Connected technologies can help shift the emphasis from sick care to predictive care.
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Technology can help build a healthy future

Neil Mesher, CEO of Philips Health Care UK and Ireland, says connected health care will transform our lives. 

To gain deeper insight into the perceptions of the people working at the core of health-care systems – patients and health-care professionals (HCPs) – Philips recently commissioned an international study that explores how countries around the world are positioned to meet long-term global health challenges through integration and connected-care technologies. The resulting Future Health Index (FHI) aims to examine how “connected care” could help address the global health challenge.

Drawing on data from 13 countries, more than 2,600 HCPs and over 25,000 patients, the report created a league table of preparedness to achieve a sustainable integrated health system through connected care. The UK’s position is ninth out of 13. While we rank highly for access to health care, we fall down in the adoption of integrated health care. People feel that the patient experience could be improved, as could health-care outcomes, and that patients could take more responsibility for their health. So, how can “connected care” address the UK’s key health challenges?

I spend a great deal of time inside the walls of the National Health Service and there are three areas where I believe connected technologies can help the NHS address UK health challenges and make the NHS sustainable for the future.

Homecare: Resources need to be shifted to help people take control of their health and stay healthy at home.

In the FHI, 29 per cent of patients said that keeping track of health indicators and symptoms would make them more effective in managing their health, and nearly a quarter of HCPs agreed (24 per cent). This capability and technology, to help people change their lives for the better, and reduce the pressures on the NHS by empowering patients to manage their own health and chronic conditions at home better, exists now. In a three-year study conducted by Liverpool Clinical Commissioning Group in partnership with Philips, supported self-care was shown to reduce emergency admissions by 22-32 per cent for patients with above-average risk. Over 90 per cent of patients also reported feeling more in control of their condition. Providing people with the technology and knowledge to manage their conditions better could significantly reduce pressure on acute care, an NHS priority.

Rapid response: Connected technologies can help detect complications in a patient’s condition faster, potentially leading to improved patient outcomes as well as time and cost efficiencies. For example, the early detection and escalation of clinically unwell ward patients is important for reducing unanticipated critical-care unit admissions. Philips recently completed a pilot study of our Early Warning Scoring system to evaluate its ability to support clinicians by spotting patient deteriorations quickly and automatically sending clinical notifications to Rapid Response Teams, with positive results.

Enabling the adoption of change: The technology and solutions already exist to support the shift from sick care to predictive care, but our systems need to be integrated if the UK is to enjoy a healthier future. The UK is low on uptake of innovation, but the good news is that the government recognises this and is working with industry to update health systems in the Accelerated Access Review (which aims to speed up access to innovative drugs, devices and diagnostics for NHS patients).

We are living in one of the most exciting times in health-care history. I believe that, by bringing together proven medical practice and emerging connected technologies, we can address today’s health-care challenges and shift from a society in which we merely care for the sick to one where technology helps people take control of their health.

Photo: Getty
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Scotland's vast deficit remains an obstacle to independence

Though the country's financial position has improved, independence would still risk severe austerity. 

For the SNP, the annual Scottish public spending figures bring good and bad news. The good news, such as it is, is that Scotland's deficit fell by £1.3bn in 2016/17. The bad news is that it remains £13.3bn or 8.3 per cent of GDP – three times the UK figure of 2.4 per cent (£46.2bn) and vastly higher than the white paper's worst case scenario of £5.5bn. 

These figures, it's important to note, include Scotland's geographic share of North Sea oil and gas revenue. The "oil bonus" that the SNP once boasted of has withered since the collapse in commodity prices. Though revenue rose from £56m the previous year to £208m, this remains a fraction of the £8bn recorded in 2011/12. Total public sector revenue was £312 per person below the UK average, while expenditure was £1,437 higher. Though the SNP is playing down the figures as "a snapshot", the white paper unambiguously stated: "GERS [Government Expenditure and Revenue Scotland] is the authoritative publication on Scotland’s public finances". 

As before, Nicola Sturgeon has warned of the threat posed by Brexit to the Scottish economy. But the country's black hole means the risks of independence remain immense. As a new state, Scotland would be forced to pay a premium on its debt, resulting in an even greater fiscal gap. Were it to use the pound without permission, with no independent central bank and no lender of last resort, borrowing costs would rise still further. To offset a Greek-style crisis, Scotland would be forced to impose dramatic austerity. 

Sturgeon is undoubtedly right to warn of the risks of Brexit (particularly of the "hard" variety). But for a large number of Scots, this is merely cause to avoid the added turmoil of independence. Though eventual EU membership would benefit Scotland, its UK trade is worth four times as much as that with Europe. 

Of course, for a true nationalist, economics is irrelevant. Independence is a good in itself and sovereignty always trumps prosperity (a point on which Scottish nationalists align with English Brexiteers). But if Scotland is to ever depart the UK, the SNP will need to win over pragmatists, too. In that quest, Scotland's deficit remains a vast obstacle. 

George Eaton is political editor of the New Statesman.