As part of a series of events and publications on digital public services, the BSA held a Digital Healthcare seminar in partnership with Associate Member Pinsent Masons LLP. With thanks to our speakers:
- James Hawkins, Director of Programmes, NHS Digital
- Rachael Hunter, Health Economist, UCL
- Matthew Godfrey-Faussett, Partner, Pinsent Masons
The opportunities for digital solutions and technology to improve healthcare across the patient pathway are clear. More than one in ten people wear a fitness tracker, encouraging active lifestyles and, in turn, reducing the likelihood of developing a number of medical conditions in future. Technological advancements are enabling point-of-care testing to be introduced in GP practices and hospitals, speeding up diagnoses. E-health interventions and genetics are helping to tailor treatments for patients, improving outcomes and patient experience. Telecare solutions are already helping people to manage long-term conditions at home, reducing dependence on GPs and emergency hospital admissions.
Digital solutions applied to healthcare, as well as technologies developed specifically for the health sector, aim to transform how health and social care is delivered, integrate services, empower patients, enable choice, support clinicians, and help to manage the system effectively.
Putting these principles into practice, James Hawkins explained how a number of initiatives led by NHS Digital have helped the NHS cope this winter. NHS 111 has been available online for around 30% of the population, and is being fully rolled out this year. E-booking out-of-hours appointments via 111 reduced attendances at A&E and electronic repeat dispensing eased the burden on GP practices. Improved system resilience and cyber security reduced the chances of critical system failure and increased productivity. Data collected on the flow of patients through A&E departments and hospitals fed into NHS Improvement situation reports, informing responses to pressures on hospitals and reducing the burden on providers in reporting and validating data.
It may come as a surprise that these measures were not in place before. It is true, by its own admission, that the NHS has been slower than other industries in adopting technology to its greatest advantage and, although technology is now relied upon in many areas, there is still progress to be made and challenges to overcome.
One challenge is that digital platforms often involve an element of upfront cost for devices, software or training. Pressures on NHS funding means, for many Trusts, any upfront cost is beyond their reach in the short term. In these cases, partnership arrangements with private sector companies can be explored. There may be alternative funding options available to help digital transformation plans get off the ground. This is also an area where government funding could be targeted.
As Rachael Hunter explained, there is also a challenge in ensuring digital infrastructure is in place. Reliable wi-fi in GP practices, community health centres, hospitals and across the health estate is one example. Many BSA members are already helping Trusts to become digitally enabled by working with them to install wi-fi and procure devices that mean, as an example, clinicians can access scans on tablets in the room with the patient moments after the image has been taken. Another part of the challenge is ensuring that, as new software and technologies are developed, they can talk to each other. Particularly in regards to electronic patient records, interoperability is a basic requirement.
Data, particularly data sharing, underpins the potential for digitally transforming healthcare. Understanding the needs of the local population can help commissioners to prioritise services most appropriate to their constituents. Big data can help researchers to understand more about diagnosing, treating and, hopefully, preventing or curing diseases. However, as care.data has shown, the public has concerns about sharing sensitive personal information. There is a paradox here as most of us would expect a hospital consultant to have access (digitally) to our medical history, so they have all the information required to treat us. But this is still not the case for many.
Alongside a public debate and educational campaign on sharing health records, General Data Protection Regulations (GDPR), coming into force in May this year, may go some way to ensuring providers have rigorous data protection systems in place and reassuring the public that their data is safe. The consequences of a breach will be much more severe in terms of the maximum fine, Matthew Godfrey-Faussett cautioned the audience at the event, and data controllers, as well as data processors, both have a role, and are liable, in protecting data.
Cultural and behavioural change across the system is also needed to truly embed digital healthcare.
As one speaker at the event put it, the NHS is a brand rather than an organisation and is made up of hundreds of Trusts, arm’s length bodies and partner organisations. Instilling change across all these organisations takes leadership and time. There can be a “not invented here” mentality in the health sector, but, particularly in digital, it is imperative we build on what is already happening to avoid duplication, learn what works well and avoid repeating mistakes. Support and leadership from NHS England, NHS Improvement and NHS Digital will be vital in achieving this.
We must keep in mind the drivers behind digitising healthcare – to improve services for patients and clinicians. Efficiency plays a role in this and in areas such as estates management and back office functions, where BSA members have much experience across private and public sectors, digital solutions will create better, more informed ways of working to optimise estate use and streamline processes. Efficiency gains in these areas mean money can be directed back to frontline care.
The strong message to take from the BSA Digital Healthcare event is that the best is yet to come. All parties are building an understanding of what works for patients and clinicians and learning from other sectors. Ongoing research means we can continue to put patients at the heart of services, whilst demonstrating the benefits of digital healthcare.
The business services sector will continue to play a central role in developing digital solutions and technologies for the health sector and working in partnership with the NHS, local authorities and wider health and social care providers as digital healthcare continues to evolve.