The NHS has extraordinary hidden potential

By Tom Bulford Mar 19, 2013

Tom Bulford

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Last week, I went down to the Innovations in Healthcare show at London’s Excel Centre. I subjected myself to some standard medical tests. My body mass index is 23.6kg/m2, my pulse is 97 per minute (a little high, I fear), and my flow mediated dilation score (a measure of the elasticity of my arteries) is 6.9.

But aside from offering a free health check, this exhibition gave some useful insights into the future of healthcare.

The pioneering UK health industry

A glittering cast of speakers included Health Minister Jeremy Hunt, Sir Mark Walport, who is to be the government’s new chief scientific advisor, Lord Darzi, the head of surgery at Imperial College and Sir John Bell, who founded the Wellcome Trust Centre for Human Genetics. They were bullish about the UK health industry, which has a proud history.

In 1928, the Scottish bacteriologist Sir Alexander Fleming discovered penicillin. In 1953, Francis Crick and James Watson of Cambridge University were the first to describe the structure of the DNA molecule. The Sanger Centre is a leader in gene sequencing. We also have the NHS, which we should see as an asset rather than a liability, explained the speakers.

To understand why, listen to James Heywood, co-founder of PatientsLikeMe, a site on which anyone can chat about their health with others of similar experience. Instead of relying on medical theory, Heywood believes that the best way to judge medicine is to see what works. That means asking other patients.

Despite this rather obvious insight, there has been little attempt to measure outcomes. For this to be possible we need access to patients’ records, but these have been written on paper with different files for primary care, secondary care and for old-age homes.

It beggars belief that the NHS still does not have fully digitised patient records, but that is the situation and Hunt has now set a deadline of 2018 to change this.


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Two advantages of a digital patient database

This will bring two important advantages. First it will make patient records available to anyone who has a smartphone and an internet connection. Nurses will no longer have to gather armfuls of files before visiting patients. Whether you are at home, in hospital or travelling in a foreign country, the doctor can access your full medical history.

But the second benefit of paperless patient records is that they become a digital database. This can then be used to check outcomes and search for other factors, physical or otherwise, that might have affected the success of treatment.

Because of its long history, and because of is uniquely large and varied list of patients, the NHS gives us a real advantage over other countries, and its patient records should be a highly valuable database.

Some other themes emerged from the event. One was the importance of managing ‘wellness’ as well as ‘illness.’ Dr Brigitte Piniewski from Peace Laboratories, Canada, said that the majority of young Americans are "profoundly unwell", due to a poor diet and a lazy lifestyle.

The health service, though, does not move into action until somebody becomes ill, when treatment costs can be high. This point was echoed by Sir Mark Walport, who said that we should "focus on health as well as disease".

Prevention is better than the cure

Diagnostics is another strong theme. The tests that I was able to take are designed to tell me whether I am likely to get ill. The AngioDefender, which measured the elasticity of my blood vessels, gives an early warning of cardiovascular disease.

Another product on show was the Peptest which can quickly identify the presence of pepsin, associated with cystic fibrosis and sinusitis. Prevention is not only better than cure, but it saves money for the Health Service.

Finally, many of the exhibitors were involved with telehealth. This involves self-monitoring medical devices allied to wireless communication that can allow us to monitor our condition from home, and send information to a remote location where it is monitored by experts.

There’s special equipment to monitor your blood pressure or blood glucose levels. Not only can this spot potential health problems, but it also takes the pressure off GPs' surgeries.

In future, then, we will be encouraged to participate. We will be asked to stay fit and monitor our health. And with the data that we provide into this interactive ecosystem, medical experts will be better able to devise the best treatment.

• This article is taken from Tom Bulford's free twice-weekly small-cap investment email The Penny Sleuth. Sign up to The Penny Sleuth here.

Information in Penny Sleuth is for general information only and is not intended to be relied upon by individual readers in making (or not making) specific investment decisions. Penny Sleuth is an unregulated product published by Fleet Street Publications Ltd.

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  • 1. Susan Reed

    (19 March 2013, 05:34PM)  Complain about this comment

    After an extremely traumatic stay in NHS hospital for surgery to remove a growth I am pleased to hear some positive steps are being taken to improve the System ( it hardly merits being called a Service )

    I am now starting a campaign called Lets Cancel "cancer"' and we start with abolishing our own fears. asyou pointed out we must focus on a healthy lifestyle continuously. In China it used to be that you only paid your doctor as long as he kept you well.

