The medical profession is populated by individuals, many of whom have had years of training to equip themselves for a vocation that will always be needed by society. There are thousands of dedicated staff committed to improving health or curing health conditions. The notion that the future of health service practices will necessitate transferring health responsibilities to others without health practice backgrounds is clearly unpalatable to most health practitioners, especially if funding and livelihoods are threatened. The reality is that such change is inevitable as technology empowers us with the tools to take more control over our lives. For the NHS to make a fresh start, we need that consumer empowerment to be linked to responsibility. If we have better tools to monitor our health embedded into our daily lives, we should also accept the consequences of our lifestyle habits. Currently the model for the NHS and Health Insurance provides little incentive to change those habits but, as we are already seeing with motor insurance policies linked to in-car technologies that monitor how well we are driving and offers discounts to drivers who can prove they have good driving practices, these technologies offer incentives for behaviours which reduce risk of accidents. Encouraging the voluntary use of wearable lifestyle technologies that collect valuable data about the daily habits that can best improve our lives is, in my opinion, the most cost effective way to avoid the obesity “slow-motion” car crash that could destroy the health service as we know it. It would require leadership and vision to implement a “tough love” strategy in which those who contribute to good personal health management are encouraged and rewarded whilst those whose lifestyle habits place a burden on health resources bear some of the cost consequences.

1. The NHS and UK Social Serviceshave been goodfriendstome andmy familyoverthe years.My father’s
quadruple heartbypassoperationover30yearsago at St Marys Hospital inPaddington extendedand
dramaticallyimprovedhislifeandthe care and attentionmymotherreceivedfromsocial servicesas
dementiatookherfromindependentlivinginaCouncil runflatintoherfinal yearsina care home
exceededmyexpectations.Iam convincedthatthose of usluckyenoughto be babyboomersand those
of currentand future generations are unlikelyto see thatstandardof care and attentionagain unless
radical changesare made to national healthandcare provision.
It isoftensaidthat true friendsare those people whocare enoughtospeaktheirmindaboutwhatthey
see happeningtotheirfriendsevenif itputsatriskthat friendship.ItisinthisspiritthatI am writingthis
article to suggestthatunlessthe NHSgraspsthe pricklynettle of disruptivetechnological change itwill
riskbeingdamagedbeyondrecognition.Observingthe NHS’srole insocietyislikewatchinganover-
protective parentindulgingafeckless andungratefulchildinthe mistakenbeliefthatsuchunconditional
love and care will developabetteradult.Experience tellsme thatthere are timeswhen“toughlove”is
neededtoturnthe fecklesschildintoaresponsible adult.Forthe NHS,that time isNOWbefore the
damage isirrepairable.
The NHS and Obesity
The NHS will notsolve the obesityanddiabeteschallenge.WhilstIapplaudChief ExecutiveSimon
Stevensforhiscampaigntotackle the “slow motioncar crash” of obesityandconsequential lifestyle
relatedconditionssuchasdiabetes,cancerandcardiac problems,Ifearthat hisstrategyof requiringGPs
to advise over-weightpatientswillbe ineffective.LikeSimonStevens,Imanagedtolose almost4 stone
inweightin3 monthsthrougha combinationof dietandexercise.

2. That weight-lossexperience notonlytransformedmylife andmywell-beingbeyondall expectation,it
alsogave me an insightintothe problemsfacedbythe medical professionandtheirlackof recognition
and/oracceptance of the impactof disruptive technologiesonhealthpractices.Ihave beenlucky
enoughtobe healthythroughoutmylife.Myonlystayin hospital waswhenIhada burstappendix in
1971. I probablyowe mylife tothe NHSand the skill of the staff at Queen ElizabethHospitalin
Birminghambutsince thattime I have had lessthanone weeksickabsence fromwork.Like almost
everyone Iknow,Ihave readabout diets,triedthemforawhile andalsospenttime inthe gymbut once
my sportingdayswere behindme,Igraduallyputonweightuntil,bymid2013, I weighedalmost18
stone whenmyideal weightshouldbe around12.5 stone.
It was a combinationof circumstancesthatledme tomake some critical changesinmy lifestyle thatnot
onlytransformedmylife butcouldalsobenefitmillionsof otherswho,likeme,have become“Personal
HealthSpectators”.InMay 2013, I was ina playcalled“Ioughtto be inPictures”at the Little Theatre in
Leicester,playingafailedHollywoodScriptwriter.One of myfriendsaskedme whereIgotmy stomach
paddingfrom(Iwasn’twearingany) andanothertoldme bluntlythatIwas fat.The followingweekImet
an AustralianworkcolleagueforlunchinCoventGardenandshe suggestedIhad some Russianbloodin
my ancestrythat I couldinvestigate bysendingoff asample forDNA testingat23andme.com.I took up
hersuggestionandwhilstthe DNA sample showedthatmyancestral originsare 99% certainto be
WesternEuropean,italsoindicatedthatIhad a 32% likelihoodof developingDiabetes2.If I am honest,
I wouldsaythat none of these events,bythemselves,wouldhave made me seriouslychange my
lifestyle habitsbutitwasa chance article on the BBC website,combinedwiththese eventsthatsetme
on the path to a verymuch improvedlife.

