The future of healthcare systems: catching up with patients’ expectations

Published by Paula Franklin
Chief Medical Officer

30 August 2017 . United Kingdom

Hospitals and healthcare delivery models have changed little in the last 50 years, but the pressures to reform have never been higher. In a digital era patients want immediate access to the healthcare that’s right for them as individuals. They expect technology to help prevent illnesses before they develop. And healthcare costs are becoming unsustainable. The combination of these elements presents a great opportunity to change healthcare as we know it.


Other industries have leapt forward, but healthcare systems are inching their way to the future. Despite advances in medicine and technology, many hospital wards look and operate the same as they did in the 1800s and people access care in much the same way as they did 50 years ago.

There are three key forces driving significant system change – people, cost and technology. These three forces are leading to a future where care is delivered by different people in different care settings, and will eventually result in health services that are more in line with what patients want and need.

1. People demand change

People are frustrated that health delivery remains largely unchanged, despite huge advances in other areas of their lives. Today we can do just about anything on a smart phone or online, but when it comes to healthcare it is still hard to book a doctor’s appointment online or get a prescription electronically. People want access to healthcare that is responsive and flexible as online shopping.

Meanwhile, the availability of information and demand for healthcare is rising. Thanks to the internet, people know a lot about their conditions before they even see a doctor. Every day, 160 million searches are made on Google for healthcare related issues. Increasing demand from patients for flexible, high quality care, coupled with an increase in innovation, is contributing to the second biggest driver of change: cost.

2. Rising costs force change

In 1983, the UK spent 3% of GDP on healthcare. Today it’s around 10%. By 2060, the King’s Fund estimates it’ll reach 20%, the equivalent of adding an extra £3,500 tax bill to every household - clearly unsustainable. And spending more doesn’t necessarily give us better healthcare; the measure of quality is how much health improvement a system delivers.

We need finances that are aligned with quality outcomes and value, rather than health systems that pay merely based on the volume of activity. Today, a surgeon is paid for a hip operation but not for restoring a patient’s ability to walk. We’re more likely to see better outcomes and a more cost-efficient process in future, if we have a payment system that awards coordination of care, from pre-operative patient education to clinical follow-up after discharge.

Measures should be focused on health improvement, with the patient reporting the outcome. This would reduce unnecessary clinical intervention and save money.

3. Technology will bring change

Technology is not only changing individual expectations and demands, but also enabling different ways of delivering care in different places.

Traditional health services, with large hospital facilities delivering separate services, are out of step with what people want and need. The future will be care delivered in convenient outpatient settings; in the shopping mall, at home, or in the workplace, with hospitals reserved for highly specialist care.

As medical technology allows patients to be monitored in their homes the location of diagnosis and treatment will begin to shift. Unlike a traditional model of care, routine long-term management of a condition will be possible without frequent in-person appointments.  Instead, your condition will be monitored by teams of specialists hundreds of miles away who converse with you remotely, supported by in-home care where needed.

An example of this is the eCare 21 remote monitoring system, which collects data from elderly patients drawing information from their mobiles, wearables and remote blood pressure monitors. Caregivers, clinicians and relatives can keep an eye on them and provide proactive care, preventing unnecessary admissions.

A second change driven by technology will be who delivers the care. Doctors may be reserved for work where only their expertise can help, while nurses take over many of their other tasks, and non-clinical work is delegated to other team members.

Patients are the biggest underused resource in healthcare. In future, individuals are going to be caring for each other in networks and using peer-to-peer care.

Smart assisted technology will help people stay in their homes longer rather than move into nursing homes or residential care. The tremor spoon, for example, enables people with Parkinson’s disease to feed themselves and sends data remotely on the nature, severity and instances of tremor that allows treatment to be adjusted.

The companion robot will provide practical help to remind people to take their medicine or find their glasses but it will also be able to address loneliness, isolation, depression and anxiety. In a future where human resources are scarce, robots could be a useful supplement.

The combination of the ubiquitous nature of digital tools, combined with some of the world’s biggest health problems, presents a great opportunity to change healthcare as we know it.

These changes will be better for patients but it’s important to keep their interests in mind as we move forward. Immediacy serves many industries well, but it’s not always optimal in healthcare. At medical school, we were told that most patients would get better in spite of us clinicians. We also need to leave space for people to get better without our medical intervention.

Watch Paula's full presentation on healthcare systems below:


This blog is part of the series ‘The Future of Healthcare’ where Bupa’s Chief Medical Officers from around the world, shared their views on how technology and innovation will have an impact on healthcare, deep diving in four key topics: diagnosis, treatment, data and systems of care

Paula Franklin

Chief Medical Officer

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