Some of the greatest healthcare innovations in New York occurred during the Great Recession. And that’s why the director of New York State’s $54bn Medicaid programme is urging the NHS to innovate at all costs.
Money. There is never enough in healthcare. Funding shortfalls often cause people to believe that innovation and better outcomes are not possible. Any reasonable assessment would say that the National Health Service is underfunded. Underfunding causes stress on all system elements. Patients have to wait and providers feel overwhelmed. Innovation is often at the bottom of a long list of priorities.
My challenge to all who care about the NHS is to innovate – even in the face of funding challenges. The patients you care for need you to solider on. In New York, some of our greatest innovations came during a funding crisis. We actually used the funding crisis caused by the Great Recession to drive vested interests off the status quo and embrace change. I am convinced this can be done in the NHS.
Innovation must include a serious effort to address the social determinants of health. All countries are starting to realise that healthcare challenges are often driven by broader societal problems. This fact creates a unique opportunity for cross-system collaboration in which people in health, social care, education, criminal justice and other sectors work together to achieve better outcomes in multiple systems. I challenge the NHS to lead this effort and invite the other sectors to join in collaborative efforts.
I also suggest that providers across the system deploy rapid cycle continuous improvement as a tool for driving innovation at the point of care. No process is ever completely efficient. This is especially the case in processes that involve multiple organisations. Look closely at those processes and explore ways to both improve outcomes and lower costs. Many process improvements cost nothing and such efforts have proven highly successful in New York.
New York stands ready to partner. We have much to learn from each other. I am often surprised by how little we share across national borders relative to healthcare innovation. We must increase our sharing and look to replicate successes in other countries. I am especially excited to see the outcomes from devolved regions like Manchester, as well as the various vanguard projects. I suspect they will shine a bright light on new care models that work for patients and lower total cost of care.
Money can’t stand in the way of better healthcare. It is easier to say than to do. That said, we have no other choice. Millions of our fellow citizens in England and New York are relying on us. We can’t let them down even when money is a challenge. Don’t ever let a lack of funds prevent you from innovating to improve health.
Jason Helgerson is New York State’s Medicaid director. Follow him on Twitter @policywonk1
Learning from Medicaid: Jason Helgerson podcast
Listen to our new podcast to hear Jason Helgerson outline how New York's Medicaid programme worked against a challenging financial climate to deliver cost-effective, integrated healthcare to the population of New York State.
This is the first in a new series of podcasts focusing on what the NHS can learn from international healthcare systems.
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