3. Wearable Technologies are Game-Changers
The article I read aboutconcernedthe “Jawbone UP”braceletwhichmeasuresyourphysical activityand
sleeppatterns.Itwasthisarticle thatpromptedme to use wearable technologytohelpme manage my
weight.Beingable tomeasure andanalyse myactivity,sleepandeating habitsenabledme tolose 21Kg
within3 monthsandsince I startedinJune 2013, I have beenable tolearnhow to manage my lifestyle
to not onlystabilisemyweightwhilsteatinganddrinkingverywell butalsoimprove mybloodtest
resultsandmy physical andmental fitnesswithoutanymedication,supplementsorvisitstothe gym.
Havingexperiencedthe potentialof wearable technologiestotransformmylife andrecognisingthat
medical practitionerswithexpertise indiabetes,nutritionandexercise mightnotonlybenefitfromwhat
I learntaboutmy ownlifestyle habitsbutalsohelptodevelopimprovedprograms,Isoughttoshare my
experiencesandcollaboratewithleadingfiguresandorganisationsinvolvedintacklingobesityand
diabetes.Iimaginedthatmyexpertise andindustryconnectionsasthe formerFoundingDirectorof the
SeriousGamesInstitute atCoventryUniversity wouldgive some credibilitytomyoffertodiscusshow
wearable technologiesand“gamification”methodologiesmighthave asignificantimpactonlifestyle
habitsinthe general population.HowwrongIwas !!!
The reasonwhy wearable technologieshave the potential tobe real game-changersinthe fightagainst
obesityandlifestylerelatedmedical conditionsisthattheyprovide eachof uswiththe toolsto measure,
understandandmanage the factors whichaffectourpersonal health.Itisthisempowermentof
personal healthmanagementwhichcandeliverthe intrinsicmotivationwhichiscritical totransforming
us from“Personal HealthSpectators”to“Personal HealthPlayersandManagers” withthe greater
acceptance of responsibilityforpersonalhealththatisessential forthe future of the NHS.
Breaking the Mould

4. Daily Mail Article
We have become sodependentonestablishedpracticesandperceptionsof the NHSas a solverof
healthproblemsregardlessof whetherourbehaviourshave contributedtothose problemsthatwe have
come to expect“quickfixes”ora “pill forall ills”fromsocietyratherthanhavingtotake responsibility
for our ownbehaviour.Thisisthe essence of today’s“SpectatorSociety”exemplifiedbythe DailyMail
“Life on Benefeats”article inwhichanover-weightwomansuggestedthatshe shouldreceivegastric
bandsurgeryand a personal coach because spendingherbenefitsonjunkfoodhadmade herfat.
Thisis an extreme exampleof the growingtendencytoexpectsomeone else todevelopacure for our
healthproblemswithoutushavingtomake anychangesto our ownlifestylehabits.Thisisamouldthat
has to be brokenbutit will require leadershipanda level of cross-sectorcollaborationthatisdecidedly
absentinthe silomentalitythat,inmyexperience,currentlyexistswithinthe NHSandleadinghealth
sectorprofessionals.
The Writing is on the Wall
The impact of disruptive technologiesonsocietyisillustrated bythe way technological change has
affectedknowledgeprofessionalsinotherareas.Educationhasalreadystateda painful transitioninthe
role of teachersfrombeingthe source of knowledge tobeingcoaches,facilitators,guidesandmentors.
Studentshave the toolsandresourcestofrequentlybecome more knowledgeable thanteachersandyet
teachersstill bearthe burdenof responsibilityforeducationandblame forinadequaciesinthe system.
The medical professionandhealthserviceswillsufferexactlythe same painfultransition.Itisalready
happeningwhenpatientswithmore rare andseriousmedical conditionscome totheirGParmed with

