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Scans in shopping centres and AI

Alison Holt

Social affairs editor

BBC Phil Brown, who has brown hair and glasses, lying down wearing grey jeans and a blue checked shirt that is open at the waist. A technician wearing red scrubs and blue gloves holds the ultrasound device to Phil's stomach while he examines the results on screenBBC

Phil Brown was able to get an ultrasound scan quickly and easily in a Barnsley shopping centre

“That was really quick – straight in, straight out,” says Phil Brown as he leaves a smart glass building in a shopping centre in Barnsley.

He has just had an ultrasound scan at an NHS centre which sits between familiar High Street names. It is easy-to-reach healthcare – as convenient as popping out to the shops.

This is part of the government’s vision for the future of the NHS, soon to be set out in a 10-year plan. In England, ministers have already promised three big changes: shifting more services from hospitals into the community, focusing on preventing ill-health and making more use of new technology.

BBC Panorama spent months in South Yorkshire meeting people already changing how they work, to see what it will take to fix a health service which is buckling under increasing demand.

The NHS also has to cut waiting times, money is tight and the organisation which currently runs it, NHS England, is being scrapped to reduce bureaucracy.

There is another deep-rooted problem – a care system, supporting older and disabled people in the community, that is understaffed, underfunded and in crisis.

Government critics say you cannot reform the NHS unless you reform social care, because it helps get people out of hospital more quickly and prevents some being admitted in the first place.

An independent commission will begin looking at social care reform next month. There will be an interim report, but the final report is not due until 2028.

Challenged on whether you can reform the NHS without changing social care, Health and Social Care Secretary, Wes Streeting tells Panorama that he doesn’t need to wait for a review and plans to divert more NHS money into social care.

“I want to spend more of our resources through social care, because it delivers better outcomes for patients and better value for taxpayers,” he says.

Wes Streeting, who has brown hair and blue eyes, wearing an air-force-blue suit with a navy patterned tie and light blue shirt, sitting in a dark wood panelled room

Health and Social Care Secretary Wes Streeting says spending NHS funds on social care can deliver better outcomes

Streeting would not be drawn on how much money would be involved, but said details about spending on social care would be in the 10-year NHS plan.

Most care is paid for by councils, or by the people who need it. It can end up costing some families tens of thousands of pounds. Only those with the very highest needs get help from the NHS.

Future of the NHS

At Barnsley Hospital it used to take about six weeks to get a non-urgent scan, but at the town’s NHS centre next to the shops most people are seen in two weeks.

The centre’s new scanners and X-ray machines have increased the number of patients staff can see and freed up the hospital so it can concentrate on emergencies and inpatients.

Phil had skin cancer removed four weeks ago from his chin and the consultant wanted to check a couple of pea-sized lumps in his stomach. The scan results will be sent to his GP.

“It’s about peace of mind. You’re not waiting for appointments,” he says.

Liz Elfleet, medical imaging manager at Barnsley Hospital NHS Foundation Trust who helped set up the unit, describes this as the future of the NHS.

“We’ve seen around a 50% reduction in patients not attending for appointments,” and the number of women accepting an invitation to have a routine breast screening appointment has risen “from 43% to just under 80% over the three years,” she says.

The centre, which offers a range of health checks and scans, was opened in 2022 under the last Conservative government. The current Labour government says many more services will now move out of hospital into the community.

In Barnsley, that is already happening. Part of another shopping centre is being converted into a second, large health hub. The project will be funded by the local council, regional mayor and a government grant.

The leader of Labour-run Barnsley Council, Sir Steve Houghton, says the scanning centre has shown NHS facilities can boost town centres, and they estimate people spend about £17 on average in local businesses when they visit.

Preventing ill-health

The second big shift the NHS is being asked to make is to focus more on preventing ill-health. In Sheffield, a GP practice has already begun to do this, to help them manage a workload which they say had become overwhelming.

Five years ago, Steel City General Practice analysed the data for 10,000 of their patients who needed the most help. “So we then said, let’s actually proactively bring them in. They haven’t contacted us – we’ve contacted them,” says Dr Krishna Kasaraneni.

