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Why the NHS needs a Fresh Start in 2015


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The medical profession is populated by individuals, many of whom have had years of training to equip themselves for a vocation that will always be needed by society. There are thousands of dedicated staff committed to improving health or curing health conditions. The notion that the future of health service practices will necessitate transferring health responsibilities to others without health practice backgrounds is clearly unpalatable to most health practitioners, especially if funding and livelihoods are threatened. The reality is that such change is inevitable as technology empowers us with the tools to take more control over our lives.
For the NHS to make a fresh start, we need that consumer empowerment to be linked to responsibility. If we have better tools to monitor our health embedded into our daily lives, we should also accept the consequences of our lifestyle habits. Currently the model for the NHS and Health Insurance provides little incentive to change those habits but, as we are already seeing with motor insurance policies linked to in-car technologies that monitor how well we are driving and offers discounts to drivers who can prove they have good driving practices, these technologies offer incentives for behaviours which reduce risk of accidents.
Encouraging the voluntary use of wearable lifestyle technologies that collect valuable data about the daily habits that can best improve our lives is, in my opinion, the most cost effective way to avoid the obesity “slow-motion” car crash that could destroy the health service as we know it. It would require leadership and vision to implement a “tough love” strategy in which those who contribute to good personal health management are encouraged and rewarded whilst those whose lifestyle habits place a burden on health resources bear some of the cost consequences.

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Why the NHS needs a Fresh Start in 2015

  1. 1. The NHS and UK Social Serviceshave been goodfriendstome andmy familyoverthe years.My father’s quadruple heartbypassoperationover30yearsago at St Marys Hospital inPaddington extendedand dramaticallyimprovedhislifeandthe care and attentionmymotherreceivedfromsocial servicesas dementiatookherfromindependentlivinginaCouncil runflatintoherfinal yearsina care home exceededmyexpectations.Iam convincedthatthose of usluckyenoughto be babyboomersand those of currentand future generations are unlikelyto see thatstandardof care and attentionagain unless radical changesare made to national healthandcare provision. It isoftensaidthat true friendsare those people whocare enoughtospeaktheirmindaboutwhatthey see happeningtotheirfriendsevenif itputsatriskthat friendship.ItisinthisspiritthatI am writingthis article to suggestthatunlessthe NHSgraspsthe pricklynettle of disruptivetechnological change itwill riskbeingdamagedbeyondrecognition.Observingthe NHS’srole insocietyislikewatchinganover- protective parentindulgingafeckless andungratefulchildinthe mistakenbeliefthatsuchunconditional love and care will developabetteradult.Experience tellsme thatthere are timeswhen“toughlove”is neededtoturnthe fecklesschildintoaresponsible adult.Forthe NHS,that time isNOWbefore the damage isirrepairable. The NHS and Obesity The NHS will notsolve the obesityanddiabeteschallenge.WhilstIapplaudChief ExecutiveSimon Stevensforhiscampaigntotackle the “slow motioncar crash” of obesityandconsequential lifestyle relatedconditionssuchasdiabetes,cancerandcardiac problems,Ifearthat hisstrategyof requiringGPs to advise over-weightpatientswillbe ineffective.LikeSimonStevens,Imanagedtolose almost4 stone inweightin3 monthsthrougha combinationof dietandexercise.
  2. 2. That weight-lossexperience notonlytransformedmylife andmywell-beingbeyondall expectation,it alsogave me an insightintothe problemsfacedbythe medical professionandtheirlackof recognition and/oracceptance of the impactof disruptive technologiesonhealthpractices.Ihave beenlucky enoughtobe healthythroughoutmylife.Myonlystayin hospital waswhenIhada burstappendix in 1971. I probablyowe mylife tothe NHSand the skill of the staff at Queen ElizabethHospitalin Birminghambutsince thattime I have had lessthanone weeksickabsence fromwork.Like almost everyone Iknow,Ihave readabout diets,triedthemforawhile andalsospenttime inthe gymbut once my sportingdayswere behindme,Igraduallyputonweightuntil,bymid2013, I weighedalmost18 stone whenmyideal weightshouldbe around12.5 stone. It was a combinationof circumstancesthatledme tomake some critical changesinmy lifestyle thatnot onlytransformedmylife butcouldalsobenefitmillionsof otherswho,likeme,have become“Personal HealthSpectators”.InMay 2013, I was ina playcalled“Ioughtto be inPictures”at the Little Theatre in Leicester,playingafailedHollywoodScriptwriter.One of myfriendsaskedme whereIgotmy stomach paddingfrom(Iwasn’twearingany) andanothertoldme bluntlythatIwas fat.The followingweekImet an AustralianworkcolleagueforlunchinCoventGardenandshe suggestedIhad some Russianbloodin my ancestrythat I couldinvestigate bysendingoff asample forDNA took up hersuggestionandwhilstthe DNA sample showedthatmyancestral originsare 99% certainto be WesternEuropean,italsoindicatedthatIhad a 32% likelihoodof developingDiabetes2.If I am honest, I wouldsaythat none of these events,bythemselves,wouldhave made me seriouslychange my lifestyle habitsbutitwasa chance article on the BBC website,combinedwiththese eventsthatsetme on the path to a verymuch improvedlife.
