Iain O'Neil, managing partner for health at TPXimpact, warns that significant changes must be undertaken in order to streamline the NHS, but believes a few simple strategies, underpinned by technology, would help to solve some of the most-pressing issues
The NHS digital revolution continues, but health services need to take a more-joined-up approach to technology adoption, argues Iain O'Neil
The pressures placed on the NHS continue to mount.
Whether it’s chronic shortages and more staff leaving the service, or waiting times for treatment hitting record highs; many recognise the health service is under as much pressure as at any time since its creation – and action needs to be taken.
This strain on the NHS has prompted the Government to look at changes to the way care is provided – although not always to universal approval.
Most recently, initiatives such as enabling pharmacists to give patients prescription medication without prior consultation with their GP have been put forward as potential solutions.
But some of these initiatives look a bit knee-jerk and it feels like we are missing the big ‘joined-up’ view of how we tackle issues at a system level.
Patient pathways cut across primary, secondary, social care, and sometimes beyond, and when a pain point appears somewhere a targeted ‘fix’ often just pushes the problem elsewhere
Patient pathways cut across primary, secondary, social care, and sometimes beyond, and when a pain point appears somewhere a targeted ‘fix’ often just pushes the problem elsewhere.
If we are going to relieve some of the pressure on the NHS, we need significant structural and strategic changes.
And, of course, we need thoughtful and responsible consideration of the role technology can play in supporting change.
Technology is often talked of as a silver bullet to addressing many of the challenges the NHS faces.
There’s no doubt we need better use of technology to help meet these, but while current programmes, such as digitising patient records to make them more accessible, or using automation to carry out repetitive tasks in patient administration, will help, there needs to be a better sense of the collective impact of all of these programmes of work.
It’s good to see EPRs being taken up, but these metrics don’t tell us or the NHS anything about the benefits being delivered by this investment in technology
For example, how does the implementation of electronic patient records (EPRs) connect with the procurement of a Federated Data Platform to support reducing health inequalities or the ‘backlog’ of patients waiting for consultation and treatment?
What are the top three outcomes all of these procurements are working collectively to tackle and how?
How are they connected and who owns the outcomes?
And we need to make sure we are measuring impact against these outcomes.
NHS England recently published progress figures showing what percentage of hospitals ‘now have an EPR’.
It’s good to see EPRs being taken up, but these metrics don’t tell us or the NHS anything about the benefits being delivered by this investment in technology.
What are these hospitals doing with their EPRs that they weren’t able to do before?
The same can be said about the NHS App. What has the growth in its uptake meant for patients, staff, and clinicians?
The NHS needs to continue to embrace new technologies and innovations, but it must do so in a way that provides the greatest value to both patients and service providers.
To achieve this, I would argue that decision makers shouldn’t take a ‘technology-first’ approach, but rather a humans-first, human-centred approach to designing solutions that truly understand what can, and should, be digitised to provide the best outcomes for people – both staff and patients.
Start with the problem, not the solution.
If the NHS wants to address overcrowding in GP surgeries and A&E departments, and long waiting lists for consultations and treatment, it needs to put some real effort behind prevention and work with its partners in local government, social care, and the third sector to take a holistic approach to managing health.
It also needs to double its efforts looking at solutions which allow for monitoring and treatment of patients away from hospital settings – whether that’s in their own home or in care homes.
The NHS needs to continue to embrace new technologies and innovations, but it must do so in a way that provides the greatest value to both patients and service providers
Remote monitoring and self-care technologies are improving all of the time – in part because they generate data, which unlike with paper-based pathways, can be used to continuously learn and optimise care.
Used well, these technologies can increase the ‘partnership’ between patient and clinician while also freeing up invaluable hospital space and allowing efforts to be focussed where most needed – with patients who require intervention.
The move to the ICS/ICB landscape has huge potential, but as the Hewitt Review revealed, it is not clear that we are on a path to realising it.
In order to do so, we need to move away from a centralised approach to providing care.
Healthcare needs are not universal and can differ from region to region.
Through wisely investing in technology, joining up care, ensuring the right data is available where it’s needed most, and giving local areas more of a say in how services are run, we can create an NHS fit for the modern age that meets people’s needs now, and in the future
ICBs need more power to operate autonomously and ensure they are able to prioritise the needs of the communities they serve.
Local services must also ensure they have identified and are able to articulate the needs of their populations.
We need systems designed for the challenges local services identify and technology providing data to support interventions.
The pressures faced by the NHS are not going away any time soon. They may well even increase due to an ageing population, and reductions in funding.
However, this doesn’t mean that we can shy away from the important steps to mitigate critical issues the health service faces.
Through wisely investing in technology, joining up care, ensuring the right data is available where it’s needed most, and giving local areas more of a say in how services are run, we can create an NHS fit for the modern age that meets people’s needs now, and in the future.