One of the main reasons being because the original sale of this device and technology was around replacing part of a system. Which meant dealing with hospitals to buy your product, which is going to compete with your hospital service and paid by a commission group, the CCG’s, who are the payers that commission the service. There is therefore a massive conflict. If you are going to be going into a certain route and you are going to be competing for part of that pathway, you need to find a way of being embraced within it.
In order to do this, you need to be talking the language of collaboration, co-designing how your product is going to fit, and obtain measures that allow you to show the benefits that you’ll create in the context of the existing pathway. The more you try and change something, the harder it’s going to be to get it embedded in the NHS.
There are also simple products that are very easy to get into the NHS because of the natural structure. We have diagnostics and various tools that are very simple. You ask for a test, the test is sent away, and the test comes back with a result – a very clear pathway that hundreds of providers will offer. And then there are the more complex ones around day to day management of patients and platforms which patients will use as a means of communication, self-managing or delivering information between clinicians and others.
These can become massively complicated and difficult to embed because of the number of touchpoints, information sharing that is required, interoperability of that information, and the maintenance of it.
We are moving towards a world where some of these things are becoming possible and that’s only because of the world of integrated care. We are moving from a transactional relationship from the commission and the provider to a more consistent long-term view of relationships between commissioners and their patients as a partner.
As this partnership strengthens in an integrated care environment, between your GP, hospital visits, community management, personal care management, health management, become management under one banner.
You are then able to see how that gives an opportunity to cross-talking and embed platforms. But it’s only really in that environment where we see relevant uptake. There needs to be a way of overlaying on the transactional relationship within those pathway designs if you really want to succeed.