[0:00]Hello, good afternoon, everyone, and welcome to the future of healthcare. My name is Matt Mcland and I'm a managing director at EY and it's a real pleasure to welcome you here this afternoon. We've got a fantastic turnout, a wonderful audience, some great speakers lined up and an opportunity for us to share some insight, some thinking and some debate around some of the challenges and opportunities that we're facing across the healthcare sector, across the UK. We're going to try and cover three themes this afternoon. The first is around how we recover, how we reform and how we rebuild our healthcare system post pandemic and thinking about the longer term transformation that's needed to deliver that. The second is thinking about the potential for technology and innovation to transform the way that we deliver care and thinking about some of the amazing things that are happening to to help us to do that. And thirdly, how we deliver that for citizens, for patients, for people up and down the country, thinking about health inequalities, thinking about prevention and how we create a healthier society and a healthier population. So we're going to cover all of those things over the course of the next hour and a half and we're going to touch on a few things that I think are relevant to the times that we're living in, an election year coming up. We're going to hear a lot about the NHS. We're going to hear a lot about healthcare and hopefully we can contribute to the debate and the discussion that's already underway. So, just briefly on on how we're going to cover all of these things. We're going to kick off with a with a keynote speech from from Dr. Vin Daga, who's the chief executive of the NHS Confederation. Then we'll have a panel discussion with some amazing guests from from NHS England, from Kings College Hospital and from health tech not just for the for the UK but globally. Then we'll have a bit of a discussion, a fireside chat with an entrepreneur who's really transforming the way that we think about care through the use of technology. And then we'll have a chance for for Q&A from all of you in the audience and then we'll be heading for some drinks and canopies and an opportunity for us to network. And for those of you who want to stick around later, we're going to have a little bit of a private round table discussion with some of our guests and some of our clients around some of the key themes that we're covering. So without further ado, I'd really like to welcome our first speaker, Dr. Vin Daga. Vin, please come up.
[3:07]Good afternoon, everybody. It's a real pleasure to be here. Thank you so much for the invitation and it's a pleasure to speak after after Matt's introduction. Um I'm very excited about what we're going to discuss today. We, as Matt says, we have an important election coming up and it feels like for the first time in a very long time. We actually have a bit of a competition in the political sphere to talk about the NHS. Um if you think back to the last few elections, you know, we had Brexit, we had various other things, but this election I think is going to be about the economy and it's going to be about public services and the NHS is going to feature very, very highly. And my sense of what politicians are saying and what people on the ground are feeling is that they want to know how are we going to fix it. And I think that's why this conference and these discussions are so important, because there's a real appetite out there to actually have a proper discussion and move beyond what is, you know, often can be quite, um, political footballing of the NHS. So let me give you some kind of thoughts from my perspective, and I'm coming to you from the NHS Confederation, which is the membership body for health leaders in England, Wales and Northern Ireland. So my membership ranges from acute hospitals, mental health trusts, community trusts, primary care, general practice, right the way through to the new integrated care systems and indeed the arm's length bodies as well. And I'm going to really give you a very quick sense of what I think the current state of play is, but also where I think we should be going. So I think we often like to say the NHS is on its knees. It's in crisis and it's always going to be in crisis and it's always on its knees. And I think it's important to reflect that actually healthcare systems are complex and if you think about how we deliver healthcare. In a modern environment, it requires a significant amount of coordination, a significant amount of expertise and a significant amount of money. And the NHS is actually very, very successful at what it does. And what I mean by that is it treats over a million people every 36 hours. You know, it's something that we should be proud of. But the challenge really comes from the fact that it is a system that is constantly having to change, constantly having to reform and constantly having to adapt. And what we're finding at the moment is that because of the challenges that we face, which I'll come on to. It means that the system is not able to respond in the way that it wants to and in the way that the public wants it to. So what are the challenges? Well, the first is obviously our finances. We're in an incredibly challenging financial position at the moment, partly because of inflation, partly because of the rising cost of living, which means that wages are going up. It means that the cost of medicines, the cost of technology, the cost of everything is going up. And actually, if you look at the NHS budget in real terms, it's actually been cut. So that's a real challenge. The second is our workforce. We have over 120,000 vacancies in the NHS. That's one in ten posts that are unfilled and actually if you think about it in primary care and general practice, it's one in four posts that are unfilled. And that's a real challenge, because without the workforce, we can't deliver the care that we need to. The third is obviously the demand for services. We have an aging population. We have an increasing prevalence of long term conditions. And we have a population that is actually becoming sicker and sicker, partly because of the pandemic, partly because of the cost of living crisis and partly because of health inequalities. So the demand for services is just going up and up and up and we're struggling to meet that. And the fourth is obviously the backlog that we face from the pandemic. We have over 7 million people on waiting lists for elective care. And that's just for