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In the process of personalisation as leading to the downfall of the monolithic provider, I think there is a fascinating point here.

At the moment an awful lot of the healthcare system is conceptually centred on providers. For example, another article I read today on the HSJ talked about an overperformance in outpatients. This isn't a meaningful perspective - instead it could have been reported as an overperformance on certain pathways.

The most robust way to reduce acute hospital usage is not to create acute-light alternatives elsewhere, but instead to improve a large number of pathways.

Thought provoking and fascinating interview.