In Part 1 of this blog I discussed how companies need to build innovative products together with clinicians, in order to work out what helps them and their patients, rather than companies making assumptions about medical needs which may not actually be valid, which can create barriers to innovation.
Another barrier to innovation in the NHS which was raised in the Nuffield Trust’s report (link) was that, “Products are sought which lead to short-term savings, rather than transforming care pathways leading to more efficient services”.
Stories of NHS managers introducing cheaper versions of products which turn out to be more expensive overall are rife: examination gloves which split, and two or three are wasted before a useful pair is found. Paper towels which don’t come out of the dispensers properly, and end up being wasted on the floor. But far more worryingly – spending money on areas which do not improve care, and can actually hinder it.
Last year, Jeremy Hunt announced that he would be putting millions of pounds of investment into more CTG machines, despite there being zero evidence that continuous monitoring is safer than intermittent monitoring. Imagine instead if that money had been allocated to increasing midwife numbers to implement Continuity of Carer? Unlike CTG machines, Continuity of Carer has been shown to reduce stillbirth, as well as costs to the NHS such as caesarean births.
Far cheaper investments, such as birth pools, also leads to significant cost savings. Labouring in water increases the rate of spontaneous vaginal births, reduces the need for instrumental delivery, reduces the numbers of 3rd and 4th degree tears, lowers the chance of a woman wanting opiate pain relief or an epidural, and increases women’s positive experiences of birth which might lead to lower levels of PND. (1) ALL of these mean that the NHS spends less money on fixing the consequences of these interventions, as well as the cost of the intervention itself.
Let’s see the NHS looking at the wider picture with every new innovation or investment. We call upon commissioners to look past the cost of installing new equipment which supports women to birth more easily, and instead see the full spectrum of ways that an investment in a birth pool, or other normal birth promoting products, can save the cash-strapped NHS money, while leading to better outcomes for women and their babies.
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