As a follow up to this work, I have started to look at stakeholder stories for each of the four scenarios, to describe the impact of each world on the stakeholder. More on those as they develop.
In the meantime, here is the latest Impact / Uncertainty Plot.
Here are the latest – slightly tweaked – scenario overviews.
Who chooses, wins
This world is characterised by a buoyant national economy - the policy of prioritising debt clearance in the early 10’s reaping benefits - and by a growing sense of consumer power and consumer rights on the part of patients and the public.
There is a range of innovative public and private sector providers operating effective and efficient services to a receptive market. Who chooses, wins is the media induced mantra.
The consumers – motivated by the choice agenda from the 90’s and 00’s – are more informed than ever before and exercising their choice. Clinicians have embraced the prospect of informed patients, in part through the necessity to be competitive in attracting their consumers.
The programme to improve efficiency back in the mid 10’s was successful and provided scope for funding to be re-directed to innovative products and services. New biotech and nanotechnology products are revolutionising treatment of both chronic and acute conditions.
Breakthroughs in the diagnosis and treatment of Alzheimer's disease, paralysis and heart disease have been instrumental in improving the health of the nation, and in preventing 70’s and 80’s children dying before their parents.
Improving health into later years has allowed the older population to continue to work and fund their increasingly adventurous leisure activities.
National Hell Service
This world is characterised by a struggling national economy - the recovery in the 10’s never really happened - and apathy regarding consumer power and choice on the part of patients and the public.
The double edged sword of increasing demand and lower funding for health services has hit patients and providers hard, with mortality rates increasing rapidly. There is disillusionment with the state of the public health services as all the progress made at high cost to the economy during the 00’s has been reversed with round after round of funding reductions.
New players that had started to come into the Health Service market have withdrawn, adding to the burden on the NHS which the media has dubbed the National Hell Service. Innovation in products and services introduced and promised during the boom times have stalled and many have been reversed. Health insurance has become very expensive leaving the market available only to those with high disposable income.
There is extreme polarisation between those that can afford to fund their own healthcare and those that have to wait for sub-standard care. Health tourism for those that can afford it is growing significantly but any problems for the patient on their return to UK that are treated in the NHS cause resentment on the part of those on ever expanding waiting lists.
A generation of 70’s and 80’s children are dying before their parents.
Choice, what choice?
This world is characterised by a struggling national economy - the recovery of the 10’s never really happened – but by a growing sense of consumer power and consumer rights on the part of patients and the public.
The consumers – motivated by the promise of choice agenda from the 90’s and 00’s – are more informed than ever before but increasingly frustrated by the inability of the health service than to meet their expectations, claiming Choice, what choice?
A sense of being dis-enfranchised has led to regular demonstrations about access to care as services are cut in response to the poor economic health of the nation.
Innovation in products and services has stalled and despite there being an interested consumer base, the economics don't stack up and providers (existing and new) are struggling in the current financial climate to generate enough business within an expectant market. New biotech and nanotechnology products have trickled onto a depressed market and are failing to live up to expectations as a result. Global manufacturers and being ever more selective into which markets they launch their products, and the UK is missing out.
This hasn’t stopped health tourism becoming the option of choice for those that can afford it. But, any problems for the patient on their return to UK that are treated in the NHS cause resentment on the part of those on ever expanding waiting lists.
NHS Inc.
This world is characterised by a buoyant national economy - the policy of prioritising debt clearance reaping benefits – but apathy regarding consumer power and choice on the part of patients and the public.
Consumers never bought back into the choice agenda after national debt clearance policies of the 10’s reversed the momentum built up over the 00’s. The public health service is therefore built on the premise that the gatekeeper clinician prevails and it is he / she that directs patients to preferred providers.
New players have struggled to enter a market that is dominated by assertive public sector providers who have sewn up their local markets through effective collaboration across the sector. It’s NHS Inc. New biotech and nanotechnology products are revolutionising treatment for both chronic and acute conditions and the NHS is willing partner in getting these outcome priced treatments to patients.
Breakthroughs in the diagnosis and treatment of Alzheimer's disease, paralysis and heart disease have been instrumental in improving the health of the nation, and in preventing 70’s and 80’s children dying before their parents. Improving health into later years has allowed the older population to continue to work and fund their increasingly adventurous leisure activities.
Links
The underlying models have been developed in Sharpcloud’s collaborative strategic roadmapping application. (MS Silverlight required to view).
- The Healthcare System Futures 2030 roadmap
- Who chooses, wins – Stakeholder model
- National Hell Service – Stakeholder model
- Choice, what choice? – Stakeholder model
- NHS Inc. – Stakeholder model
The informing choices website – http://www.informingchoices.com/.
If you are interested in knowing more about this project or getting involved, contact me.