planned care. If you think about the unplanned care, the emergency care, the ambulances, the A&E departments. They're all under significant pressure, and that's partly because of the demand that's coming through. So those are the challenges. But I think it's important to say that we have an opportunity to actually reform the NHS and to actually make it fit for the 21st century. And I think that's where the discussion today is so important. And I'm going to really focus on three things that I think we need to do. The first is around prevention. We need to shift the focus from treating illness to preventing illness. And that means investing in public health, investing in health inequalities, investing in healthy lifestyles, investing in all of the things that actually keep us well. And that's a long term game, but it's a game that we have to play, because if we don't, then we're just going to be constantly chasing our tails. The second is around technology and innovation. We have some amazing technology out there that can help us to deliver care in a much more efficient and effective way. And that means using AI, using digital, using all of the things that are available to us to actually transform the way that we deliver care. And I think that's a real opportunity for us to leapfrog some of the challenges that we face and actually to deliver a truly 21st century health service. And the third is around our workforce. We need to invest in our workforce. We need to recruit more people, we need to retain more people, and we need to train more people. And that means thinking about how we attract people into the NHS, how we make it an attractive place to work, how we make it a place where people want to stay. And how we make sure that we have the right skills mix to deliver the care that we need to. And I think those three things, prevention, technology and workforce, are going to be absolutely critical to the future of the NHS. And I think that's where the discussion today is going to be so important, because we're going to hear from some amazing people who are doing some amazing things in all of those areas. So I'm really looking forward to the discussion and I'm really looking forward to hearing from all of you.
[11:42]Thank you very much. Thank you, Vin. Thank you very much for that. Um some really great insights and I think some really important challenges that we're facing as a sector. And I think the point that you made about how we shift the focus from illness to prevention is absolutely key. And I think that's something that we're going to hear a lot about today. So without further ado, I'd like to welcome our panel to the stage. We have Professor Sir Stephen Powis, who's the National Medical Director of NHS England. We have Professor Clive Kay, who's the chief executive of Kings College Hospital NHS Foundation Trust. And we have Dr. Claire Novotny, who's the co-founder and chief medical officer of Ada Health. So please welcome our panel. Thank you.
[12:51]So, Stephen, if I can start with you. Um you've heard Vin's remarks. You've heard about some of the challenges that we're facing. Um from your perspective, what are the key priorities for NHS England over the next 12 to 18 months? Thanks, Matt. And it's a real pleasure to be here. Um and great to be part of this discussion. I think Vin set out really clearly the challenges facing the NHS, and I agree with him about the opportunities. I think the NHS is an amazing organization, and it's constantly innovating and constantly changing. And I think what we've seen over the last few years, particularly through the pandemic, is that ability to adapt and to respond. So what are the priorities for NHS England? I think the first is around recovering services. We have a significant backlog as Vin mentioned, over 7 million people on waiting lists. We need to address that, and we need to address that quickly, and we need to address that in a way that is equitable. And that means focusing on those who have been waiting the longest, and those who have the greatest clinical need. The second is around workforce. Vin also mentioned this, and it's absolutely critical. We cannot deliver the services that we need to without the workforce. So we need to recruit more people, we need to retain more people, and we need to train more people. And that means looking at how we make the NHS an attractive place to work, how we support our staff, how we make sure that they have the right skills. And that means looking at new roles, new ways of working, and how we empower our staff to deliver the best possible care. The third is around prevention and health inequalities. Again, Vin mentioned this, and it's absolutely fundamental. We need to shift the focus from treating illness to preventing illness, and that means investing in public health, investing in healthy lifestyles, investing in all of the things that actually keep us well. And that means working with our partners across local government, across the voluntary sector, to deliver that. And the fourth is around technology and innovation. We have some amazing technology out there that can help us to deliver care in a much more efficient and effective way. And that means using AI, using digital, using all of the things that are available to us to actually transform the way that we deliver care. And that means supporting innovation, supporting research, and making sure that we're always at the cutting edge of what's possible. So those are the four key priorities for NHS England over the next 12 to 18 months. And I think they're all interconnected, and they all rely on each other to deliver the best possible care for our patients. Thank you, Stephen. That's really helpful. Um Clive, if I can turn to you now. Um you're leading one of the largest and busiest trusts in the country. Um what are the immediate challenges that you're facing on the ground, and how are you addressing those? Thanks, Matt. And it's a real pleasure to be here. Um and great to be part of this discussion. I think Vin and Stephen have set out really clearly the challenges facing the NHS at a national level. And I think at a local level, we're seeing all of those challenges amplified. So what are the immediate challenges? I think the first is around workforce. We have significant vacancies across our trust, and that's across all staff groups, so nurses, doctors, allied health professionals. And that's a real challenge, because without the workforce, we can't deliver the care that we need to. And that's