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Predicting the health “crimes” before they happen – Dr Martin McShane

In the film Minority Report there is a scene where Tom Cruise stands in front of an interactive screen, filled with random images of future events, to analyse and interpret what is going to happen, so that action can be taken to stop a predictable crime.

The NHS remains a highly reactive system where we wait for the ‘crime’ to happen, measure the failure of prevention by tracking hospital based activity as our prime metrics and have directed more and more funding towards hospital based care.

The Five Year Forward View sets out a vision to change this approach and focus on prevention, while also building capacity and capability in the community to support individuals and communities as well as realising the assets they bring to creating a sustainable NHS.

With the biggest challenge facing the NHS being the growth in long term conditions, finding ways of helping people and professionals to get ahead of the curve and be proactive in prevention and mitigation of risk is crucial.

This will only be possible if we can take the mass of data available to us now and, like Tom Cruise, use it to predict what is highly likely to happen but could be avoided with focussed effort.

This is why I believe risk stratification is a diagnostic tool professionals should embrace and be deeply involved with improving and advancing so they have the equivalent of an MRI for the population they serve and to reach out to individuals at risk.

There is a growing insight and experience that using data in this way is incredibly helpful. Combining it with invaluable human intelligence about services and local context greatly increases the usefulness of such data.

This was emphasised in a recent article from the Commonwealth Fund which said : “Some health systems are also starting to look beyond traditional data sources in an effort to understand patients’ preferences, attitudes, and behaviours related to their health and care”, which is essential if we are to deliver person centred, rather than bio-medically defined, care.

Using such data to run simulations and explore different interventions to inform commissioning decisions is also a skill to be harnessed to maximise the benefits of change.

My belief is that we are the foothills of being able to measure ‘nothing happening’. By that I mean that we will know historically what has happened and should happen if we carried on doing what we have always done then make visible the impact of proactive care and prevention.

This will make evident the value of primary care, of community based care and help deliver a sustainable, person centred, health and care system into the future.

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