Demand and supply

Here’s a third and final blog off the back of this week’s King’s Fund discussion about innovation in healthcare.

I’ve argued on a number of occasions that we have focused too much on trying to adjust demand within social care -by giving people personal budgets and Direct Payments with which they could, in theory, demand the service of their choice – at the expense of thinking about supply. Without developing diversity of supply, it turns out that people only have the same old choice of services to spend their personal budgets on, and that problem gets worse as supply organisations find it easier to compete on price than on personalisation of their offer and the market consolidates into fewer, larger organisations.

In conversation with colleagues in healthcare innovation, it was suggested that if social care’s innovation problem is that we focus too much on demand and not enough on supply, perhaps the main barrier to innovation in the NHS is focusing too much on supply – new contracts, payment by results, innovation in medicines and procedures – and not nearly enough about demand. We are all ‘patients’ and ‘consumers’ when we step into the realm of the NHS, which talks about things like increasing our level of ‘compliance’ with treatment regimes.

Could we bring together social care’s progress on thinking about demand, and the NHS’s progress on streamlining supply?