Doing the Wrong Things Faster, Is That the Best We’ve Got?
I’ve been wrestling with something that I think sits right at the heart of UK healthcare — something uncomfortable, but vital to name.
It’s this: we’re building more capacity to do the wrong things faster. We are actively finding ways to service more of the failure demand we continue to create instead of stopping it’s creation.
Sounds harsh, I know. But stay with me.
“Build it and they will come”... and they do!
With the excitement around digital hospitals and virtual wards, there’s a growing belief that more capacity — physical or virtual — will fix the system.
But if you only need an acute setting when you require hands-on care, why would creating a virtual acute environment not simply drive even more innapropriate demand into the same acute pathways?
We’re not short of evidence.
Approximately two out of every three A&E attendances are unnecessary. At least 30–40% of elective referrals don’t result in an inpatient or daycase episode.
So when we add new capacity — whether bricks or clicks — we’re not reducing demand, we’re redistributing it.
And, worse, we’re reinforcing a system philosophy that mistakes throughput for true demand.
It’s a philosophy problem, not a funding one
Every week we see headlines: new hospitals, expanded outpatient hubs, “catch-up theatres”.
But this isn’t fixing the root cause. It’s feeding the beast.
We’re pouring money into faster wrongness.
The focus is on seeing more patients, not necessarily the right ones — in the right place, at the right time.
As my Lean Six Sigma friends will tell you:
“Automate a process that produces crap, and you just get more crap — faster.”
Digital transformation without philosophical transformation just accelerates dysfunction.
The data has no manners
At VUIT, we live by one truth: data doesn’t lie — and it has no manners.
Here’s what it’s telling us:
At least 20–30% of elective referrals could be avoided with better GP support.
At least 50% of A&E attendances could be managed better elsewhere.
In 2023, 118,474 one-day COPD or bronchitis admissions cost acute providers £75.5 million.
That’s not hypothetical. That’s real money, real people, real opportunity.
We could make a dent in this within one month — not through new capacity, but by redirecting demand to where it’s care actually belongs and putting the right resources in place to service it.
So why don’t we?
Because systems protect their wiring.
Sometimes it feels as if the NHS has become a living organism — one that repels attempts to rewire it.
But if we strip away the sci-fi metaphors, we’re left with a simpler, harder truth.
Who actually loses if we fix this tomorrow?
Not patients. Not the Treasury. So who?
Until we face that question head-on, we’ll keep doing what we’ve always done: building more, spending more, and calling it progress.
The shift we need
It’s not “more with more”.
It’s not “the same with less”.
What it is is a fundamental shift from acceptance to active dis-satisfaction, a genuine belief that the way we have always done things round here are exactly what got us ‘here’.
Because doing the wrong things faster isn’t transformation. It’s failure demand, dressed in innovation’s clothes.