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Digitising the NHS – Celebrating 70 years

This year marks the 70-year anniversary of the National Health Service (‘NHS’). That’s seventy years of fixing broken bones, delivering babies, and providing ongoing treatment for diseases such as diabetes and combating cancer to name just a few.

Digitising the NHS – Celebrating 70 yearsThe NHS deals with over 1 million patients every 36 hours. On the 5th July 1948 when Aneurin Bevan (the Health Secretary of Clement Attlee’s Labour government), decided to launch the NHS at the now Trafford General Hospital, it was heralded
as one of the biggest and most ground-breaking initiatives to revolutionise the healthcare sector

in the UK. Hospitals, as well as all the staff that keep them running around the clock, were joined together beneath the NHS umbrella to provide free healthcare at the point of access. In 2018, its mantra is the same as when it was first created in 1948: the NHS is a health service available to all and funded through taxes which means you pay according to your means. With life expectancy rising by five hours a day and a steady stream of emerging technologies and techniques, is the NHS in a position to face the future and survive beyond another seven decades?

Digitisation is the process of converting information into a digital format that creates binary data that can be processed and handled by computers.

The challenges faced by the NHS in 2018 are drastically different than those faced by the Labour government of 1948. At the outset, the focus was on treatment, and not preventing illnesses in the first place. Today, we’re faced with ever-increasing levels of obesity, and a rise in the number of patients suffering from type 2 diabetes which hinder the work of the NHS, and last year, the Red Cross labelled the state of the NHS a ‘humanitarian crisis’.

With staff shortages, waiting times in Accident & Emergency departments nationwide exceeding the government’s 4-hour window, and tens of thousands of operations being cancelled, should the focus of the NHS be on digitising its services? Or will making the transition into the digital age empower the NHS to provide better and more efficient healthcare which could help to reduce repeat visits to a GP or hospital?

The NHS Five Year Forward View

As part of the NHS’ strategic outlook for the next five years, they pledged to ensure that all patient records would be paperless by 2020. This also extends to the way that GP practices are helping patients to use online services, for example to seek advice or to book their own appointments.

The digitisation of the NHS allows it to continue to transform the healthcare sector, and to support patients. In 2015, local healthcare systems produced Local Digital Roadmaps which set out how they would become more digital by 2020.

These road maps give a clearer sense of the areas a patient might live in, how many Clinical Commissioning Groups (‘CCGs’) there are, the authorities in place, and the different Health and Wellbeing Boards. Knowing what’s on offer, and how to access it empowers patients to approach the right organisations with their specific needs. It also helps each of the different healthcare organisations to understand the best way of sharing patient information to create a more joined-up and comprehensive experience.

To digitise the NHS, it’s all about implementing healthcare’s Triple Aim: better health, better healthcare, and at a lower cost which will hopefully result in £22 billion in efficiencies.

Making the NHS more digital

In order for the National Health Service (NHS) to continue to provide a high level of healthcare at an affordable cost, it has to move with the times. This digital transformation will involve a wide scale cultural shift, revisiting the existing structure, greater governance, an energized workforce, and sufficient training. But it’s creating a fully digitised NHS that is one of the greatest challenges.

Impressively, the English GP sector began digitising in the 1980s by installing practice-based microcomputers that had tailored software. In 1982, a ‘Micros for GPs’ scheme saw 150 practiced buy microcomputers for £2.5 million with over 2000 practices vying for a piece of the tech revolution.

The goal was to better aggregate, review and plan the delivery of health at a practice level. By the mid-2000s, GP practices were nearly 100% digital. By contrast, an ambitious programme to digitise the secondary care sector – the National Programme for Information Technology (‘NPfIT’), which was launched in 2002 – was shut down in 2011 after having mostly failed to achieve its goals. A post mortem of the NPfIT criticised the fact that it was too centralised, failed to engage with trusts and their healthcare professionals, and that it ignored the old adage of ‘slow and steady wins the race’.

