Future Hospital and the ‘buck stops here’ culture

After reading report after report detailing crisis after crisis throughout the NHS in the recent past, it is refreshing to see the latest forward-thinking report ‘Future hospital: Caring for medical patients’ by The Royal College of Physicians (RCP) on the future design of hospital care. Though I fear this report will not get enough political and NHS support and funding from the appropriate sources to get it to the implementation stage, I am keen to see the response from the Department of Health and various NHS bodies. The report involves a significant amount of change management so it is absolutely vital that it has support and commitment from the grass roots to make it a reality.

The report places a considerable focus on the importance of patient involvement in their care and consequently in the design of IT systems to support them, it states that patients should be “fully engaged in the design and implementation of electronic health record systems and other digital health tools”. I welcome this key recommedation in encouraging patients to contribute to their own care and provide feedback to enhance their experience.

The ‘buck stops here’ approach for senior clinicians is also refreshingly bold. I sincerely hope the senior clinical community approves of this bold reform approach as it is absolutely essential that the clinical community is appropriately supported with both finance and other resources as they bring about this change.

The report not only sets a broader vision for hospital services structured around the needs of the patient, now and in the future, it also made 50 specific recommendations on how to get there. However, I am slightly disappointed that there are no clear timeframes. My hope is that the government will use this opportunity to set the expectations as to when the recommendations should be implemented and achieved, meanwhile showing their commitment by re-purposing the current NHS reform agenda.

Though the report talks about the future hospital, it comprehensively defines the new model of clinical care and boldly extends its reach through the integrated services of primary care, social services and mental health services with clinical care coordination at acute care hub level and the coordinated community services.

This holistic thinking of care coordination approach necessitates the need for comprehensive access to information, without it care coordination will be near impossible. One of the specific recommendations in the report is the appointment of a chief clinical information officer at the board level. This kind of board level empowerment and the need for information at the centre of this approach strengthens the case for innovation in IT systems.

As the RCP acknowledges itself “this report will not sit on a shelf; it wil continue to be at the top of the RCP’s agenda into 2014 and well beyond”, which therefore presents a great opportunity for innovation and the future of technology providers.