News / HFMA FT conference: Britnell calls for sustainability focus

The NHS needs to start thinking over three to five years and across health economies to ensure the system is sustainable, KPMG's Global Health Practice chairman Mark Britnell told the HFMA FT conference.

Former foundation trust chief executive Mr Britnell said that a survey of chief executives across industry revealed that they were 'more concerned with today than tomorrow'. 'Transaction trumps transformation,' he said. 'And in healthcare, we are even more obsessed with today.'

He added that most healthcare leaders accepted that their own sectors needed substantial change, but felt their own organisation's plans were robust. 'Most health systems are digging deeper holes away from the sustainability of those systems,' he said. At a recent international gathering at health leaders, 75% of participants believed integration would reduce costs and 90% thought it would improve outcomes. 'But how many are integrated? Who will take the first step?' he challenged.

Mr Britnell highlighted five trends across international health systems. Payers are becoming more activist and some hospitals are transforming into whole health systems. Patients are becoming active system partners. High growth systems are providing new perspectives on reform. And there is a trend towards innovative integration and partnership.

He said that health systems needed to focus on need and where their costs were arising. For example, referring to work at Kaiser Permanente in the US, he said that 1%, 5% and 10% of population accounted respectively for 30%, 50% and 80% of the cost of care. Other US organisations are also trying to operate as integrated health systems – Geisenger, for example – offering the opportunity to redesign services across the whole patient pathway.

Mr Britnell called on health commissioners and providers to see patients as partners and to be given support for self-care. 'The average amount of hours people spend in healthcare is five hours [a year]. Why spend all our attention on the five hours and not the other 8,755?' he said.

And he flagged up the potential of telehealth to transform existing models of delivery. Japan is investing heavily in this technology, he said, acknowledging that payment systems did not provide the right incentives for investment in England. In general he said that the English payment system needed to increasingly be focused on the delivery of value in healthcare.