In late 2015, the National Advisory Group on Health Information Technology in England advised the Department of Health and NHS England on its efforts to digitise the secondary care system. Their recommendations fell into 2 broad categories: 10 overall findings and principles, followed by 10 implementation recommendations.

To digitise the NHS, it’s all about implementing healthcare’s Triple Aim: better health, better healthcare, and at a lower cost which will hopefully result in £22 billion in efficiencies. Rather than digitising the NHS at a rapid pace, it’s about doing it in a staged fashion. The return on investment from digitally modernising the NHS won’t be just financial, it’ll also result in improvements in safety and quality terms.

Digitising the NHS – Celebrating 70 yearsThe improvements in technology, training the workforce, and adapting to digital technologies will also create a more innovative outlook for the NHS in general. The focus should be on sharing information between local and regional levels, which also includes giving patients access to their own electronic data. Especially in light of GDPR, privacy is increasingly important, but not sharing information can hinder research and prevent improvements to patient care.

The new Health IT Systems are going to be built with end-users in mind to make them easier to work with and minimise human error. Attitudinally, the NHS’ digital strategy has considered that a lot of clinical leads or management might not have the understanding of IT systems, and to be able to implement a truly digital NHS, there will need to be a willingness to adapt by all staff. Alternatively, there’s the option to source a trusted managed service provider who might be able to bear the burden of managing your NHS trust’s network, and keeping it secure and productive on a daily basis.

With a goal for all trusts to be digitised by 2023 in light of the £4.2 billion that was made available by the Treasury to promote digitisation, that won’t be enough for every trust. However, with the help of local government, and a staged implementation process, the hope is that we’ll all see a much more digital NHS in 2023 than we do in 2018.

Is the digitisation of healthcare a health-risk?

E-health systems are gathering momentum, not just in the UK but overseas. Removing legacy systems that stop effective data integration is a big driver for not just the NHS but other organisations looking to support clinicians and patients. Likewise, smartphones allow us to do so much more than make calls and texts: we can check our bank balances, watch TV, and reserve seats on trains, so we should be able to hold our health in the palms of our hands?

What does the future of digital healthcare look like?

One thing we all need is access to healthcare. Digital health innovations will help us to cut long-term healthcare costs, treat patients better, empower both patients and clinicians to have real-time data and connections with each other, and will also allow others to join the healthcare system.

A model of healthcare that lives alongside you, gathering data about what you eat, how often you exercise, what your environment looks like, and then feeds into your healthcare record can make your interactions with your doctor more meaningful. With the help of smartphones and smart watches, cloud storage, and data analytics, digital health will be able to help in predicting diseases you might contract, and in some cases can help to shape your behaviour to prevent them.

How is Intercity driving innovation in healthcare?

We work alongside Virgin Media Business to bring Cumbria and Lancashire NHS Trust its out-of-hours stroke thrombolysis (‘clot-busting’) service, which ensures that anyone from the area’s population of 2.2 million can benefit from treatment to reduce the likelihood of disability or death resulting from a stroke. The network remotely connects a team of 15 specialist Stroke Consultants who can provide advice from their own homes to eight hospital sites. Each consultant has a secure broadband connection to a video-enabled Telecart which is placed at a patient’s bedside.

The Telecart enables a two-way consultation, so that the stroke specialist can see and hear the patient, view CAT scans and recommend treatment. With strokes being the 4th most common cause of death and the most common cause of permanent disability, the quicker that surgical intervention can take place, the better the outcome for the patient. Telestroke is an example of IT being used to save lives and proves that technology has a vital role to play in driving forward our healthcare system.

