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Weirdos and misfits

Can diversity improve engagement in healthcare?

Craig Mills

by Craig Mills

Dominic Cummings has written a rambling blog calling for ‘weirdos and misfits with odd skills’ to apply for new positions to shake up a civil service that impedes the ability of government to achieve its ambitions.

Ignoring the danger of an unelected power in Downing Street, the idea is to hire less traditional people with different skills and backgrounds to inject non-establishment- led ideas to improve performance. He claims that advisers “have to make decisions well outside their ‘circle of competence’, meaning they lack the necessary expertise to support ministers. This must change fast so we can properly serve the public”.

Many industries are going through a similar revolution, a period of change driven by the application of data to a more forensic way of working. A change based on opportunity and necessity. Healthcare is no different.

According to WHO, today’s health challenges are formidable: an ageing population; unhealthy lifestyles and the burden of behavioural issues leading to mortality/morbidity; the rapid transfer of infectious pathogens and antimicrobial resistance. Consider a few examples.

On mental health, the European Commission’s State of Health in the EU estimates suggest that one in six people across the EU experienced mental health issues in 2016 – that’s 84 million people, at a cost across the EU of 4% GDP or €600bn.

In 2015, mental health was a direct factor in 85,000 EU deaths. Meanwhile, obesity continues to increase across the EU with one in six defined as clinically obese. Inequality here remains substantial: 20% of lower educated adults are obese, vs 12% of those with a higher education.

Life expectancy disparities confirm the complexities involved. An uneducated man in his 30s can expect to live 8 years less than a university educated man, highlighting the role of education in risk factor exposure as well as access to care.

Faced with such challenges, healthcare structures appear outdated. Traditional approaches feel inadequate. So, change is essential if we’re to make progress. The challenge is to accept that old ways don’t work and won’t work – and respond.

In Rebel Ideas, Matthew Syed highlights the failings and opportunities that thinking differently can bring. The issues of 9/11 and the lack of staff diversity in the CIA are explored as reasons why they failed to see warning signs.

He states: ‘... the real benefits of engaging with varied perspectives and thinking differently about the world, aren’t widely understood. Diversity is central to humanity’s progress, and why people who are open to different viewpoints will enjoy more fulfilling and successful lives.’

We need to adopt new ways of thinking, new ways of planning, new methods for defining engagement. All informed by a superior understanding of our audiences and their patients.

At Frontera Group, we’re using diversity to help pharma to better pilot with the audiences they seek to influence. Exploring ideas with the help of experts from outside healthcare, we immerse clients in our scientific approach, Behaviour Engineering, to determine and implement the optimal approach to create the change they seek.

For healthcare challenges, any single intervention is likely to have a limited impact. A clear strategy, supported by a sustained portfolio of initiatives, delivered at scale, is needed to address each condition and associated health burden.

Such approaches can be cost-effective for society: savings on healthcare costs and higher productivity can outweigh the direct investment required to deliver the intervention, when assessed over time for the target population.

Evidence suggests that a fifth of spending across healthcare is wasteful (and so could be reduced or reallocated, without reducing quality of care). When it comes to pharmaceuticals, we have an ability to support improved value in the form of outcomes.

This involves working with HTAs to evolve treatment assessment to be more meaningful for everyone and crucially to be more holistic and less siloed. But also to support professionals and patients directly to get the best out of prescribed treatment. By better supporting professionals and the public, evidence confirms that improved outcomes are indeed possible.

Craig Mills is MD at Frontera Group

18th February 2020

From: Healthcare

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