“Digital enablers” all over the STPs - meaning?

It’s been a tumultuous week as big business interests threaten our way of life like never before.  Thankfully the attempt by Toblerone to bury the bad news as they cut 10% off our chocolate has spectacularly backfired.

More important news struggling to get heard is the publication of the first of 44 STPs covering England.  BMA complains “GPs shut out of STP talks”, so what do they mean for primary care?  Well I’ve pored over them so you don’t have to (at least, the parts I want to, with my secret method,  ctrl-f in the document and search for the words…).

So I started with “demand” and there are dozens of references.  What’s funny is that about half of them bemoan the inexorably growing demand across all our services, usual stuff.  And then without a trace of irony, the other half outline our plans to reduce demand.  One quotes 30% of GP activity!

Compared with predicting election outcomes, forecasting healthcare demand is laughably easy.  Add 1 - 2% to last year’s demand and you’ll be within a gnat’s.

Apart from a few niche areas, the reason that demand keeps going up is because no one has found a way to reduce it.  Everyone including us has tried - are we the only ones to admit it isn’t working?  So reducing “demand” in STPs is either wishful thinking or in reality reducing supply, more concisely called rationing.  That word doesn’t occur even once as it very quickly gets you the sack.

Try another word, “digital”.  Dozens and dozens of references, all positive, and generally linked with the word “enabler”.  I like this way to describe digital, because it can be an enabler of change though I don’t see it working as a driver.  We haven’t yet found a way to reduce demand but it certainly can enable us to deal with demand more efficiently.

There is no doubt that digital is going to be a major component of change in the NHS over the next few years.  What is unknown is how, but I’m sure it will only make an impact if it works brilliantly both for patients and GPs.

STOP PRESS:  this new Dutch study on the impact of their NHG health info website is seriously encouraging for demand reduction.


Dr Sara Cowell

PS  We put a lot of effort into measuring patient feedback, as unless it’s very positive patients won’t use digital channels.  High usage is the only way to get a return on all that investment in technology.  We’re putting these patient measures in the public domain and keeping them updated.

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