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WHY ARE WE WAITING? Healthcare challenge might be less about resources and more about logistics, argues Phil Storer

21 Feb, 2020 | published at 16:03 CET

Phil Storer

In his latest blog, IPP UK & Ireland director Phil Storer says healthcare challenge might be less about resources and more about logistics...

Healthcare is never far from the news agenda whether it’s isolation wards for the first cases of Coronavirus – Covid 19 - to reach the UK or the predictable mix of contagious headlines around the ‘winter of discontent’ and examples of crowded corridors linked to the chronic underfunding of the NHS - but is that the real story?

The ever-present word in healthcare is “waiting”; waiting rooms crammed with patients;  waiting for a bed;  waiting times, waiting lists, waiting to be discharged, waiting for a doctor/specialist, waiting for medicines from the pharmacy, waiting for an ambulance or waiting for the results of the tests – the list goes on. Yet waiting is really no more than the symptom of supply chain inefficiency. And actually, alongside the brilliant teams of caring people who work in healthcare every day, it’s all about making that supply chain work harder.

Like Beckett’s Waiting for Godot, the narrative never shifts and the elusive Godot never shows up. So, we are stuck in a cycle of never-changing headlines in an ever-changing world.

Winter challenges

Every winter we see people lying on trolleys in hospital corridors, accompanied by conflicted paramedics who should be back on the road dealing with other emergencies. This blockage is often caused downstream by the unavailability of a bed on the ward, which may be because an elderly person, who should and could be discharged, cannot leave the hospital because their prescription is not signed off by a senior clinician or the pharmacy can’t cope.

Or, it could be their post hospital outpatient care is not in place because of a lack of social care provision so, instead of recovering at home, they become the involuntary ‘bed-blockers’ causing the corridor log jams. This is also the case upstream, because of fewer available appointments at GP surgeries resulting in patients accessing accident and emergency departments for minor ailments as a default. This is the wrong “supply chain” for the wrong product.

Although funding is, without doubt, a major issue for healthcare, many chronic issues are as much to do with making sure that people, patients, equipment, accommodation, drugs and treatments all get to the right place at the right time in our hospitals, surgeries and social care. Or, put another way, the optimisation of the supply chain through effective and targeted logistics.

The appropriate levels of funding should follow the need but forecasting, communication and planning, the underpinning stratagems of effective retail and industrial supply chains, are easily overlooked by politicians and headline writers to the frustration of clinicians. In reality, it is all about effective logistics – hypothecating the scarce resources to deliver against key performance indicators (KPIs) or, in plain English, ring-fencing cash for healthcare and being able to track its effectiveness through the medical and surgical supply chain – all the way from prognosis to prescription to post care.

Logistical challenges

Yes, these are all resource issues - but there are also logistical challenges. Just maybe, clinicians, clinical commissioning bodies and hospital managers need a larger injection of supply chain management to ensure, for example, those leaving hospitals have their medication with them in a timely fashion, or, at least, the ability to pick them up from a pharmacy closer to home.

It’s about the right resource in the right place at the right time, so medical care becomes a virtuous circle where the experience improves for everyone.

In our supply chain, we repair and repatriate sustainable wooden pallets and put them back into the supply chain in an expeditious fashion, while at the same time working with customers and suppliers to reduce CO2 emissions and congestion on the roads. This is all about planning and collaboration and making sure every link in the supply chain is pulling together and as strong as the next.

Yes, there are differences between the provision of a wooden pallet in a circular economy system and treating a human being but the common link is that no one – customer or healthcare consumer – should be kept waiting any longer than necessary, so effective logistics changes the narrative away from the concept of the impatient patient to that of the satisfied customer.