (VIDEO/PICTURES)
Watchdog Bans 'Misleading' Listerine Mouthwash Dental Health Advert
Beta Blockers Could Boost Effect Of Chemotherapy, Study Suggests
I fully accept that professional, leading retail organisations, like supermarket chains, are miles away from the blinkered snail pace NHS. But the underlying problem with the NHS, (and other public bodies), is both the (poor) quality of the senior management, (when was the last time you heard of an FTSE 100 company headhunting an NHS or Local Authority CEO), and the constant meddling of politicians for the sake of headlines. That won't change, anytime soon.
If you don't get the top sorted, then all the trendy initiatives in the world won't change a thing.
Reading between the lines of the above article it is easy to see how the NHS could follow the retail example without compromising it's status.
Consultants are predominantly 9 - 5 workers, often only working part time for the NHS. Evening and weekends are covered by overworked and often under experienced junior doctors!
Expensive operating theatres are under utilised during evenings, nights and weekends.
A perfectly good source of dedicated nurses, SENs and RGNs was abandoned for Degree qualified career nurses, a fair percentage of whom have no experience of, or interest in daily patient care.
In the main GPs are just part time medical centres and whose services are almost impossible to obtain when required. Out of hours services being provided by Primary Care Trusts who often have limited access to patients notes.
All of the above, seem more interested in compiling statistics rather than providing the primary care patients require!
My late wife was student nurse, staff nurse, sister, nurse manager and GP practice manager during her career, but the system let her down badly when she needed it!
I feel so frustrated at having to put a stamp on a letter, to return my sorn form which should be done online without any cost at all to anyone. Plus there are 1.000s of other things the government could do online without any cost to either us or them, and they would save the government agents 100s of 1.000s of pounds a year, but these ideas aren’t for free from me.
Telephone is answered on third ring :-
"Mumbai NHS how can i be helping you today sir ?
" I need a doctor quick"
" I am sorry to tell you that there will be a nine month wait and the statisticals say that you are more likely to be having a Boy "
" NO, a Dock - tor "
"sorry i am sending you to a colleague because i am not understanding you"
Phone is answered on second ring :-
" hello this is sanjay speaking, i am understanding that you want to upgrade your Sky package"....
Newspaper stories of pensioners dying of starvation and neglect in NHS hospitals are not exaggerated. Whatever you do, do not get old and make sure you have a family to come and visit you when you end up in hospital, that way you can be sure to be looked after and your needs attended to.
and a technological, revolution. What if the interweb could be allied to bio-sensors. Couldn’t assistance be computerized, with a 24/7 optimized “expert” (the sum total of the best of the best knowledge) system?
“fashion retailers are a byword for”
the emperor’s outfitters? But enough about the power of placebos.
“Getting diagnosed and treated is not like buying a packet of crisps.”
As there’s usually far more in the former than the latter.
“Retailers know that customers want”
a little subtle psychology. Although whining can be perfectly fine, lifting spirits is definitely frowned upon.
“little is automated”
outside the carousel of the pharmacological lobbying industry.
“the phone always gets answered before the third ring”
if you’re a potential new customer. Yet hardly ever, if you’re an existing customer complaining.
“British retail is now reinventing itself”
So an in-store booth that scans a subject’s signs, and sends them on for analysis, isn’t beyond the bounds of rocket science fiction then?
Also, I'm not sure where you get the idea that the NHS is "a bottomless pit for wasting money" when it consistently scores as one of the most efficient health services in the world.
You know what you get when you add a "retail" element to a healthcare system? The US healthcare system. Nobody wants that.
Essentially, half your article is things the NHS are already doing (do you really think they don't see the value of better customer service? Do you really think they aren't running online awareness campaigns?), and half of it is wishful thinking nonsense. Considering that most people use the same password for their bank account as for Farmville, it would be an insanely bad idea to make medical records available online, unless you want scammers to know exactly when you last visited a doctor and what for.
Leave the retail model to retail, where it works. Get all the consultants and private companies out of the NHS.