What will healthcare in Norwich look like in 20 years?
PUBLISHED: 11:10 15 February 2019 | UPDATED: 11:19 15 February 2019
Copyright (C) Andrey Popov
Doctor appointments on your mobile phone, smart watches taking vital stats and fewer visits to hospital.
That is the vision for the future of health care and the NHS in Norwich, as we consider what our city may look like in the years to come in a special series this week.
The digital health revolution is just starting and already the majority of patients in Norfolk can book their GP appointments online, request medications, see test results, share their medical records between their doctor and the hospitals and have prescriptions sent electronically to their pharmacy of choice.
But this is just the tip of the iceberg, as health secretary Matt Hancock plans to overhaul the NHS’ technology.
The next step in revolutionising how we see our GPs is through apps such as GP at Hand, which already has more than 30,000 patients signed up in London.
Patients can arrange video or phone conversations with doctors, which are recorded so they can review them later, and the GP sends over written notes after the consultation.
If a face-to-face appointment is needed, a visit to a local health centre is arranged, usually within 24 hours.
It’s a quick turnaround compared to the weeks patients in Norfolk and Waveney are often quoted when asked when they can next see their GP.
The problem? GP at Hand is a private company (providing NHS services) and it should be the NHS leading the way. Traditional surgeries are worried they will be left only with older patients, whose conditions are more complex - and more expensive.
But it is hoped with Mr Hancock’s commitment to technology it will soon catch up, starting with a £200m boost for a new NHS app which will include features such as organ donation preferences and £45m set aside for individual surgeries to dip into to buy online consultation systems.
Technology will also have a bigger role in our hospitals, with the James Paget University Hospital (JPUH), in Gorleston, saying last year it could introduce online consultations within three years.
Mark Davies, the outgoing chief executive of the Norfolk and Norwich University Hospital (NNUH), said: “In 20 years time I think there will be more use of technology, so I think fewer people will come to hospital for outpatients, that will be done video or app-based.
“It’s only a few steps away and apps, they’re very good. I think on the one hand fewer people will come anywhere near to a hospital because they will be treated in or near their own homes. And it leaves hospitals doing what they should be, treating the very sick.
“Twenty years, on one level, is a long time but also look at where we are. Back in the 80s people were talking about care in the community, they were saying that 40 years ago. And we’re still saying it now.
“So I don’t believe this is the end of hospitals but we will see them being much more technological, much more tailored to people.”
Mr Davies also said there would have to be a focus on older person’s medicine, as better healthcare kept people alive longer.
“We’ve already got the largest singular trust for older person’s medicine,” he said.
“We will be able to keep people alive longer but they will have many more things wrong with them, we’re talking dementia, heart attacks, stroke.”
It is these complaints which were the focus of the government’s NHS long term plan, released last month.
And in Norfolk by 2039 there should be readily available thrombectomy, a little-used procedure which is said to “bring patients back to life”.
It is hoped it could be introduced at the NNUH this year, but would only be offered to a small number of patients. By 2039 Mr Davies said it could be routine.
The procedure involves a catheter being inserted into the patient’s body through their groin and guided through veins and arteries up to their brain, at which point the radiologist wraps a stent around the blood clot and pulls it out.
He said: “Probably about 10pc to 20pc [of stroke cases] that we deal with, they come in very, very disabled. But in a very short amount of time after the procedure they can recover and are like me and you again.”
One of the big challenges over the next 20 years will be recruiting GPs and finding a way of funding primary care which works. Mr Davies added: “I would worry about primary care and general practice. I’m a great believer and supporter of primary care, so if you can’t get the GPs I do worry.”
Primary care also looks set to change in the future, firstly with the introduction of primary care networks around the city and county.
Last week Patricia Hewitt, former health secretary and independent chair of Norfolk and Waveney’s Sustainability and Transformation Partnership, revealed new plans for 20 primary care networks in Norfolk areas.
There is already one up and running in Norwich, the OneNorwich partnership, where GP practices work together.
But this was set to be expanded to include things such as mental health support, social workers, and voluntary groups, to provide more support.
The aim is for GP practices within each network to work in partnership with each other and other professionals in community and social care to deliver care that is more joined up and delivered closer to home.
Mrs Hewitt said: “It’s just a way of making sure we build our community services around primary care to enable far more people to get the care they need close to home and in their own home.”
Could Amazon Alexa help with social care?
One of the major challenges in 20 years will be how we look after the elderly, as the aging population looks set to rise as people are kept alive for longer.
Currently Norfolk has a high percentage of care homes rated inadequate or requiring improvement, with more and more people being cared for in their own homes.
But again bosses are turning to technology and asking whether it could help stem the loneliness that can come from staying at home for care.
James Bullion, director of adult social services, previously suggested gadgets such as Amazon Echo Dot could help.
The county council is focusing on reducing people’s dependency on council services, such as residential homes, while helping people live independently.
Mr Bullion said: “We would not expect [Alexas] to replace human care or be the only form of communication, but I think they could play a role.”
• The Norwich Society and Evening News are holding a public debate about the future of the city at the Forum on Tuesday, February 19 at 6pm. Admission is free, but booking here is recommended.
• Our Future of Norwich takeover week is brought to you in association with Norwich City Council and Norwich Business Improvement District (BID).