particularly acute in some of our specialist areas, so critical care, emergency departments. So how are we addressing that? We're focusing on recruitment, we're focusing on retention, and we're focusing on training. So we're working with universities to increase the number of training places, we're working with international recruitment agencies to bring in staff from overseas. And we're also focusing on making sure that our staff feel valued and supported, and that they have the right development opportunities. The second is around demand for services. We're seeing unprecedented demand for our services, particularly in our emergency department. And that's partly because of the aging population, partly because of the increasing prevalence of long term conditions, and partly because of the backlog from the pandemic. So how are we addressing that? We're working with our partners across primary care, across community services, to try and manage that demand. So we're trying to shift care out of the hospital and into the community, and we're trying to prevent people from needing to come into hospital in the first place. And that means investing in primary care, investing in community services, and investing in prevention. The third is around finances. We're operating in a very challenging financial environment. And that means we have to be very careful with our resources, and we have to make sure that we're delivering value for money. So how are we addressing that? We're focusing on efficiency, we're focusing on productivity, and we're focusing on innovation. So we're looking at new ways of working, new technologies, and how we can deliver care in a more efficient and effective way. And the fourth is around quality and safety. We have to make sure that we're delivering high quality, safe care to our patients. And that means investing in training, investing in equipment, and investing in our staff. And that means making sure that we have a culture of continuous improvement, and that we're always learning from our mistakes. So those are the immediate challenges, and how we're addressing them. And I think it's important to say that we're working very closely with our partners across the integrated care system to deliver this. Thank you, Clive. That's really helpful to hear about the challenges on the ground. Um Claire, if I can turn to you now. Um you're at the forefront of health tech and innovation. Um what do you see as the biggest opportunities for technology to transform healthcare? Thanks, Matt. And it's a real pleasure to be here. Um and great to be part of this discussion. I think Vin, Stephen and Clive have set out really clearly the challenges facing the NHS, and I think technology has a massive role to play in addressing those. So what do I see as the biggest opportunities? I think the first is around prevention. We can use technology to empower individuals to take more control of their own health, and to prevent illness in the first place. And that means using wearables, using apps, using AI to provide personalized health advice, to monitor conditions, to predict risk. And that means shifting the focus from treating illness to preventing illness. The second is around access to care. We can use technology to improve access to care, particularly for those in rural areas, or those who have difficulty accessing traditional services. And that means using telemedicine, using virtual consultations, using remote monitoring. And that means making care more convenient, more accessible, and more equitable. The third is around efficiency and productivity. We can use technology to make the NHS more efficient and more productive. And that means automating tasks, using AI to support clinical decision making, using digital tools to streamline processes. And that means freeing up staff time to focus on what matters most, which is patient care. And the fourth is around personalized care. We can use technology to deliver more personalized care, tailored to the individual needs of each patient. And that means using genomics, using precision medicine, using AI to analyze data and to provide personalized treatment plans. And that means delivering more effective, more targeted, and more compassionate care. So those are the biggest opportunities for technology to transform healthcare. And I think it's important to say that we're only just scratching the surface of what's possible.
[24:34]Thank you, Claire. That's really exciting to hear about the potential for technology. Um I think one of the challenges that we often face is how we scale these innovations across the NHS. Um Stephen, if I can come back to you. How do we ensure that these innovations are adopted and scaled across the NHS? Thanks, Matt. And it's a really important question, because we have a lot of great innovation happening in pockets across the NHS. But the challenge is how do we spread that and how do we scale that across the entire system. I think there are a few things that we need to do. The first is around creating the right environment. So that means creating a culture of innovation, a culture where people are encouraged to try new things, to experiment, to learn from their mistakes. And that means supporting leaders to champion innovation, and to create the space for it to happen. The second is around providing the right infrastructure. So that means investing in digital infrastructure, investing in data, investing in all of the things that enable innovation to happen. And that means making sure that we have interoperable systems, that we have data that can be shared, and that we have the right cybersecurity in place. The third is around providing the right incentives. So that means rewarding innovation, rewarding people who are trying new things, and rewarding those who are demonstrating impact. And that means looking at our commissioning models, looking at our payment models, and how we can align those to support innovation. And the fourth is around building the right partnerships. So that means working with industry, working with academia, working with other sectors. To bring in new ideas, new technologies, and new ways of working. And that means creating platforms for collaboration, creating opportunities for people to come together and to share their learning. So those are some of the things that we need to do to ensure that these innovations are adopted and scaled across the NHS. And I think it's a really exciting time for innovation in the NHS, and I'm optimistic that we can achieve this.