    Keeping well starts with a positive and healthy mental attitude healthy in mind healthy in body. More government concentration on removing the stress factors in our modern society that lead to obesity, and diseases of anger such as arthritis and "cancer" will cut the costs of the NHS Substantially. Prevention is always better than cure.Please everyone get on board the campaign for a better life. You can contact me through my website MagicMyWorld.com.

  • 2. Nacho

    (19 March 2013, 05:47PM)  Complain about this comment

    “We also have the NHS, which we should see as an asset rather than a liability, explained the speakers.”

    “Because of its long history, and because of is uniquely large and varied list of patients, the NHS gives us a real advantage over other countries, and its patient records should be a highly valuable database. “

    This is the kind of positive thinking that we need. Utilising our assets and developing our potential intelligently is surely key to the UK’s development and prosperity. The amount we spend/ cut, which there seems to be a lot of focus on, are surely only means to this end and not ends in themselves.

  • 3. S Griffiths

    (19 March 2013, 06:04PM)  Complain about this comment

    With respect to James Heywood's assertion that 'the best way to judge medicine is to see what works. That means asking other patients'... I beg to differ!

    Placebo effect is real and considerable. The individual in not in a position to know how their experience of a therapy sits in the wider scheme of things. Randomised, blinded controlled trials are the most effective way devised yet of evaluating healthcare interventions. New cancer drugs are evaluated on hundreds of new patients and cost-efficacy, tolerability, and the health services' ability to deliver the therapy all have to be taken into account. With all due respect, taking into account patients' subjective experiences in an online chatroom seems unwise. Science is evidence based not opinion based.

  • 4. S Griffiths

    (19 March 2013, 06:14PM)  Complain about this comment

    Secondly, the NHS only spends less than a quarter of 1% of it's budget on prevention...that's all breast, cervical and prostate cancer screening, and anti-obesity, smoking and alcohol campaigns. If anything they are scaling back prevention. Breast cancer screening is under review. It's an enormous blind spot. But creating healthier citizens goes beyond lifestyle...limiting working weeks, creating genuine prosperity, ensuring that modern life is as stress free as possible. Mental health is an enormous drain on the NHS. But whilst the government colludes with banks to push people into lifetime debt it's hard to see people giving up their vices.

  • 5. Michael

    (19 March 2013, 06:49PM)  Complain about this comment

    Tom, I thought you were being sarcastic about the digital patient database! Surely, you know the history on this?! It will never happen by 2018, I promise. It will take longer than that just to persuade patients to give their consent. Very naive, very expensive and following the recent reforms, very much more difficult....I have just re-read the article and you suggest doctors could access our records when we're "travelling in a foreign country". Do you have any experience of public sector IT procurement?! Best wishes.

  • 6. David Evans

    (19 March 2013, 09:20PM)  Complain about this comment

    This optimistic article quite cheered me, I have never had anyone before suggest a use for computerising patient health records, even noting Michael's comment above there might be benefit one day from all the expense.

    Also your corrspondent who thought it a change from the doom and gloom views he thinks predominate on these websites, the quote from the 1970's he is looking for is from Jim Slater I think; he advised wise investors to go and '...... buy gold, canned food and a gun'. Not yet that bad here, but Cyprus, Beppo's Italy?

  • 7. An Encephalic

    (19 March 2013, 11:44PM)  Complain about this comment

    I would suggest a frontal lobotomy. Helpful advice can be found by talking to fellow patients who also suggest Bank of Cyprus for all your banking requirements.

  • 8. John C

    (20 March 2013, 10:57AM)  Complain about this comment

    Historical patient records will never be fully digitised because most of the old manual GP records are either about minor, now- irrelevant problems or are inadequate or illegible.

    A more important point is privacy and security. Records may be lost on memory sticks, hacked into and sold by NHS staff - not to mention access by the security services. Knowledge can be a bad thing in the wrong hands.

