The digital revolution and the NHS
The NHS is at the forefront of the digital revolution, from the 100,000 Genomes Project to the development of digital pathology, we have seen huge advancements in the way technology and digital services can support better patient experience and improve clinical outcomes.
With the creation of NHSX there is an even greater focus on harnessing technologies to transform healthcare and the recent announcement to merge NHS X into a Transformation Directorate, shows the aspiration to leverage digital across the health and care ecosystem to support the delivery of the Long Term Plan. The plan sets out that ‘Digitally-enabled care will go mainstream across the NHS’. But what does that mean and how will this revolution become a reality. Below we set out the areas in the plan which are seen as critical:
Empowering People: Block believes empowerment is one of the cornerstones of the digitisation agenda. Providing patients with access to systems and data and allowing them to proactively manage their care outside of the ‘four walls’ of NHS organisations.
Supporting Health and Care Professionals: The digital revolution for staff reflects that for patients, enabling them to capture information at the point of care, optimising clinical process and reducing burden. But it requires solutions that deliver exceptional usability and requires staff to have the digital skills to take advantage of technology.
Supporting Clinical Care: The focus here is on outcomes as well as patient experience. We believe the key is enabling patients to develop an ongoing and joined-up relationship with the NHS, rather than one that is siloed. As well as ‘patient experience’, we see ‘clinical outcome’ as the other key factor. The use of digital to support clinical pathway redesign, for example, shows how the digital revolution can support improvements in clinical care.
Improving Population Health: As the structure of the NHS transforms with the introduction of Integrated Care Systems, the importance of population health will grow. Enabling clinical teams to understand and better manage the issues that exist across a population. Harnessing the power of population health will also begin to combat many of the health inequalities that exist within society by shining a spotlight across a population, highlighting patient cohorts who are being disproportionately impacted by certain conditions or events.
Improving clinical efficiency and safety: There are many instances where the digital revolution has already positively impacted clinical efficiency and safety. The use of digital pathology and electronic prescribing are just two examples of the enablement of staff to successfully deliver clinical services with greater accuracy and speed and in doing so driving efficiency, while simultaneously reducing error rates and improving safety.
NHS implication
As critical as technology is to the digital revolution, it is the implication on NHS staff that is most important. Within his government review: Making IT work, Robert Wachter sets out, “digitising effectively is not simply about the technology, it is mostly about the people.” Since the release of Wachter’s recommendations, there have been many examples of important workforce digital development, e.g. the NHS Digital Academy where we see a focus on supporting those individuals who will be the future digital leaders of our NHS. We believe this development of NHS leaders is critical to the success of the digital revolution.
Digitising effectively is not simply about the technology, it is mostly about the people. Robert Wachter, Making IT Work
Another critical implication of the digital revolution for the NHS is the importance of data sharing. As set out in the government’s Integration and Innovation whitepaper, ensuring more effective data sharing across the health and care system, is key to effective integration of services and will be a critical component in enabling the digital transformation of care pathways.
The DOHSC white paper: The future of healthcare our vision for digital data and technology, sets out many of the challenges that digital transformation brings for the NHS, from the complexity of legacy infrastructure to a risk-averse culture. It also sets out four guiding principles that should be maintained: 1: user need, 2: privacy & security, 3: interoperability & openness, and 4: inclusion. Block very much agree with this position, but would build upon this in also focussing on:
- Integration: The importance of organisational and care setting integration is clear, but Block see the integration of digital systems and solutions being equally important. The challenge here covers not just software, but infrastructure as well. Without technical and system integration, the NHS will not be able to reach the required level of digital maturity.
- Standards: As Robert Wachter set out, ‘interoperability should be built in from the start [1], a focus that has grown since Wachter’s 2016 report. To achieve that vision, however, it is critical the NHS bases its digital and technical foundations on solid standards, which can be managed and developed to deliver robust and scalable solutions. Importantly this should focus not just on software, but infrastructure too, where standards are just as important.
- User-centred design: Block believes that technology alone will not allow the digital revolution to embed at scale. It is only through consideration of the user that the NHS will be able to embed digital services that really enable widespread uptake of digital services.
- Scalability: To deliver the digital revolution, Block believes being able to scale technology is critical, especially in an organisation as large and complex as the NHS. Therefore, being able to replicate digital and technical design consistently and at pace is critical. This can be seen as a cornerstone of the Global Digital Exemplar and fast follower model and we believe should be embedded as a first principle in all digital development moving forward.
Digital opportunity
One of the core beliefs that Block hold is the importance of understanding the user story and working closely with our customers in the development of new products and services. We are therefore excited by the focus NHSX has placed on the development of a Tech plan for health and care and in doing so engaging with stakeholder groups to ensure that the digital revolution is a journey followed together, not one that is enforced upon staff & patients without engagement.
By following this approach, the digital revolution will provide almost endless opportunities to harness new technologies and in doing so transform the way healthcare is delivered.
It’s not just about leveraging cutting edge technologies, such as AI, Cloud, Robotics and Automation, it’s also about the fundamentals that need to be embedded, to ensure the cutting edge can flourish. Matthew Mahoney, Director of Digital Transformation at Block.
Block believe however this is not just about leveraging cutting edge technologies, such as AI, Cloud, Robotics and Automation, but as set out in the government paper The future of healthcare, it’s also about the fundamentals that need to be embedded, to ensure the cutting edge can flourish. We agree with the priorities set out in the paper, ensuring infrastructure, digital services, innovation, and skills & culture are not forgotten and remain as critical, in delivering the overall digital revolution.
In terms of what has already been achieved, we have seen so many digital opportunities taken, many of which have been set out by NHSX delivery. From foundational progress such as the provision of iPads and internet connections to care homes and the critical work done by the centre with the development of the Covid-19 data store, to better understand and manage the virus, through to more cutting-edge developments such as NHSX’s AI Lab to test and evaluate promising Artificial Intelligence development.
These examples show that the digital revolution is not just about far-reaching, blue sky innovation, but about a balanced mixture of the ordinary and the extraordinary, which together will support the NHS and each member of its patient and staff population to engage in the digital agenda and embrace digital as an integral part of their healthcare journey.
[1] Making IT work: harnessing the power of health information technology to improve care in England – GOV.UK (www.gov.uk)
