The Biggest Wins In The NHS Are Cheap! - Chewing It Over with Luke Kellaway

ultimately MSK is obviously in the context of the healthcare spend is vast.

I think it accounts for 25% of GP appointments, a third of all surgical spend.

I think I'm right in saying it's an annual spend of about 6 billion for the NHS, let alone the cost of the lost days of working, which I think is in the 25 million days lost.

And so I guess ultimately the context of a small two to three million pound spend that can knock off 20% of waiting lists, et cetera, et cetera, is obviously bang for buck.

When you compare it against things like AVT, so the ambient voice technology, that are looking to save, there's a brilliant pilot that suggests that savings of around 834 million can be achieved by deploying AVT across the NHS.

What we don't see in that is that that sounds great as a figure, obviously huge, But with reducing or making clinics run more efficiently, what do the clinicians do with the extra time? They see more patients, which is an extra tariff spend.

So you actually don't save the money.

achieving efficiencies with technology, you often spend more money because there is an unlimited waiting list.

If you think about the waiting list as it currently stands, that is for people who ultimately have gone into a formal healthcare pathway.

And how many of those people are there out there that have decided that they just won't, whether that is in the private sector or whether that is just complete negativity around trying to go into formal care because they don't feel like they'll get what they want.

I guess when I see things that are effective, that are low cost in the grand scheme of things and have huge kind of positive outcomes, particularly in a field that obviously is close to my heart, I kind of like it miffs me off a little bit.

And that's something that I think physiotherapy in itself, needs to kind of grasp and shout a little bit more about.

But I also think it's kind of the underutilized profession within the NHS that could offer so much more than it is doing at the moment.

And then for fear of sounding like I'm kind of on one, The GERF piece also had a massive mental health aspect to it as well.

And ultimately, MSK and mental health are two of the largest spends across the NHS.

And so if you've got a low-cost initiative that is creating massive impact, surely you want to not just limit that community waiting list, you want to move that into seeing whether that could have larger impacts in another waiting list.

So, you know, the piece that I wrote was about a specific pilot, but I think it is a common thread that we're seeing across the NHS and probably not just limited to uh the health sector um it's you know is what we're seeing across the country in different sectors but um but yeah i think there obviously is um there is strategy that could be deployed that could help with those even just asking at the start of a pilot what happens if it's successful um is is you know uh you know um that's a flippant comment and it probably is asked but um uh you kind of you kind of hope that if you're asking that question it's like well if it's a massive success and we chop off 20 of a waiting list then we're going to explore how we can push that far and wide but

um i'm close enough to some of it to know that they definitely will you That's the question.

But the problem that they have is that I think really some of these pilots should be conditional on appropriate support if it meets a certain threshold.

And especially with something like this, it was known from its early origins that that was successful and would seem unlikely that the particular pilot geographic context was going to radically change those.

It was hopeful that it would replicate.

So in doing so, some of the pilots could well have been, you would think, and again, in business terms, you would say, what are the conditions for this to be translated? And also what would then be the support and spend associated to them? And if then the answer came back at pennies on the pound, it'd be like, well, no, because you wouldn't set yourself up for that.

However, because of the nature of the internal mechanics of it within an NHS pilot, especially from what isn't supplementary technologies using third parties, it became then something that like, we'll stretch whatever we need to as a means of translating whatever we can.

And I understand that instinct, but it's just that I think that's one of the reasons it happens.

And I definitely want to, in this chat, get into some of those details because I think they're interesting.