Healthcare is the only sector that the UK ‘owns’ at every level, from the NHS’s service provision to systems, manufacture and research. Compared to other sectors, healthcare both leads and lags in the way it manages itself using numbers. As a comparison, Deming was on the industrial scene in the middle of the 20th century, showing how numbers, particularly statistics, could inform industrial processes improvement.
And yet, a century beforehand, Nightingale applied statistics to health, creating an early version of the pie-chart to communicate what the numbers were saying. Meanwhile In 1950, Doll and Hill linked smoking to lung cancer and, in doing so, opened up a stream of methodology in controlled trials, meta-analysis and a concept of evidence that transformed medicine.
However, the application of numbers to predictive risk, operations management and service delivery has not taken off. The Cumberland Initiative is a response, initially from the academic community, to the call to invest in the service and systems side of healthcare: the business of delivering repeatedly, reproducibly, against agreed plans to commonly expected outcomes.
The Cumberland Initiative advocates a sustained level of massively cross-disciplinary research and transformational activity to define the evidence, develop the methods, deliver the tools and dig in with service providers, including the NHS. In meeting these challenges, it seeks a solution ultimately embedded and overseen though a new National Institute for (Health) System and Service Excellence (NISSE). NISSE could balance the scales and make a huge impact in operations, services and commissioning.
The non-drugs, non-technology piece of healthcare is about 85 percent of the healthcare pie. Some 85 percent of more than three trillion dollars spent around the world on healthcare provides considerable scope for new businesses in improvement, risk-management, modelling, operations research, and data mining. Good for healthcare. Good for UK plc. NISSE could make sure that we got the system solutions right.
Professor Terry Young is Chair of Healthcare Systems, School of Information Systems, Computing and Mathematics, Brunel University