The NHS is facing increasing pressures that need immediate action. Shortages of staff and record-high waiting times for treatment, to name two, show the immense strain the health service is under.
These pressures are not going unnoticed by decision makers. The government is exploring changes, both to positive and less enthusiastic responses. Recent initiatives, such as allowing pharmacists to provide prescription medication without prior GP consultations, can have benefits. But these often seem reactive and fail to address the larger systemic issues. This is because patient pathways span primary, secondary, and social care. Addressing only one pain point can exacerbate problems elsewhere.
If we are going to create an NHS that thrives, we need significant structural and strategic change. This also requires thoughtful and responsible consideration of the role of technology.
Technology is often touted as a panacea for the challenges faced by the health service. Solutions like digitising patient records and automating repetitive administrative tasks are steps in the right direction. But we also need to understand the cumulative impact of new technologies to inform decision making. How do electronic patient records (EPRs) align with the implementation of a Federated Data Platform to address patient backlogs or health inequalities? What are the outcomes all these procurements are tackling and how? We must measure the impact of these technological investments. Tracking the percentage of hospitals with EPRs does not shed light on the benefits derived from these investments. The NHS App is another example of this, the focus on number of users would be considered a “vanity metric” in the private sector – what benefits are patients, staff, clinicians getting from the app or how is ‘the system’ benefitting from this increase in users?
The NHS should continue embracing new technologies and innovations. But it should do so with a focus on providing value to both patients and service providers. Rather than adopting a “technology first” approach, decision-makers should prioritise taking a human-centred approach that focuses on digitisation opportunities which achieve the best outcomes for staff and patients. We should start by identifying the problems before seeking solutions.
To address overcrowding in GP surgeries and A&E departments, as well as long hospital waiting lists, the NHS must move the dial on prevention. This requires collaboration with local government, social care, and the third sector. It necessitates a different, less paternalistic approach to its partners in the health and care system. They need to come together as equals to adopt a holistic approach to healthcare management.
At the same time, we should continue exploring solutions that enable remote monitoring and treatment outside hospital settings. This includes both patients’ residents or those in care homes. There have been great advances made in remote monitoring and self-care technologies. This means that tools are now able to generate data which can be used to continuously learn from, improving care. This is a lot harder to achieve through traditional, paper-based pathways. If used in the right way, these technologies foster a stronger partnership between patients and clinicians. They can also free up hospital space for patients requiring immediate intervention.
The move to Integrated Care Systems (ICS) and Integrated Care Boards (ICBs) have huge potential to improve how we provide care. Yet realising this potential requires moving away from a centralised approach to care provision. Healthcare needs are not uniform and vary across regions. Empowering ICBs to operate autonomously and prioritise the needs of their communities is crucial. Local services must meet the requirements of residents. Technology can again provide the data to support such targeted interventions.
The struggles faced by the NHS are not going to vanish overnight. Ageing populations and funding reductions are likely to even exacerbate the challenges. Despite this, we must be bold and not shy away from critical steps to mitigate these issues. By making wise technology investments, integrating care services, ensuring data availability where it is most needed, and empowering local areas in decision-making, we can create a modern NHS that meets the needs of people today and in the future.