In conversation with… Michelle Tempest, Partner at Candesic
Dr Michelle Tempest spent 14 years as an NHS doctor before making the move into digital health consultancy at Candesic, where she’s worked in almost every continent to improve health and care. In this interview, Michelle tells our Head of Communications, Rose de Mendonça, why she thinks automation is one of the only realistic routes to dealing with the NHS’s staffing crisis, and why she thinks the UK has a unique opportunity to rocket boost digital health solutions globally.
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What does your role involve?
“I was originally a medical doctor and worked in the National Health Service for 14 years. It was a huge honour to work there, but as a frontline clinician it was a challenge that hospitals, community and home weren’t linked up. So, in 2004, I moved into healthcare strategy consulting with Candesic, which is where I still work, with the idea that I would try and look at a much more holistic setting for healthcare and try and be much more strategic, looking at the whole healthcare ecosystem.
“What's really nice now is that digital has augmented that capability. Thoughts that were seeded many, many moons ago are coming to fruition, which includes all the things you at Infinity do. There is now a tangible link right across a 360 degree view of health and care. There's still much to be done, but things are changing.
“I've never left my love of healthcare, but have tried to go from a very traditional problem solving approach of medicine into the strategy consulting world. Now, I advise companies that work within healthcare and life sciences, tech, all the way through to special educational needs, and investors. Money is sometimes a bit of a dirty word in healthcare, but it's not for free, it's taxpayer funded, and we do need investment into the sector.
“One of the pleasures of my job is that I can think about innovation when working with global investors who want to problem-solve. It's not just the status quo and trying to firefight, which is often what happens in the NHS, but also about the problems of today and how we can solve them so they don't happen tomorrow. That's a slightly different mindset to being on the frontline and having more demand than you can handle.”
Since you moved from clinical practice into consulting, what changes have you seen with respect to health tech - either in the NHS or in other healthcare environments?
“People from the healthcare sector moving into management was as rare as hen's teeth back in the day. I think it is a wonderful thing that the healthcare sector as a whole, whether or not it's technology, is much more multidisciplinary. That's so important if we're going to innovate, because these days, healthcare is not just about vaccination, right? COVID reminded us all of that it includes research and development, how to get global distribution, and very much needs a multidisciplinary team. This is for the better because it means that it means that strategic thinking is something that that that everyone in clinical frontline care can also get involved in. That wasn’t the case around 20 years ago.”
So that's what the NHS is doing well… with health tech, is there any one thing you think it could be doing that would make a big difference?
“My thesis is that the issues that we're facing in healthcare are pretty much the same no matter where you are in the world, and doesn't matter if it's the NHS or hospitals or community care in Australia.
“Fundamentally, we are out of human staff. Could the NHS have done more about this? Sure. But, it didn’t, so when you know that there's not enough people around, you have to start thinking differently. The NHS has to understand that there's a huge raft of things which frontline staff - humans - don't have to do, and that it really has to automate.
“Back in my day, I had to go in early and get a pen and paper and handwrite in everyone’s blood results in a paper folder, and here's hoping that I copied each number down right from the computer! Now, there are things which we can fundamentally change by automation - clinical support decision tools around blood results, triage so that the clinician goes to see the sickest person first.”
“Infinity is one of the answers, but the NHS should have seen this coming. It has been the juggernaut coming down the hill with the handbrake off.
“You've also got the the other side, which is interoperability. No matter what you're doing, obviously, you need to be able to share that care record. That comes back to my original clinical issue, which was that care has always been in silos. With digital, the beauty of it is that you can join it all up if there is interoperability.”
In your experience, how does healthtech in the UK compare with other countries?
“I've done lots of work in pretty much all the continents, and healthcare is in a way quite global. The positive is that the Royal Colleges here in the UK have very much been at the forefront of ensuring training and clinical standards have been kept to some of the highest standards. We should be very proud and feel very blessed to know that we have all the different subspecialties here. By following best practice, things can spread globally. No matter where the patient is, they should, in theory, get access to high quality health care with a certain standard, which is measurable and outcome related and evidence based.
“I think that one of the challenges is that for all sorts of historical reasons around the world, digitalisation - which in theory will become much more globalised - is still fragmented.
“Healthcare as a whole has also lagged behind other sectors such as FinTech. How do we leap frog? It's understandable that healthcare tech isn't the same as FinTech, because this is very human centered - there's more risk involved so standards do need to be higher. But we should be thinking ahead of the curve, rather than waiting for things to happen.
“We've got a unique and massive opportunity here in the UK to rocket-boost digital healthcare, because if it works for the UK, where we've always developed care in a very evidence based way, it should work anywhere. But for some reason, we seem to be sort of stuck.”
Why do you think we haven't rocket boosted it yet? What do you think the barriers are?
“Maybe we're having too many parties, and we've got to actually get on with some work.
I think politicians need to get involved, stop firefighting and start thinking strategically. Some of the issue is that they're focused on today's headlines rather than tomorrow's opportunities.”
What do you think the biggest barrier for healthtech companies looking to scale or implement within healthcare systems?
“There are certain countries where pen and paper is being used a lot in health and care - even in the UK. We have to first of all digitalise and then operationalise and then go global. GymShark, when they go into new geographies, think through what's going on in that country before they deploy. They can't just rock up and say because they’ve cracked it in Spain they’re going to automatically crack it in Germany. I think this kind of approach will translate into healthcare; consumerisation of healthcare. I think that will happen naturally, but historically, that hasn't happened.”
With all your experience across the world, are there any types of innovations that you feel particularly excited about for the future of healthcare?
“Oh my God, without mentioning Infinity?! I think that the number one need across the whole of the world is exactly what Infinity does: finding ways to redistribute admin and tasks that humans just don't need to do. You’re making sure that staff are caring for people rather than filling out forms. I would actually put everything that Infinity does up there, it's really exciting, and it's going to be the biggest problem-solver.”
“I also think that the new innovations around diagnostics at home are exciting. We're going to have to be much more mindful of looking after ourselves. All right, you can't always care for yourself when you are sick, but how can we help ourselves first and take ownership before we need to see somebody clinical? For instance, with physiotherapy I know for a fact that there are lots of online tutorials people can use as part of normal life - before they get sick or deteriorate with MSK conditions. That's something which is a global shift, and COVID definitely helped with that journey.
“I think it's all great to have that consumerisation of healthcare. Right now I've got this Oura Ring on and it tracks everything, but we mustn't become hypochondriacs. It's about keeping things in context, because we can track everything, but at the end of the day, we're all human.”
If the NHS could do one thing tomorrow to a digital future a reality, what would it be?
“I don't know why they don't just do it.
“We don’t have a “national” health service, we have a fragmented health service. The NHS could aggregate all of the things which we do have to have in our healthcare system. We have this huge access to frontline clinicians and research centres and Academic Health Science Networks, and yet there is still an opportunity for the whole NHS to work together to create something digital.
“The NHS also needs to make sure it's innovative for the people who work there. We’ve let 1,000 flowers bloom, and that's great, but the NHS should sift through winners, such as Infinity, much faster. Get them rocket boosted.
