Tim Kelsey: The patients' man
Tim Kelsey is National Director for Patients and Information for NHS England. He talks exclusively to Sarah Kidner about how he’s trying to transform the way we interact with the NHS.
The newly appointed National Director for Patients and Information, Tim Kelsey, takes his responsibility extremely seriously. He says the NHS needs to make some radical changes if it is to survive over the next ten years. “Despite everything that people have done since 1948, we are still not delivering high-quality care for all, routinely. NHS England has recently disclosed that, in its view, the funding gap over the next five or so years is £30bn,” he says.
Read our illustrated guide to the care you should expect in hospital
It’s Tim’s job to help secure the future of the NHS by ensuring that the patient’s voice is listened to. Arguably, he’s the ideal person to do it. He spent a year as the Prime Minister’s adviser on transparency and open government, and is a former national newspaper journalist and TV reporter. In 2000, Tim set up the company Dr Foster to publish information about hospital performance, including details of heart surgery and general mortality rates. The inspiration behind it came from Tim’s mother who, at the time, was working as a GP.
She rang him in tears because she suspected that one of her local consultants was being negligent to the point that people were dying. Tim, who had spent a lot of his career dealing with whistle-blowers, admits that initially he wasn’t sure she should speak up. “There’s never a good outcome for a whistle-blower, however brilliant, important and courageous their mission is,” he says.
His mum did blow the whistle, the General Medical Council launched an investigation that found negligence and the consultant was struck off. “The thing that struck me, having spent a decade in journalism fighting for transparency, was the complete lack of openness. I literally couldn’t believe that the NHS was flying blind as to whether doctors were doing the right things for patients. So, I set up Dr Foster.”
There’s never a good outcome for a whistle-blower, however brilliant, important and courageous their mission is
Tim is in no doubt about the complexity of transforming the health service. “It’s at precisely the moment that the NHS is under the most pressure that it is the right time to be the most transformative, but – as you can imagine – that’s a tough message to sell,” he says.
The key to success, he says, is to put people at the heart of the NHS, and to encourage them to help change it. That means making the NHS more customer-centred, listening to patients more, and encouraging people to actively participate in the NHS and in their own healthcare.
When it comes to customer relations, Tim says the NHS has failed to keep pace. “If we think back a decade to a time before we could pay our bills online, the NHS is still way back there and we need to get it over here where the patient is in the driving seat,” he says. Tim believes that technology – for example, introducing online booking systems – is part of the solution. But more critical is to make data “liquid”, by which he means information that is free flowing and transparent. One part of this, he argues, is the urgent need for electronic patient records. “We have to get our hospitals to adopt digital record keeping as this is essential if we are to offer safer treatment to patients; it’s as simple as that,” he says.
However, it isn’t just about clinical data. “There are a lot of other types of very valid data that we want to make liquid, in terms of arming a doctor and a patient with better information,” says Tim. “One source of data that may turn out to be as important – or more – than the clinical data is data provided by the patient or patient-centred outcome measurement,” he says. “With muscular dystrophy sufferers, for example, fatigue and pain are two really important ongoing issues that are not captured on the clinical record. We want to give those patients the opportunity to self-report that data. It becomes part of a conversation between the patient and their doctor. It will lead to a much more personalised and holistic outcome.”
We need to get the NHS to where the patient is in the driving seat
Alongside this, there will be more information available about the quality of services delivered at GP surgeries and in hospitals to facilitate patient choice. Tim says: “Someone with heart failure, for example, will over the next few years find themselves flooded with data, and tools that they can use to decipher it.
“It will put them in a position where they can have a more informed conversation with their GP, lead clinician or nurse and feel a load more empowered about how they can look after themselves better and, frankly, extend their quality of life and life expectancy.”
It’s critical that the NHS improves its ability to listen, something that Tim says it hasn’t historically been very good at. “We’re trying to introduce new approaches to listening and with real urgency because one of the keys to having a long-term sustainable health service is that we listen more to what people are telling us about the services that they want,” he says. For example, NHS England has been developing a patient insight dashboard to enable it to see what patients really think about NHS services. The dashboard, due to be launched this November, will use a range of data feeds, including social media.
Patients need to speak up if we are to ensure a healthy future for the NHS – something that is beginning to happen already, believes Tim. “People who have for so long been passive, grateful recipients of a sort of handed-down paternalistic health service are beginning to feel that perhaps that’s not the best way to manage things in the future.
One of the keys to having a long-term sustainable health service is that we listen more to what people are telling us about the services that they want
“People are becoming more aware of the sad truth that, without their activism, things won’t actually get any better; that has been the story from the Bristol scandal to the Staffordshire scandal. A big part of the existence of those tragedies was down to us not being demanding or activist enough.”
Can the health service survive?
The need for greater transparency is already reaping rewards. “Back in 2007, heart surgeons started to publish individual surgeon-specific data,” says Tim. “Last year they attributed the reduction in death rates – which is about a third across all procedures – to this transparency, which changed behaviours. It equates to about 1,000 people alive because of a very bold act.”
Tim envisages an NHS in which we engage more actively in our healthcare. “What will have happened is that there will have been a really important shift of power from the doctor to the patient and, with it, an increased responsibility on the patient to do more for themselves,” he says.
Tim is in no doubt as to what is at stake. “Unless we make these technological advances real, activate the citizen and make data more freely available, we are out of the race – and I don’t like to think of that because it’s not an option I want for my children.” To see a video of our interview with Tim Kelsey, go to bhf.org.uk/HMkelsey. More online
Read our guide to who does what in hospital, and how you can make the most of them
What can you do?
To find out how you can make your voice heard, visit the Heart Voices section of our website. From there you can download free fact sheets on how to campaign on the issues that matter to you and your rights under the NHS constitution. You’ll also find more information about how you can get involved in the NHS, wherever you live in the UK.
For more on how you can help shape the NHS, read our feature on patient involvement or call Katie Wilson on 020 7554 0194.