The NHS has a secret weapon. Why doesn't it use it?

Why is no-one talking about predictive care?

Two different but related stories on the NHS have emerged recently: Chris Smyth in the Times (paywall) reported  on £300m of ostensibly wasted funds from a set of tests focussed on over-40s, which operated in direct conflict with the "best available evidence." In other news, the Daily Telegraph (paywall) reported on a "time-bomb," anticipating that three in four adults will suffer from chronic disease by 2030, stressing the NHS’s ability to cope with patients as it continues to be challenged by budget constraints and a dearth of medical practitioners and support staff.

In the wake of the NHS’ recent 65th birthday, and radical recent structural reform, dealing with both of these issues form part of the broader challenge that must be met to ensure the long-term sustainability of the NHS. The organisation has to deal with severe budget constraints, and insufficient staff, and yet continues to be a jewel in the crown; one of the world’s largest employers and fulfilling the remarkable accomplishment of delivering near universal healthcare in England. An entirely different approach to healthcare is needed to ensure the NHS remains fit for purpose into the future.

What both the Telegraph and Times reports point to are issues that ultimately could be mitigated through better use of information.

In the case of the expensive and unnecessary tests the Times reports on, trials are already underway to deliver "stratified medicine" into the UK –  matching treatment with a patient’s genetic markers to assess not just the tests required, but the treatment options that will deliver the swiftest route to recovery and ultimately, improved survivability. This is already proving that we can  eliminate the need for "unnecessary" tests. The key here is that illness can be dealt with before it manifests into symptoms, at far reduced costs. After all, using a DNA test to prescribe the correct chemotherapy drugs for skin cancer raises the rate of effectiveness from 10 per cent to 70 per cent creating a significant saving in later treatments, hospital and in-home care.

Key to dealing with the staff shortages that the Telegraph writes on is shifting the overall paradigm for healthcare to one that no longer expends 70 per cent of NHS budgets on chronic disease care, dealing with illnesses including cancer, diabetes, breathing conditions and heart disease. Stratified healthcare can clearly play a role here, drawing on patient, environmental, social and genetic data to deliver the best treatment. In addition, increasingly popular advances in "body data" technology including everything from Nike’s Fuelband through to sophisticated wireless sensors deliver an opportunity to the medical profession: the correlation, analysis and interpretation of telehealth, telemetry and genomic data to treat disease pre-emptively. For example; an anomalous heart beat within someone that has a specific genetic and weight profile might be cause for pre-emptive medical intervention (avoiding emergency by-pass surgery in someone who is extremely overweight, for example); for the same symptoms in someone who had a fitter profile, it might be ignored, limiting the risk of "false positives." Similarly, this sensor data could have a dramatic impact in reducing the number of emergency hospital readmissions (that is, people who had to come back to hospital through A&E after being discharged) – of which there were 650,000 in 2010/11, a rate which has been climbing for a decade.

This transformation will need to happen in stages: the NHS will need to continue to make progress in digitising the way healthcare is managed in the UK and there will need to be better and more widespread data sharing between medical authorities, academic institutions and research organisations. Crucially, great care and thought will need to go into securing the privacy of individual health data even as it is used as a resource to provide better healthcare for others.

However – the prize – a significant reduction in the £80bn spent in chronic disease care, and a potentially dramatically improved quality of life for citizens – is one that must be sought after. And doubtless we may still face up to wasted tests or stretched wards – but hopefully this will become the exception, rather than the rule, and the NHS will endure to celebrate its centenary and beyond.

Illness can be dealt with before it manifests into symptoms, at far reduced costs. Photograph: Getty Images

James Petter is the Vice President & Managing Director of EMC, UK & Ireland

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Jeremy Corbyn challenged by Labour MPs to sack Ken Livingstone from defence review

Former mayor of London criticised at PLP meeting over comments on 7 July bombings. 

After Jeremy Corbyn's decision to give Labour MPs a free vote over air strikes in Syria, tonight's Parliamentary Labour Party (PLP) meeting was less fractious than it could have been. But one grandee was still moved to declare that the "ferocity" of the attacks on the leader made it the most "uplifting" he had attended.

Margaret Beckett, the former foreign secretary, told the meeting: "We cannot unite the party if the leader's office is determined to divide us." Several MPs said afterwards that many of those who shared Corbyn's opposition to air strikes believed he had mishandled the process by appealing to MPs over the heads of the shadow cabinet and then to members. David Winnick declared that those who favoured military action faced a "shakedown" and deselection by Momentum activists. "It is completely unacceptable. They are a party within a party," he said of the Corbyn-aligned group. The "huge applause" for Hilary Benn, who favours intervention, far outweighed that for the leader, I'm told. 

There was also loud agreement when Jack Dromey condemned Ken Livingstone for blaming Tony Blair's invasion of Iraq for the 7 July 2005 bombings. Along with Angela Smith MP, Dromey demanded that Livingstone be sacked as the co-chair of Labour's defence review. Significantly, Benn said aftewards that he agreed with every word Dromey had said. Corbyn's office has previously said that it is up to the NEC, not the leader, whether the former London mayor holds the position. In reference to 7 July, an aide repeated Corbyn's statement that he preferred to "remember the brilliant words Ken used after 7/7". 

As on previous occasions, MPs complained that the leader failed to answer the questions that were put to him. A shadow minister told me that he "dodged" one on whether he believed the UK should end air strikes against Isis in Iraq. In reference to Syria, a Corbyn aide said afterwards that "There was significant support for the leader. There was a wide debate, with people speaking on both sides of the arguments." After David Cameron's decision to call a vote on air strikes for Wednesday, leaving only a day for debate, the number of Labour MPs backing intervention is likely to fall. One shadow minister told me that as few as 40-50 may back the government, though most expect the total to be closer to the original figure of 99. 

At the end of another remarkable day in Labour's history, a Corbyn aide concluded: "It was always going to be a bumpy ride when you have a leader who was elected by a large number outside parliament but whose support in the PLP is quite limited. There are a small number who find it hard to come to terms with that result."

George Eaton is political editor of the New Statesman.