5. up to date reportsand print-outsondiagnosisandtreatmentthatgowell beyondthe currencyof the
GPs knowledge.
Exactlythe same phenomenonhastakenplace inmanyothersectors.Asa Corporate Marketing
Executive sellingmainframeandmid-range computersforIBMin the early1980s I wouldneverhave
imaginedthatthe average maninthe streetwouldbe asknowledgeable aboutcomputersasmost
professionalsinthe industryatthe time.Inretrospectitwasinevitable asthe disruptivetechnologiesof
the desktopcomputer,the internetandmobile devicesbecame consumerised.
The most likelyreasonwhythe medical professionandthe bankingindustryhave beenrelatively
untouchedbythese developmentsisbecause bothsectorshave ahighlevel of perceivedriskof the
consequencesof lackof knowledge/experience.Withthe new wearableandconnectedhealth
technologiesthatare aboutto become mainstream, thatsituationwill change andunlessthe NHS
respondsbyembracingthe inevitable,itwill face averypainful anddamagingfuture.
Fresh Start for the NHS
The medical professionispopulatedbyindividuals,manyof whomhave hadyearsof trainingtoequip
themselvesforavocationthat will alwaysbe neededbysociety.There are thousandsof dedicatedstaff
committedtoimprovinghealthorcuringhealth conditions.The notionthatthe future of healthservice
practiceswill necessitate transferringhealthresponsibilitiestootherswithouthealthpractice
backgroundsisclearlyunpalatable tomosthealthpractitioners,especiallyif fundingandlivelihoodsare
threatened.The realityisthatsuchchange isinevitableastechnologyempowersuswiththe toolsto
take more control overour lives.
For the NHS to make a freshstart, we needthatconsumerempowermenttobe linkedtoresponsibility.
If we have bettertoolstomonitorourhealthembeddedintoourdailylives,we shouldalsoacceptthe
consequencesof ourlifestyle habits.Currentlythe model forthe NHSandHealthInsurance provides
little incentivetochange those habits but,aswe are alreadyseeingwithmotorinsurance policieslinked
to in-cartechnologiesthatmonitorhowwell we are drivingandoffersdiscountstodriverswhocan
prove theyhave gooddrivingpractices,these technologiesofferincentivesforbehaviourswhichreduce
riskof accidents.
Encouragingthe voluntaryuse of wearable lifestyletechnologiesthatcollectvaluabledataaboutthe
dailyhabitsthatcan bestimprove ourlivesis,inmyopinion,the mostcosteffectivewaytoavoidthe
obesity“slow-motion”carcrash that coulddestroythe healthservice aswe know it.Itwouldrequire
leadershipandvisiontoimplementa“toughlove”strategyinwhichthose whocontribute togood
personal healthmanagementare encouragedandrewardedwhilstthose whose lifestylehabitsplace a
burdenonhealthresourcesbearsome of the cost consequences.
Health as a National and Personal Index
Healthstatisticsshowthe UK as one of the mostvulnerable countries tothe consequencesof obesity.
Wearable lifestyle technologiesofferaseamlessandautomaticwayto measure the healthof the nation

6. and everycitizen’scontributiontoanoverall healthindex withoutplacinganyadditional burdenonthe
tax payer.
In a worldwhere itisincreasinglyfashionabletohighlightthe deficienciesof our National Health
Serviceswithoutofferinganyplanorpersonal commitmenttochange the statusquo,I reallyhope the
NHS listenstothe viewsof averyconcernedfriendandstartsto embrace the technologiesandpractices
whichwill eitherbe itssalvationoritsdestroyer.
About the Author
David Wortley is the author of “Gadgets to God”, a historical perspective of mankind’s changing relationship with
technology over the last 60 years and a vision of the future impact of disruptive communications technologies on
business and society. He is CEO and Founder of GAETSS (www.gaetss.com), a consultancy on the strategic use of
Gamification and Enabling Technologies for the transformation of business and society. His passion is helping
organisations and individuals to leverage the power of these technologies for competitive advantage and
business/personal development.
David is a Fellow of the Royal Society of Arts (FRSA) and the former Founding Director of the Serious Games
Institute at Coventry University. He has recently relocated to Malaysia to focus on establishing a commercially
sustainable social enterprise with a mission to tackle global challenges such as obesity,diabetes and lifestyle
related medical conditions.He is a serial entrepreneur and innovator with a passion for applying technology to
social and economic development
David Wortley
Tel: +44 (0)789 665 9695 +6011 2318 0284
Email: david@davidwortley.com
Web Site: www.davidwortley.com
Skype:davidwortley