We’re at an important moment in healthcare. Across Europe, the challenges of meeting increasing and ever more complex and individualised demands of patients are straining both countries’ economies and their healthcare systems. 

Karina Malhotra, founder and director, Acumentice Healthcare Consulting

To deal with this, more and more governments are looking to digitally transform their health services. The UK’s National Health Service published its long-term plan in January 2019, outlining how it would become fit for the future, which included establishing NHSX to drive digitisation across the entire service. Elsewhere, the EU is aligning its mission to change the delivery of health and care with that of the Digital Single Market.

 

While each initiative is different, the fundamentals remain the same – reducing health inequalities, improving prevention and providing better quality outcomes for patients, both in periods of relative normality and while dealing with pandemics such as Covid-19. In addition, the setting and point of delivery of care itself needs to be right for patients’ individual needs. Underpinning this valuable effort is making sure that it is  financially sustainable and delivered by a robust, correctly skilled and appropriate workforce. 

 

Overcoming the challenges to unlock benefits

 

It’s undeniable that digital transformation and innovation is critical to all health services. Being able to harness data does not just provide better outcomes, engagement and experience for patients and healthcare professionals, but also has the potential to provide great financial and operational savings to healthcare providers, whether public (such as the NHS) or private. It is the only way we are going to be able to deliver high quality care and prevent the spread of disease in a hyperconnected, globalised and diverse society in a responsible, inclusive and long-term manner. 

Yet challenges remain. From a technical perspective, these range from how providers incorporate mission critical legacy systems into digitalised operations, to the fragmentation and non-standardisation of data across hospitals, regions and countries. Then there’s the paucity of investment resources and established quality assurance frameworks available to validate new technologies.

Just as important are the cultural and human considerations. This new era of healthcare has to be inclusive; that means being able to deliver care that meets the needs of patients in the ways that best suit them – rather than in a way that best suits providers. New perspectives, views and considerations need to be incorporated to overcome established bias and legacy thinking – the only way to do that is through greater diversity, at all levels of healthcare.

 

The gap between workforce and leadership diversity

Traditionally, this has been a challenge; as an article in The Lancet from 2019 notes, from a gender consideration, while “women’s representation in science and medicine has slowly increased over the past few decades… this rise in numbers of women, or gender diversity, has not been matched by a rise in gender inclusion.”
The numbers back up the argument – the NHS workforce is 75% women, yet only 37% of Foundation Trust directors are female. It’s a similar picture across the European Union, where 78% of workers in 

the healthcare sector are women. While the US has a very different delivery system, the gap between representation at an employee level and an executive level is even more stark – three percent of healthcare CEOs and Chief Medical Officers are female, yet women comprise 80% of the entire workforce. 

 

From an ethnicity perspective, the story is even worse – appointments of black, Asian and minority ethnic candidates (BAME) to non-executive positions at NHS trusts and hospitals have fallen over eight years, with the latest UK government data stating that 4 out of 5 (79.2%) NHS staff were white. In the US, 70% of physicians and surgeons were white. 

 

Does the diversity of the people who make investment decisions behind the scenes, or those in senior management positions at providers, matter? Of course it does. In an article for the World Economic Forum, entrepreneur and economist Vijay Eswaran writes that “The coming together of people of different ethnicities with different experiences in cities and societies is a key driver of innovation.” He is considering the issue of diversity from a business perspective, yet the lessons apply just as powerfully in a public service setting. Particularly one, like healthcare, that desperately needs to engage innovation to unlock the benefits of digital transformation to suit its increasingly diverse users. 

 

Evolving mindsets to deal with legacy structures

Interestingly, the tackling of both the diversity issue, and overcoming the technical obstacles, are about dealing with legacy structures. In the case of the latter, solutions such as data validation, artificial intelligence (once data is cleaned), automation and the deployment of hybrid cloud (allowing the use of legacy systems alongside newer applications) can help speed up digital transformation. With the former, it’s about looking at the cultural structures in place that stop more diverse individuals progressing. What suited traditional leadership applicants may no longer work. In the same way that, what were once considered appropriate management skills are now outdated or not as necessary, and need to be replaced by different attributes and strengths that non traditional candidates may offer. 

 

It is a mindset change, but then all transformation is. Ultimately, if healthcare providers are serious about being innovative in order to deliver better care and keep people healthier for longer, then they need to ensure that they are not only transforming their systems, but their workforces as well. What once worked in healthcare delivery clearly need to be reshaped; the same goes for who delivers it.