Today, most of the NHS is helping patients to manage long-term illness, rather than curing short-term illness on their behalf. This requires a much more integrated health and social care system. In particular, three kinds of integration represent three new opportunities for innovation.
The first is the blurring of roles between clinicians and patients. Over a hundred years ago, Nietzche said, ‘a doctor is no longer at his intellectual peak because he knows the best methods... he must also have a talent for conversation’. Today that is truer than ever – innovators are helping doctors become as skilled at motivation as medicine and helping patients to take more responsibility for their own well-being.
The second kind of integration is between medical and social interventions. Social and neurological sciences are showing more clearly than ever the connections between social and medical problems. In turn, innovative medical and social care staff are developing new services that treat the whole patient.
The third area of integration is between primary and secondary care. For too long, there has been a separation within the health service between the primary services that spend most money through prescriptions and referrals and the secondary services that cost the most money. Changes that bring these budgets together are creating an environment in which a range of innovative services can flourish for the first time.