I would like to start by congratulating Brighton and Sussex University Hospitals Trust for winning the HSJ Value award for

“Acute Service Redesign”, Surrey and Borders Partnership Foundation Trust for being highly commended in the category “Using information technology to drive value in clinical services”, Medway Foundation Trust for being highly commended in “Workforce efficiency” and to our friends at Wessex AHSN for being highly commended in the field of “Improving Value in the care of frail older patients.”

This is a great demonstration of all the good work, innovation and dedication to improvement that takes place in KSS and beyond; I hope you are all very proud of your achievements. A full list of the winners is available here.

NHS Investment

Many of you will have heard the prime minister telling the House of Commons on Monday that the government’s number 1 priority, on the eve of its 70th birthday, is the NHS – and that it will be getting an extra £400m in weekly spending. The Health Secretary has also said that in the future we’ll see a new relationship between the NHS and social care.

In the news

Radio 4’s Today programme interviewed Dr John Ribchester, GP and Chair of Whitstable Medical Practice, about the integration of health and social care. He explained how combined NHS and social care teams are providing frail elderly people in East Kent with a meaningful care plan that is understood and delivered consistently by multi-disciplinary teams.

The approach is improving efficiency, giving patients a better experience and improving outcomes. Dr Ribchester said that the aim now is to spread this model from the current 180,000 patients right across the Kent and Medway STP to benefit 1.6million people.

Along with many media outlets, BBC South East is planning a series of pieces to mark the NHS turning 70. So on Monday I found myself in a field – don’t ask! – talking with health correspondent Mark Norman about what the NHS might look like in 10 or 20 years’ time. With that in mind, I’m sure that Artificial Intelligence (AI) will be integral to care in the future and I’d like to take this opportunity to thank everyone who took part in our recent AI survey. We’ll be looking at the responses over the summer and reporting back in the autumn.

With best wishes

Guy Bowesma

Managing Director


When you can’t afford ‘cost-effective’

Robert Berry, Head of Innovation at KSS AHSN reflects on the crucial difference between ‘cost effective’ and ‘affordable.’

Andrew Dillon, CEO of NICE, recently highlighted the difference between ‘cost effective’ and ‘affordable’: 

“Something being cost-effective is not the same as being affordable. Once we have established value for money there is the beginning of the challenge associated with fitting that new product within the resources available”.

In doing so he acknowledged the direct impact this distinction can have on the uptake of new technologies. In other words, a specific barrier to adoption of innovation, including NICE guidance, in the NHS.

What’s the difference between ‘cost effective’ and ‘affordable’?

The specific issue Andrew Dillon refers to is this: evidence of cost effectiveness is often assumed to mean affordable. However, while this may be true when we look at it from a global perspective (sufficient scale of implementation and duration), it may not be true when the organisational structures (their boundaries), financial and other performance management processes within the NHS are taken into account.

Boundary issues encountered may include the different contract mechanisms used in different health or care settings. For example, a pathway that crosses a GP practice, community or mental health or secondary acute care may cross different forms of cost and volume and block contracts.  The different formulas and their separate allocation methods can inhibit, or even prohibit, adoption of new technology. This can be further compounded by the different quality and performance expectations in different settings.

What else do we know?

In addition to ensuring that both clinical and financial aspects are robustly reviewed, operational delivery needs to be similarly reviewed.  In some cases companies assume that services are both present and optimised everywhere for their technology.  Not recognising variation in services across the NHS, and the costs and time needed to achieve service changes are contributing factors to lower than expected adoption of technology.

What are the solutions?

From an individual company perspective there is little that can be done to address health system structural and financial mechanisms.  However, being aware of the specific risks related to their product will enable a company to make informed business decisions earlier and avoid disappointment or surprise when expected levels of adoption are not achieved.  That is where our ‘Bridging the Gap’ services come in.

Read on