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In this episode of the Unprescribed podcast, hosted by Jacob Haddad, we're joined by Tara Donnelly, a leading voice on tech-enabled models of care at home and former Chief Digital Officer for NHSX.
Tara's NHS career spans more than 30 years - from ward housekeeper at the Royal Surrey, to Director of Operations at the Whittington at 30, to Chief Executive of West Middlesex University Hospital, to leading the Health Innovation Network for South London. At NHSX, she helped build the first tech-enabled virtual ward in the NHS in April 2020 - a model that today supports around 9,000 people every day. She now runs Digital Care, an advisory firm helping health systems and innovators scale digital care at home.
Tara started her NHS career at 18 as a ward housekeeper at the Royal Surrey County Hospital - a job she loved. She joined the NHS management training scheme as a graduate, became Director of Operations at the Whittington at 30, and went on to be Chief Executive of West Middlesex University Hospital. The thread running through it all: step away from the email and out into the wards, theatres and clinics. As she puts it: "Pay attention to the things you want to see more of, as well as the things you want to see less of."
A week into the first lockdown, a doctor running one of the biggest virtual wards in the country phoned Tara at NHSX. He was managing it on pen, paper and phone calls, and asked whether any technology could help. Within a few hectic weeks, his team was paired with a remote monitoring platform - and the first tech-enabled virtual ward in the NHS launched in April 2020. By Christmas Eve 2021, the model was funded and mandated for every ICB. "Five and a half years ago, nobody had tech-enabled care at home," Tara says. "This morning, around 9,000 people will have woken up with that."
Tara is direct about the model: "Forget about the traditional model of outpatients, which has not been fit for purpose for a very, very long time." Her alternative is proactive care for those most in need at the apex of the pyramid, by providing remote digital support that is designed around how people actually live. "I've been barking up the wrong tree for the 30 years I was working in hospitals! But because of that, I really do have a sense of how things could be so different."
Tara is optimistic about where the NHS could go next - and specific about why. As she says, the public's appetite has shifted post-pandemic: people want to stay out of hospital, and have got used to using digital tools for their care. The NHS has done big resets before - Tara recalls the post-2000 NHS plan, when by 2005 the maximum outpatient wait at the Whittington was four weeks. And the spirit, she believes, is still there - and the tech is now available to power this forward. "We'll have to be quite bold," she says. "We'll have to take risks and do things we haven't done before. But if we do all of those things, I think we'd be in a great place."