  • 9. Mike T

    (20 March 2013, 10:58AM)  Complain about this comment

    Has any other health system (Canada, maybe? Denmark?) been fully digitised? If so, do the results support this optimism? Same for preventative technology - has it been tested elsewhere and is there any data? Otherwise, it is interesting to read something that questions the usual pessimism

  • 10. Stephen Watson

    (20 March 2013, 02:23PM)  Complain about this comment

    I read this with a sense of deja vue, having spent much of the last twenty years working on health databases and telemedicine within the NHS. In fact, one of my telemedicine systems won a prestigious innovation award, following which our IT management closed down the project - you see, it had started before the then managers had joined the organisation so they couldn't take credit for it. Besides, if undermined their strategy which was to award hugely expensive contracts to do the same thing that we'd done on a shoestring. (Of course, their programme collapsed and they moved on to do the same thing elsewhere).

    But what really stuffed NHS IT was the Labour govenment's National Program for IT (NPfIT) which blighted all the local initiatives before itself being cancelled by the incoming coalition. Well, if your idea of IT development is to give loads of money to large corporations without really knowing what you want, that's what happens.

  • 11. Stephen Watson

    (20 March 2013, 02:23PM)  Complain about this comment

    There is one hugely successful IT system in the world - and that's the internet. It got that way because nobody owns it - it's based on open, non-proprietary standards. And that's the only way that the government can ever make NHS IT work. Set open standards and then let a combination of innovative small firms and dedicated NHS teams work together. Absolutely no national programmes, no grand strategies and no large centrally negotiated contracts. Get quality developers working with top clinicians, redefine mangers as administrative assistants, stand back and watch excellence happen.

    Of course, that will never be allowed....

  • 12. Tom O'Neill

    (20 March 2013, 03:22PM)  Complain about this comment

    All efforts at digitisation of patient records will be stymied by a) patients' scepticism at the uses to which they might be put, b) by the Data Protection Act and c) by the general lethargy and inefficiency of those who manage the NHS and operate its data systems.

    And in case you think that's a cynical view, on the contrary, I've put it very mildly.

  • 13. BrianT

    (20 March 2013, 05:28PM)  Complain about this comment

    "my pulse is 97 per minute "

    Do you have atrial fibrillation? If so then no real problem. If not you should find out why.

    BTW if you discover you do have AF don't let them give you rat poison (aka Warfarin). It almost did for Ariel Sharon and it's probably done for a fair few fit, active and otherwise healthy 50 and 60 year-olds.

  • 14. Daisy

    (20 March 2013, 10:21PM)  Complain about this comment

    Agree with previous comments re: patient consent. Do we really wish to move away from secure and confidential information? I also agree with comments 1 & 4 re reducing stress and improving well being. A living wage for shorter hours, lower cost of living and less debt. More time to exercise, relax and care for self and others. Why should the health and well being of the majority suffer to benefit the few? I know I am an idealist, but it would reduce the cost of the NHS and ensure it is a service availalbe to all.

  • 15. Romford Dave

    (21 March 2013, 03:36PM)  Complain about this comment

    Most stress is self induced.

    A living wage for one person is basic rations for another, yet such a sum can still manage to represent a kings ransom in some parts.

    The cure for most stress is to look inwards and change your outlook.

    No amount of digitisation, research or placebo swallowing will change the attitude of some towards their own well being, even if the NHS budget was doubled and we all worked a three day week.

    Copius amounts of diet coke doesn't equate to a healthy diet, yet it's popularity amongst those whose BMI wouldn't see a sub 25 even if their limbs were forcibly removed, is there to be seen on both sides of the Atlantic.

    Our own mortality makes us suckers for any get well scheme, just as our greed preoccupies the thoughts of the Charles Ponzi's of this world.

    Maybe this latest wheeze is the next best thing, but I wouldn't hold your breathe...!

  • 16. Boris MacDonut

    (23 March 2013, 05:02PM)  Complain about this comment

    When I had pneumonia I endured a few days at her Majesty's pleasure with the NHS. What an awful experience.What an overstaffed and badly run place. If the NHS was a private business it would get massive deductions for capital allowances, not for the machines that go ping, but the whole blooming show. The definition of plant and machinery involves the subjection of goods to a process and I vouch that every patient that strays through its doors feel like goods . The process is everything to the NHS.

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