After her article in The Sunday Times calling for ‘brave, bold and unpopular’ solutions to save our health service, we sat down with Professor Nora Colton to delve deeper into her radical plan to save the NHS, the role of medical technology in this plan, the European system she admires the most, and how her father’s battle with Parkinson’s inspired an interest in the future of healthcare.

Could you tell us a bit about your journey to become head of the UCL’s Global Business School for Health?

I was exposed to many healthcare settings that fed my interest in healthcare from an early age. My father had an early onset of Parkinson’s disease. He was determined to be part of the cure, so we shuffled around as a family to different clinics and hospitals, with my father undertaking research and experimental treatments for Parkinson’s. My father was never cured, but I developed a real-life passion for health and healthcare.

When UCL proposed setting up the Global Business School for Health, I saw it as an opportunity for someone like myself with an interdisciplinary background to challenge the silos we often educate those who work in healthcare. This role has allowed me to take my years of experience in higher education management and couple it with my research in development and health at institutions such as Harvard and Oxford to propose a vision of what health management and leadership could look like in the 21^st century.

‘Brave, bold and probably unpopular’. This is how your plan to save the NHS was described in The Sunday Times. What part does medical technology play in this sort of plan?

We are reaching a critical point in healthcare. Workforce challenges are going to impact the quality of care in an alarming way. Globally, there are shortages of doctors and nurses across most countries. This situation is not surprising if you look at the data around demographic changes, the impact of the pandemic and the increase in noncommunicable diseases worldwide. The reality is that these diseases are not only decimating the Low and Middle-Income Countries (LMICs) but continue to wreak havoc in higher-income countries. Of course, there is also the sheer number of people on the planet – the world population is massive at 8 billion. Consequently, the demand for health and healthcare services has skyrocketed.

The supply side is not keeping up, and the need for healthcare workers is woefully behind where it needs to be. Consequently, governments worldwide are seeing more and more of their GDP spent on healthcare. There is also the ongoing investment in innovation, strategic leadership, health system strengthening, and digital health driving new thinking. This new thinking is shaping discussions focused on prevention and diagnostics to lower the demand for therapeutics. However, health systems are complex adaptive systems, so much of this investment will take time. Moreover, to address social determinants of health, we need societal change that spans beyond our health system.

When we consider these variables from a systems perspective, we see that several forces are pushing and pulling healthcare to be reshaped from the traditional models of care towards something driven much more by medical technology and innovation. Yet, these investments in our future can often be seen as trade-offs with our current needs, with an impression that we cannot increase training medical staff and advance medical innovation and technology – it is either one or the other.

We must aggressively look at ways to reorganise, innovate and add medical technology to our health service sectors by harnessing how we can transfer knowledge and know-how through artificial intelligence and data mining for solutions. We must focus on prevention by using the innovations and understanding of social determinants of health to reduce those seeking treatment. We must co-produce with patients to empower them to make choices about their health.

Most importantly, we must adopt an approach that is not couched in short-term thinking. Consequently, as much as we need to invest in doctors and nurses to sustain our people’s health, we also need to ensure that we do not lose sight of the more significant and critical gain of leveraging medical technology and innovation to transform healthcare in the long term.

You are head of a health business school with a global outlook. Our report, ‘Regional Inequalities in the NHS’ encourages NHS leaders to learn from high-performing trusts. Is there a healthcare system the NHS could learn from or even emulate, particularly when it comes to innovation and technology?

As I mentioned in my article in the Sunday Times, I am a big fan of the Danish system due to how it has embraced medical technology and leveraged it as an export to be shared with other countries. Denmark has mainly a free-of-charge health system paid mainly from taxation. This investment in medical technology has allowed its digital health infrastructure, use of health data and technology solutions to drive forward a population-centred care system, making it one of the digital health leaders in the world today. Again, it illustrates that even in a system like ours, that proper funding levels can move quality healthcare and digital health forward together.

What message would you have for the new Secretary of State for Health and Social Care?

My message to the Secretary of State for Health and Social Care is to take a strategic approach that does not just focus on shallow short-term wins but allows transformational solutions to our healthcare system to emerge.

We must stop trying to “trim the edges” with incremental change and look to create investment and vision for healthcare in the UK that is bold enough for everyone to understand but simple enough to deliver. This vision must embrace medical technology as the only way forward. To do this right, we need a workforce plan which many individuals, including myself, have been calling for, but we also need a commitment to invest in the NHS in a manner that will allow us to continue to care for our populations while also investing into the future with IT infrastructure and other medical technologies and pathways that offer patient engagement that promises value propositions that demonstrate real care.

October 2022