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The NHS, Technology and Long-Term Change

How can we enhance patient access, improve care and reduce pressure on staff?

In the last 12 months there have been rapid changes in the way care is delivered across the NHS and in the way the health system and its workforce functions. COVID-19 has served as the accelerant for change whether telephone, email or virtual consultations or remote treatment, for example. Right now, there is a time-limited opportunity to identify and evaluate those changes. It is essential to work quickly to sustain those that can deliver value for the future without slipping back into the pre-pandemic ways of working and delivering care.

We’ve been working closely with National Health Executive (NHE) to better understand the impact of COVID-19 on secondary healthcare. Supporting the NHS with appropriate technology to make the working practices of clinicians and managerial staff more efficient, easier and less time-consuming, has never been more important. In a recent webinar, in partnership with NHE, I was joined by Richard Stubbs, CEO Yorkshire & Humber AHSN, to discuss how technology can be an enabler in the next phase in NHS service delivery.

Improving the NHS in the long term

Despite the enforced pace of change in the last year, there has been little in the way of innovation. Of course, there has been greater adoption of existing technologies to support remote and at home care, but in many cases these solutions were already waiting in the wings. The pandemic has simply served as an accelerant to their adoption. The focus now and for the future must shift from what was needed in a pandemic era to how this can improve the NHS in the long term.

The crisis of the backlog could be just as bad as the pandemic

There’s no choice but to keep the conversation around technology going. The NHS has just experienced their most challenging year since its formation in 1948. The workforce is depleted and exhausted, but the post-COVID landscape means there’s no opportunity to slow down. The crisis of the backlog could be just as bad as the pandemic itself.

Richard highlighted the challenge now faced by the NHS is to tackle this unprecedented backlog of activity. There is a huge pressure on beds. This must be reduced to give better access to patients without placing further onus on an already exhausted workforce.

Digitalisation has a key role to play to free up clinician and management time

To tackle the backlog crisis head on it’s crucial to work smarter. And working smarter means embracing technology. By devolving functions to technology, it’s possible to free up clinician and management time through:

  • Enhanced automation of workflows
  • Implementation of paperless systems
  • Interconnecting different services

By freeing up time and eliminating the need to do certain jobs, the focus can switch to making the population healthier and addressing the huge inequalities across different communities. This underpins the shift from focusing on healthcare to focusing on health.

Approaching solution design

As is the case with any technology solution, you must start with the problem first and define what you are trying to solve. Questions must focus on where the issues exist with current workflows. Where does time need to be saved? What are the right solutions for both short-term and long-term challenges? The healthcare ecosystem must be understood first. There’s more jeopardy in healthcare than other industries if the solution falls down. Therefore, we need to understand what the conditions are that must be maintained. Change must also be made for the right reasons.

Technology needs to be a positive part of the workflow rather than a kink. If clinicians are given an over-complicated workflow, they will naturally find a quicker workaround when under pressure. Any new technology brought into the mix has to be an enabler for change.

Technology and a blended digital future

Using technology doesn’t fall into a yes/no equation. It is much more complex than that. In some instances, technology isn’t appropriate and forcing change isn’t the right approach. Inequalities across communities again comes into play here. Not every patient has access to technology or the knowledge and ability to use it. Assumptions also shouldn’t be made about who does or doesn’t have the skills and knowledge to use technology. The real-world distinction is much less clear cut.

The essential need for co-production

Technology decisions therefore must be the responsibility of everyone. They can’t simply be made by IT teams or the upper echelons of the NHS. But the scale and pace of the pandemic meant this wasn’t necessarily the case during the early stages of COVID-19.

“The first few months of the pandemic meant top-down decision makers had to act quickly. Now we must revert back to co-production with end users. Staff are the end arbitrators of whether something will work or not. You don’t have to be a technologist to have a conversation about technology”.

Richard Stubbs, CEO, Yorkshire & Humber AHSN

This is central to the roll-out of successful technology solutions. For it to be adopted and embraced by staff, technology must be hassle free. Co-production and co-design with end-users are therefore fundamental to understanding the necessity and achieving the simplicity of any solution. Clinician and managerial staff user experience must be satisfied, so more time can be spent caring for patients.

Looking to the future: maintaining health instead of healthcare

The scale and pace of the pandemic required quick decision making. As we look to the future there is a real need to be humble when assessing what technology to progress. Not all ways of working during the pandemic will be beneficial to long-term patient care. They were simply workarounds born out of necessity.

Time must now be spent to assess what is working and what is benefitting patient care. Workforce pressure must also be reduced. Brave decisions need to be taken based on learnings from remote and at home care methodologies. It’s essential to try and forget the concept of bricks and mortar and replace it with the concept of staff and patients and maintaining health instead of healthcare.

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