A question of being awash with inspectors evaluating data collected?

20 May 2015

By Kevin Hardy and Valentina Gottardo

Valentina Gottardo: Tim Kelsey began his professional journey as an investigative journalist with the Independent, The Sunday Times and the BBC which lead to him becoming an advocate for a popular knowledge revolution in the UK public sector. Like many people, his dedication to unpacking the complexity and inherent need for change and innovation in Health was through unplanned circumstances which touched him at an human level.

To illustrate his message for radical change, Kelsey invited the audience to consider global change and modernisation referencing the average life span in Japan. 2000 years ago the average person lived to be 36.4 years. In 2015, this is estimated to hit the age of 90.

Kelsey makes the point that as populations continue to grow, collecting and analysing patient information is paramount to sustaining effective health care. Revision and analysis of information is equally important in the move to intelligent transparency. Kelsey believes that there is a moral, commercial and social imperative to create and maintain transparency, in turn fostering a culture of safety through openness.

The question is, how does one promote this need for transparency? Kelsey suggests that Australia look to the hospitals already publishing their outcomes. There’s no doubt that the data encourages public debate, which in turn will improve the safety of our systems.

The NHS has made major strides in achieving transparency and Kelsey believes that the biggest hurdle was deciding that medical data belongs to the individual not the system. Having acknowledged ownership, the issue was to get approval from individuals to share their data.

Kelsey is encouraging of organisations to feel empowered by the ease of information sharing and recognising that accurate, free flowing data makes for a successful system e.g. To date, through the implementation of the NHS Choices website, 98% of general practices have been able to offer their patients control of their own medical records.

Kelsey is passionate about the need to remain relevant and believes that through data transparency, healthcare will stay in front of the growing demands of the population taking us into an age of integrity and autonomy.

“In God we trust, for everything else we need the data.” – W. Edwards Deming

Kevin Hardy: Having just returned from the UK where I met with about 30 executives in the NHS including several Trust CEOs, it is apparent that the system of service delivery and inspections are out of balance. In addition, and even more impactful is the sense of frustration and drop in morale.

The collection and use of data is critical. So is the ability to analyse and evaluate the data in the context of health service operations. The question has to be asked if this is political derriere and the seizing of the opportunity by the central agencies to micro manage the hell out of the system? No one wants another Mid Staff. But surely the point is to get the balance right between responsible oversight and performance assessment and patient safety and the delivery of quality services for those we are here to serve and save? Data is essential for decision making. Data that disappears into an abyss has no value.

The NHS is awash with inspectors and monitors who roam the country in whole battalions and there is serious questioning going on about the capacity of these people to understand and evaluate the data generated let alone the time that is taken up servicing these agencies. God forbid if this happens in Australia and New Zealand!

The end result of this is a flow on effect. As the cost of running the ‘Centre’ increases so do the costs to providers in terms of staffing, recruitment, meetings, inspections, rehearsals, consultants, paperwork, data collection and analysis. It is estimated that the cost to the system is an extra £1billion pa. This does not include the cost of losing highly experienced leaders and clinicians to other systems globally and the consequent loss of corporate, system and clinical knowledge and expertise. This cost is huge!

The lessons for me are that you have to get a balance between oversight and performance accountability and that the relationship between the central agencies and the providers has to be on an ethical and responsible footing where they work together, use data and evidence well, provide excellent care and save lives. The key point is working together to solve problems and achieve high performance standards and morale.