Up next

5 minutes with Andy Smith, Intercity Security Operations Centre Manager (‘ISOC’)

Tell us what your role is, and what team you work on…

5 minutes with Andy Smith, Intercity Security Operations Centre Manager (‘ISOC’)As the ISOC manager it’s my team that look after annuity services on a 24 hours per day, 7 days per week, 365 days per year basis for our managed service customers. Our customer base ranges from the public sector including customers such as Lancashire Care NHS Trust and Lambeth Borough Council, through to smaller enterprise customers, and education organisations such as GÉANT. We provide simple remote support (when the customer’s technical team might need a little more expertise), right through to fully managed services where we monitor, manage and maintain the customer’s network and infrastructure from cradle to grave.

What is a typical day like for you?

On a daily basis, I manage the staff and the coordination of resourcing to make sure we have full coverage around the clock (even on Christmas day when the rest of us are home opening our presents). Sometimes, I’ll need to deal with issues that need management escalation, or maybe report on the different facets of a customer’s service. My responsibility is to make sure that our services are effectively delivered, within SLA and to agreed contractual terms. I would like to mention my management team (John Murphy, Peter Ackerley and Teri Newell) who offer a great deal of support in working with our 24-strong team to perform their roles to the highest standards.

My job would be much more complicated without them. We have a multi-skilled, multi-disciplined team of engineers and analysts, providing a technology agnostic approach to support services – so coaching and mentoring is a staple within the ISOC. Whilst staff strive to keep up with changes in technology, they’re also committed to delivering innovative services and support.

What is the best thing about your job?

I think the most rewarding thing is being able to coach and support individual team members, and then see them fulfil their potential (and ultimately be recognised for the hard work they do). It’s always great to receive positive feedback from internal stakeholders and customers, who value the contribution made by your team. I take great personal satisfaction in being able to share in the success of my team.

I like working at Intercity because…

Intercity has always been driven by the desire to get things right first time, every time for our customers. There’s nothing better than a customer telling you how well your team have delivered what they needed and when they needed it. I think that as a family-run business, there’s a different feel to working in other organisations: you’re treated as an individual, with respect and dignity and shown recognition for doing a good job.

What’s the most challenging part of your job?

With the breadth of our customers, sometimes it can take a little while to understand the specific needs of an individual business. Fortunately, our agility as a business means that once we’ve understood the level of detail needed by our customer, we can deliver the outstanding service they deserve. It’s always really rewarding once we develop a professional working relationship where we’re supporting our customers to their exact needs.

What’s been your biggest work achievement?

I think for me, it was delivering our businesses’ first formal Change Management process. In order to make the transition from a small to a larger business (both internally, and for our customers).

We had to refine the way we manage change across operations, empowering us to deliver managed services compliant with our ISO20000 accreditation, which is the international IT service management  (ITSM) standard. This ensures we minimise the impact of change, improve the overall availability of the services we support, and ultimately raise the bar in the quality we deliver for our customers.

Tell us something interesting about you that other people might not know…

5 minutes with Andy Smith, Intercity Security Operations Centre Manager (‘ISOC’)I am 3rd dan Taekwondo instructor. In my younger days I was British champion in three weights – finweight, bantamweight through to featherweight (as I got older – I got a little heavier). I have competed at world level twice but, unfortunately the world champion got the better of me both times. I still like to keep fit as much as I can, and hope that I can go back to instructing soon.

Where do you see yourself in the next few years?

We’re undergoing a lot of growth at Intercity in my part of the business at the moment. We will be growing the team in Birmingham and making the 24x7x365 support model active, to enable us to deliver even more robust services for our customers. Once our new data centre is fully built and up and running, we’ll also be supporting the new hosting of services at Birmingham HQ. This is an exciting time for our business and I am thrilled to be a part of this chapter of our evolution.

What advice would you give someone joining Intercity?

I would say jump in feet-first, get fully immersed in your role and embrace the social aspect of the business. It’s important to visit the different sites and network with all the teams so you understand how your role interacts with others. At the end of the day, you need to enjoy your job, and a big part of that is interacting effectively with your working environment. I know it sounds cliché, but if you love the job you do, you’ll never work another day in your life! Intercity provides an excellent launchpad for your career – the rest is up to you.

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