  3. 3. Wearable Technologies are Game-Changers The article I read aboutconcernedthe “Jawbone UP”braceletwhichmeasuresyourphysical activityand sleeppatterns.Itwasthisarticle thatpromptedme to use wearable technologytohelpme manage my weight.Beingable tomeasure andanalyse myactivity,sleepandeating habitsenabledme tolose 21Kg within3 monthsandsince I startedinJune 2013, I have beenable tolearnhow to manage my lifestyle to not onlystabilisemyweightwhilsteatinganddrinkingverywell butalsoimprove mybloodtest resultsandmy physical andmental fitnesswithoutanymedication,supplementsorvisitstothe gym. Havingexperiencedthe potentialof wearable technologiestotransformmylife andrecognisingthat medical practitionerswithexpertise indiabetes,nutritionandexercise mightnotonlybenefitfromwhat I learntaboutmy ownlifestyle habitsbutalsohelptodevelopimprovedprograms,Isoughttoshare my experiencesandcollaboratewithleadingfiguresandorganisationsinvolvedintacklingobesityand diabetes.Iimaginedthatmyexpertise andindustryconnectionsasthe formerFoundingDirectorof the SeriousGamesInstitute atCoventryUniversity wouldgive some credibilitytomyoffertodiscusshow wearable technologiesand“gamification”methodologiesmighthave asignificantimpactonlifestyle habitsinthe general population.HowwrongIwas !!! The reasonwhy wearable technologieshave the potential tobe real game-changersinthe fightagainst obesityandlifestylerelatedmedical conditionsisthattheyprovide eachof uswiththe toolsto measure, understandandmanage the factors whichaffectourpersonal health.Itisthisempowermentof personal healthmanagementwhichcandeliverthe intrinsicmotivationwhichiscritical totransforming us from“Personal HealthSpectators”to“Personal HealthPlayersandManagers” withthe greater acceptance of responsibilityforpersonalhealththatisessential forthe future of the NHS. Breaking the Mould
  4. 4. Daily Mail Article We have become sodependentonestablishedpracticesandperceptionsof the NHSas a solverof healthproblemsregardlessof whetherourbehaviourshave contributedtothose problemsthatwe have come to expect“quickfixes”ora “pill forall ills”fromsocietyratherthanhavingtotake responsibility for our ownbehaviour.Thisisthe essence of today’s“SpectatorSociety”exemplifiedbythe DailyMail “Life on Benefeats”article inwhichanover-weightwomansuggestedthatshe shouldreceivegastric bandsurgeryand a personal coach because spendingherbenefitsonjunkfoodhadmade herfat. Thisis an extreme exampleof the growingtendencytoexpectsomeone else todevelopacure for our healthproblemswithoutushavingtomake anychangesto our ownlifestylehabits.Thisisamouldthat has to be brokenbutit will require leadershipanda level of cross-sectorcollaborationthatisdecidedly absentinthe silomentalitythat,inmyexperience,currentlyexistswithinthe NHSandleadinghealth sectorprofessionals. The Writing is on the Wall The impact of disruptive technologiesonsocietyisillustrated bythe way technological change has affectedknowledgeprofessionalsinotherareas.Educationhasalreadystateda painful transitioninthe role of teachersfrombeingthe source of knowledge tobeingcoaches,facilitators,guidesandmentors. Studentshave the toolsandresourcestofrequentlybecome more knowledgeable thanteachersandyet teachersstill bearthe burdenof responsibilityforeducationandblame forinadequaciesinthe system. The medical professionandhealthserviceswillsufferexactlythe same painfultransition.Itisalready happeningwhenpatientswithmore rare andseriousmedical conditionscome totheirGParmed with
