Last week, we hosted a panel session at ConfedExpo to discuss how the NHS should keep the momentum on digital innovation to tackle major challenges such as elective recovery.
The session was chaired by Andy Cowper, Editor of Health Policy Insight, and joined by Satya Raghuvanshi, Senior Clinical Lead at Accurx, Dave Triska, GP Partner at Witley and Milford Medical Partnership, and Catherine Pollard, Director of Tech Policy and Joint Head of Digital Policy Unit of NHS England’s Transformation Directorate.
Our expert panel shared insights into three key learnings from implementing technology during the pandemic and how they can be applied to deliver integrated care. Below, we’ve captured these learnings, and some key points made during the session.
1: Get generic tech into frontline staff’s hands - they’ll use it to solve all sorts of problems
Satya: During the pandemic, we saw how much innovation could happen simply by giving people access to technology.
My favourite example is an ENT consultant in the North Midlands who used text messaging to let patients know when their biopsy results were normal. The consultant had phenomenal feedback from patients saying they had been really worried - but ended up feeling much more aligned with their healthcare.
So if you give people generic technology, they will find the best ways to use it.
Catherine: Over the last couple of years, we’ve seen how need and immediacy can give people the confidence to try new things across health and social care. During the first six months of the pandemic, we saw a change in our tolerance to risk - this altered dramatically.
We now need to think about how we can embed a more thoughtful attitude to risk management going forward. This will help staff to feel safe to try new things and learn quickly from any failures. We can then make sure we improve on these for the future.
Dave: Change has risk inherent to it. The massive change I’ve seen in primary care is an embedding of the belief that people on the frontline do understand how to fix problems and of what needs to be done in terms of digital innovation. People, with boots on the ground in clinical settings, know what the issues are. It’s been a huge shift in the status quo to accept that there’ll be bumps along the way as we find the best way to implement digital solutions.
2: Care goes far beyond appointments
Satya: As Integrated Care Systems take shape in July, we should move away from talking about problems in silo. Universally across the health system, patients are worried about being seen and demand is outstripping capacity to deliver good care.
But we know that care doesn’t just happen face to face. So much coordination and delivery of care happens outside of appointments. In primary care, we’ve seen the benefits that adopting online consultations, text messaging and patient triage have brought to primary care - allowing practices to free up time to deliver more care for patients who need to be seen face to face, but also ensuring continuity of care for those who don’t need to be seen.
These learnings transition really well into secondary care, in an area like Patient Initiated Follow Up (PIFU), to drive meaningful changes system-wide. To date, PIFU has typically been tied to patient-led booking and face to face appointments for the NHS and by other parties. But actually, many hospital patients don’t necessarily need or want a face to face appointment - they want an avenue to be able to contact their service, and better information and guidance about their condition.
At Accurx, we’ve taken the learnings from the use of online consultations in primary care, to help healthcare professionals across secondary care triage patient requests, direct them to the right service and keeping patients informed about their care. That way, PIFU solutions like ours can make it easier for healthcare staff to manage and give patients a streamlined way to contact services they’re known to, providing a more consistent experience across the NHS.
Catherine: There’s also significant untapped potential in the role of people in managing their own health. There is a lot on the way around digital therapeutics that could help people with long term conditions to access support and manage their condition, helping alleviate pressure on the workforce.
Over the next three years, we’re going to be putting in hundreds of millions of pounds to support ICSs to have data platforms. There is still a reality that some people on waiting lists don’t actually need to be on them, and that’s something we need to address.
Dave: On a national level, we have a huge opportunity to cut waiting lists by stopping people from getting on them in the first place through remote monitoring and care. By the time people are on waiting lists, they have a healthcare need which can largely only be met in secondary care.
My practice now has a rolling programme of check-ins with vulnerable people and those with long term conditions - so we’re actively monitoring people remotely. Since starting this programme, our acute admission rate for chronic illness has dropped dramatically because we’re picking up people who are starting to get more ill sooner.
3: Prioritising the workforce’s experience with technology can have a huge impact on staff retention
Satya: Tech should be an enabler. It shouldn’t be a barrier to people providing their day-to-day care. When staff have to navigate numerous systems on a daily basis, it really impacts how they can feel about their ability to do their jobs well.
There are lots of intangible downstream effects of giving people access to generic technology such as people having greater job satisfaction and being able to leave work on time so they can tuck their kids in to bed at night. One of our beliefs is that technology should just work. It shouldn’t require lots of training. It shouldn’t need processes around it.
Catherine: All tech should be agile and user driven - something that we need to focus on nationally. The thing that has made the biggest difference to staff was allowing data sharing with colleagues to make safer, more holistic decisions - this makes a massive material difference if you’re able to see a patient’s record.
The most precious thing we have at the moment is people’s time. We need to have really strong user-led technology and hold suppliers to account. We should push for universality in digitisation and keep listening to what staff are telling us their pain points are. We have such immense workforce challenges - we need to make sure every moment staff spend is doing something only they can do, and not doing something that could be automated.
Dave: In my practice, we use Accurx technology to enable our clinicians to have contact with our patients, where both parties can get the information they need. I’ve heard primary care described pre-pandemic as like having 40 unscheduled meetings, where neither side knows the agenda and there is a potentially unlimited amount of time to be spent in each meeting.
That’s clearly a crazy way to use a finite resource, both in primary or secondary care. We need to use technology to enable clinical teams across healthcare to do the job that they were set out to do, which is to make diagnoses, make treatment decisions and involve patients in their care. We can provide a more seamless journey when patients feel included in digital change. Simply replicating what we did before the pandemic is a frustration for both healthcare staff and patients, and only adds to the burden.