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.

The 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.

The 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.