It’s all we have

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There is an excoriating piece in American Spectator… 

‘Britain Holds Another Baby Hostage.’

It’s about Alfie Evans and draws upon the desperate tale of Charlie Gard.  Broadly, the author challenges the rightness of the NHS going to court to decide the fate of a child, over the rights of parents.

‘… the police are standing guard outside Alfie’s room so the child’s parents cannot take him to another hospital. Alfie’s captors, the administrators of Alder Hey Children’s Hospital…’ 

A sorry spectacle.

The law and healthcare… a toxic mix that drags us into moral and ethical dilemma, few of us have a tip-of-the-tongue response for.

Should parents of these very sick children have the final say?  Ecclesiastes 9:4;

Where there is life there is hope…. seems a good place to set anchor.

If our care system is patient focussed, puts patients at the centre of every thing we do and makes no decision about them, without them… we have to listen.  Properly listen.  Listening when we hear what we want to hear, listen when it’s not difficult…. doesn’t count.

At the heart of this dilemma… disruptive innovation and our complete inability to cope with it.  

New treatments that disrupt the way we do things.  Ashya King’s parents, were thrown into jail because they wanted to try a therapy we, at the time, didn’t have.  Their lad survived, recovered and is doing well.

The establishment points out how risky and tricky it all is.  As an alternative to ‘Your child is going to die, get over it‘… I might go for risky and tricky.

Real innovation is challenging, disruptive, not for the faint hearted and yes, risky and tricky.  The NHS has no stomach for it.  

Innovation that isn’t risky or tricky isn’t innovation.  It’s merely process variation.

If there’s an example, for all patients, it has to be the impact the dial-a-doc-App, Babylon is having.  So far, over eight thousand people have said, ‘Yes, I’ll have some of that’.  

It is innovative.  Sent shockwaves through primary care.  It’s disruptive for GPs but for thousands of commuters, a god-send.

The establishment response?  A spurious collection of stories borrowed from the anti-Uber Red-Tops and the Amazon, armageddon playbook.  

NHSE, CQC, BMA all piling in to say how risky and tricky it is.  As a commuter faced with relentlessly long days and a surgery that is closed when I leave the house and closed when I get home… give me risky and tricky.  I’ll have a go.

Babylon say;

  • 94% of people rate the service 4 or the full 5 stars.  
  • People usually see a GP within two hours, 24/7.  
  • Every AI triage is recorded, for audit and ongoing improvement.  
  • Thirty six percent of appointments take place outside GP opening hours.  
  • Babylon clinicians (95%) say they can manage their workload well. 

I’m not so sure many GP practices can match all that?

No patients are excluded.  91yrs the oldest and asthma by far the most ‘popular’ group.  

Does Babylon pinch all the lucrative patients? 

Practice funding is a complicated business.  The Carr Hill formula doesn’t make it any easier but here is a factoid I wasn’t aware of; in terms of the ‘global sum’ GPs expect £69 for a woman 15-44yrs and £155 for the same woman at 65…. £213 at 85+. 

If innovation is defeated by money, we have change how we pay the money.  If innovation is defeated by the courts, we have to think about changing the law.

In Australia The My Emergency Dr app is a 24-hours-a-day medical service that connects patients anywhere in Australia to Specialist Emergency Doctors via a video link on your smartphone. 

Wacky always wins in the end.  If it seems strange now, risky and tricky, in five years time it’ll be routine.  

Proton Beam therapy is well on the way to being normal, consulting a doctor on the screen is an idea that simply won’t go away. 

We have to stop pretending we do innovation.  We don’t we hate it.  It’s disruptive, painful, uncomfortable, disagreeable, destabilising and difficult to get our heads around.  

… but in terms of survival, for the next 70yrs… it’s all we have. 

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.