A new podcast series from Healthcare Analytics provider Draper and Dash has this week published its ninth episode. The new episode sees CEO Orlando Agrippa speak with guest Steve Lash, Medical Director of Optegra.
The series explores thoughts around healthcare challenges in the past and present, while continuing to answer the question of what our healthcare system will look like in the future. Previous podcasts include conversations with Professor Stephen Smith (Chairman of East Kent University Hospitals NHS Foundation Trust) ,Richard Corbridge (ex CIO Leeds Teaching Hospitals, and current Director of Innovation, Boots Walgreens), Rachel Dunscombe (CEO NHS Digital) and Natalie Douglas (ex CEO Healthcare at Home).
The latest episode covers Steve’s thoughts on the future of Ophthalmic care. Lash joined Optegra Eye Hospital Hampshire in 2010. He is a Consultant Vitreo-retinal Surgeon (VR Surgeon) specialising in cataract, lens replacement, surgical retina, Retinal detachment, macular hole, epiretinal membrane and diabetes.
Orlando Agrippa said “Last week, I had the pleasure of spending the afternoon, and his birthday, with Steve Lash, Medical Director of Optegra and consultant ophthalmic surgeon at University Hospital Southampton. During our time together, we discussed the future of healthcare, and how the delivery of cataracts care will be disrupted in the years ahead. Steve, a.k.a. Dr Courtney, really provided some unparalleled insights into the challenges faced by doctors within the healthcare system in terms of pay and balance, something that has been echoed in recent news from NHSE/I urgent and emergency care director, Dame Pauline Philip. Dame Philip highlighted potential actions the NHS needs to take in order to improve the current landscape for clinicians, including an urgent need to begin offering additional pay to consultants following a trend in doctors refusing to take on extra shifts. With the upcoming winter pressures, these increasing staff shortages are incredibly worrying.”
“The team at Optegra, led by Steve, are really driving forward the agenda of reducing clinical variation and improving productivity through the use of data, whilst still maintaining clinician support and balance at its core. Having confessed to loving the people and problem-solving aspects of medicine, alongside the science itself, it is of little surprise that Steve has carried this focus into his work at Optegra. His early career spanned optometry, an accelerated medical degree at the University of Southampton, and a specialty in ophthalmology, endeavours which eventually found him spending a year working in Melbourne. Steve’s adventures in the Australian health system had a lasting impact on the way in which he approaches the idea of an optimal structure for healthcare services. On the other side of the globe, the combination of a public system allowing access to those of a lower income works alongside an insurance-based system, providing an option for more specialised and higher quality care to those who can afford it. Compared to countries such as the USA, where any treatment needs to be bought and therefore excludes a high proportion of often vulnerable people, this combined version therefore ensures no one is completely left behind when it comes to their health.”
“This is a style of patient care that Steve has preserved upon his return to Southampton, working as an NHS consultant, but also combining aspects of private practice. Our conversation that afternoon raised a concerning issue in the NHS today, whereby experienced clinicians are beginning to lose their good will in dedicating their lives to a system that seems to do less and less to care for them in return. Steve put the issue quite succinctly as: “the NHS cake is getting drier and drier”. Those with incredible commitment our national health service have needed to search for other means of supporting themselves as morale wanes, pressure increases, and salaries, working conditions and pensions begin to drop. While some, like Steve, combine work in the NHS with private work, others even at the consultant level are living in rented accommodation or re-mortgaging their homes. Alternatively, clinicians have begun to cut their losses and change career track entirely, or are even enticed abroad. Part of the issue, Steve believes, arises from the current culture of “entertainment is everything”, with a dwindling respect for professionals due to the abundance of easily accessible information on the internet. People are now able to self-diagnose online, and with this has come a worrying sentiment: “why do we even need doctors?”
“With all of the issues faced by clinicians in a modern-day NHS, there has also been rising concern over clinical variation. As surgeons begin to do more and more to cram patients in and meet their targets, quality of care plummets. However, there is a frequent reluctance to address and reduce variation in the face of management intervention, compounded by dispute over complexity in patient severity and comorbidities. As Steve points out, much of this comes from a natural response to draw back and disengage when faced with increasing pressure, and many clinicians feel disempowered and disconnected from a profession it’s likely they once idealised. From Steve’s point of view, it is the vision of the NHS that needs to change, and he believes that the nation should ultimately be the customer, not just the individual.”
“When it comes to the future of the NHS and disruption of current practices, it has always been my belief that policy is never the driving force. These changes come from people. In the case of Uber, it was never a matter of approaching TFL and saying “how do we change how transportation is delivered?”. Instead, the company thought to themselves “how do we get the people to change it?”. In the context of healthcare, Steve believes this disruption will come in the form of new technology. Already, robotic surgery is revolutionising patient care, with systems such as the da Vinci robot already demonstrating faster rates of healing and reduced trauma in patients following surgery. Without a doubt, however, AI stands to be a huge player in this disruption, especially in the context of imaging. In the USA this has already had a huge impact on diabetic patients, with what was originally a massive waiting list for image screening being completely erased by the introduction of AI technology. While there will always be a need for clinicians, more likely than not they will begin to take on the role of “conductors” of these suites of technology as time progresses, leaving the capture and basic processing to the algorithms. With this will need to come a change in their concepts of “anchoring”, forgoing traditional means and instead embracing an influx of new methodologies and altered practices for the ultimate good of the patient.”