Dr Krishna Kasaraneni, who has a shaved head and a closely trimmed greying beard, wearing turquoise scrubs with Steel City General Practice written on the right chest. He is photographed from the head and shoulders with the background of his GP surgery behind him out of focus.

Dr Krishna Kasaraneni says a focus on prevention helped his practice manage an overwhelming workload

GP appointments usually take about 10 minutes, but the Steel City practice gave these patients longer appointments to try to pick up problems earlier. They also took a risk and didn’t chase a national target to see all patients within two weeks.

Dr Kasaraneni says it has paid off. “The numbers of strokes have dropped over that five-year period. Coronary heart disease numbers have dropped,” he says. It has helped the doctors manage their workload better.

The improved health of the patients has freed up some appointments, and on average people don’t wait longer to see someone, but the growing older population means they are still very busy.

While GPs will be crucial to the government’s 10-year plan, there are not enough of them. Taking into account those working part-time, the equivalent number of fully qualified, full-time GPs is lower now than it was a decade ago – despite a rising population.

Better use of technology

The third of the big NHS changes is better use of new technology. At Sheffield’s Royal Hallamshire Hospital, they are using AI to speed up the comparison of heart scans.

Before, a radiographer would take about half an hour to manually plot different points around a 3D image of the heart and identify any changes from a scan carried out six months earlier. Now AI tackles it in just a couple of minutes.

Prof Andy Swift, who developed the AI tool with colleagues from the hospital and Sheffield University, says it has been used on 10,000 cases in the past few years. He says it is saving about 30 minutes each time.

“In the time that we’ve saved, we’ve managed to scan more patients and also do more reports for patients,” he says.

Despite these innovations, change on the scale the government promises is difficult in an NHS struggling to cope with growing demand.

Solving the problems of the NHS also requires tackling the difficulties of social care, which supports around a million older and disabled people in the community.

In February, NHS England figures showed around 14,000 people could not leave hospital, partly because of a lack of home and residential care. More social care can also reduce falls and illnesses.

‘We keep pressure off NHS’

The family of Martin – who is 41 and is autistic, with cerebral palsy and epilepsy – say Sheffield care worker Darren Leigh has become like a brother to him over 20 years. Darren knows when Martin is unwell and can quickly get the right help.

“We keep pressure off the NHS a lot of the time,” he says. “There are [also] people in hospital that need to come out but can’t because they can’t get the care they need.”

The care system has struggled with underfunding, staff shortages and increasing demand for years. Like many care firms, the not-for-profit company Darren works for says it is “on a bit of a knife-edge” as the government is also increasing the costs of employing people. Employer’s National Insurance and the National Minimum Wage will go up in April.

The government says it will give councils in England nearly £900m more for adult and children’s social care over the next year. Across the UK, there will be increased support for family carers and a fair pay agreement for staff is being introduced.

Speaking to Panorama, Streeting says social care has a “big part to play in terms of shifting care out of hospital into the community”. He adds: “I’m convinced that we can spend NHS resources more effectively through social care.”

Darren Leigh, who has light brown hair, wearing a teal polo shirt and a plastic apron, kneels down beside his social care client Martin. Martin is looking downwards and holding large headphones against his ears. Darren's colleague is crouching down in front of Martin with his back to camera.

Darren Leigh, left, says social care workers “keep pressure off the NHS”

The main opposition parties in England agree social care needs to be reformed.

But the Conservatives say the government has no real plan.

The Liberal Democrats say the NHS cannot be fixed without fixing social care. Reform UK wants to simplify social care through a single funding stream.

And the Green Party is calling for free social care.

There are also questions over whether the NHS has the money to make all the changes the government is promising.

It had a budget of £171bn in the financial year 2023-2024. It was also given an additional £21bn over two years. NHS Providers, representing trusts across England, says most of that money has been eaten up by everyday pressures including wage rises, inflation and drug price increases.

It warns these competing pressures make the change needed more difficult.

The health and social care secretary agrees that it will not be easy, but says he cannot “keep on pouring ever-increasing amounts of taxpayers’ money into a system that is not set up to deliver best use of that money and best care for patients”.

#Scans #shopping #centres

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