  5. 5. up to date reportsand print-outsondiagnosisandtreatmentthatgowell beyondthe currencyof the GPs knowledge. Exactlythe same phenomenonhastakenplace inmanyothersectors.Asa Corporate Marketing Executive sellingmainframeandmid-range computersforIBMin the early1980s I wouldneverhave imaginedthatthe average maninthe streetwouldbe asknowledgeable aboutcomputersasmost professionalsinthe industryatthe time.Inretrospectitwasinevitable asthe disruptivetechnologiesof the desktopcomputer,the internetandmobile devicesbecame consumerised. The most likelyreasonwhythe medical professionandthe bankingindustryhave beenrelatively untouchedbythese developmentsisbecause bothsectorshave ahighlevel of perceivedriskof the consequencesof lackof knowledge/experience.Withthe new wearableandconnectedhealth technologiesthatare aboutto become mainstream, thatsituationwill change andunlessthe NHS respondsbyembracingthe inevitable,itwill face averypainful anddamagingfuture. Fresh Start for the NHS The medical professionispopulatedbyindividuals,manyof whomhave hadyearsof trainingtoequip themselvesforavocationthat will alwaysbe neededbysociety.There are thousandsof dedicatedstaff committedtoimprovinghealthorcuringhealth conditions.The notionthatthe future of healthservice practiceswill necessitate transferringhealthresponsibilitiestootherswithouthealthpractice backgroundsisclearlyunpalatable tomosthealthpractitioners,especiallyif fundingandlivelihoodsare threatened.The realityisthatsuchchange isinevitableastechnologyempowersuswiththe toolsto take more control overour lives. For the NHS to make a freshstart, we needthatconsumerempowermenttobe linkedtoresponsibility. If we have bettertoolstomonitorourhealthembeddedintoourdailylives,we shouldalsoacceptthe consequencesof ourlifestyle habits.Currentlythe model forthe NHSandHealthInsurance provides little incentivetochange those habits but,aswe are alreadyseeingwithmotorinsurance policieslinked to in-cartechnologiesthatmonitorhowwell we are drivingandoffersdiscountstodriverswhocan prove theyhave gooddrivingpractices,these technologiesofferincentivesforbehaviourswhichreduce riskof accidents. Encouragingthe voluntaryuse of wearable lifestyletechnologiesthatcollectvaluabledataaboutthe dailyhabitsthatcan bestimprove ourlivesis,inmyopinion,the mostcosteffectivewaytoavoidthe obesity“slow-motion”carcrash that coulddestroythe healthservice aswe know it.Itwouldrequire leadershipandvisiontoimplementa“toughlove”strategyinwhichthose whocontribute togood personal healthmanagementare encouragedandrewardedwhilstthose whose lifestylehabitsplace a burdenonhealthresourcesbearsome of the cost consequences. Health as a National and Personal Index Healthstatisticsshowthe UK as one of the mostvulnerable countries tothe consequencesof obesity. Wearable lifestyle technologiesofferaseamlessandautomaticwayto measure the healthof the nation
  6. 6. and everycitizen’scontributiontoanoverall healthindex withoutplacinganyadditional burdenonthe tax payer. In a worldwhere itisincreasinglyfashionabletohighlightthe deficienciesof our National Health Serviceswithoutofferinganyplanorpersonal commitmenttochange the statusquo,I reallyhope the NHS listenstothe viewsof averyconcernedfriendandstartsto embrace the technologiesandpractices whichwill eitherbe itssalvationoritsdestroyer. About the Author David Wortley is the author of “Gadgets to God”, a historical perspective of mankind’s changing relationship with technology over the last 60 years and a vision of the future impact of disruptive communications technologies on business and society. He is CEO and Founder of GAETSS (, a consultancy on the strategic use of Gamification and Enabling Technologies for the transformation of business and society. His passion is helping organisations and individuals to leverage the power of these technologies for competitive advantage and business/personal development. David is a Fellow of the Royal Society of Arts (FRSA) and the former Founding Director of the Serious Games Institute at Coventry University. He has recently relocated to Malaysia to focus on establishing a commercially sustainable social enterprise with a mission to tackle global challenges such as obesity,diabetes and lifestyle related medical conditions.He is a serial entrepreneur and innovator with a passion for applying technology to social and economic development David Wortley Tel: +44 (0)789 665 9695 +6011 2318 0284 Email: Web Site: Skype:davidwortley