Manifesto
The clinical advances of the last fifty years have led to dramatic increases in life expectancy and years of life free from disability.These have been theresult of excellent research, increased funding and, more recently, a focus on the quality of healthcare as well as the quantity. However there are still five outstanding problems in every health service;
safety
variable quality
health inequalities
failure to prevent the preventable
waste
Furthermore every health service also has to face four new challenges;
growing demand
increasing need
no more money
a lot less carbon
These problems cannot be solved by further scientific advances. They cannot be solved by reorganising the bureaucracy of healthcare, which achieves only change without transformation, which focuses not only on quality but also on value. They can be solved by transforming healthcare. transforming the square peg of 20th Century healthcare into a service that fits with the needs of the 21st Century
The forces of transformation are different from the forces of management. They are
Citizens
Knowledge
IT and the Internet
Development of Systems rather than institutions as the most important type of organisations
These are the forces of the revolution which is needed to create a better value health service which
focuses on the patient
hates waste and transfers resources from lower value to higher value activites
serves populations, not just the patients who present or are referred
shifts the focus from hospitals to systems
shifts the focus from bureaucracies to networks
manages knowledge as carefully as money
is sustainable with a carbon footprint that reduces continuously
creates a new culture embracing these objective
Health services do not need reorganisation; they need a revolution
