Waitlists, ambulance delays, a looming GP strike? It must be the NHS’ birthday
So, happy birthday, NHS. It’s not every day a national health service turns 74, is it? And what a way to celebrate, after making it through the pandemic, doctors and nurses are threatening to strike, backlogs are getting worse and worse, and people are hopping in their cars to get to A&E because an ambulance won’t get to them in time.
When the NHS was introduced by Clement Attlee in 1948, it was off the back of a spirit of unity in the wake of the second world war. Many had hoped our reliance on overworked doctors and health staff during the pandemic would invoke a similar mood and help us nurse the service back to life.
For the moment, much of this rests on Sajid Javid’s digital transformation. Just last week, he was outlining some of the basic tenets of his modernisation plan. The idea behind it is that by devolving tasks to technology, medical staff have more time to focus on the more critical and urgent aspects of care – as well as a holistic picture. It’s about efficiency, centralisation and long-term cost-saving measures.
The healthcare system is currently facing major hiccups – backlogs, understaffing and spending issues are not going away. One might think that technological advancement is too simple of a solution. But digital innovation could help bridge the gap between disease reduction and prevention and overall patient care.
Mammoth health systems like the NHS often rely on numerical targets which can create rather crude results. For diseases, we look at how many people were cured, in primary practice, it looks for how many patients a GP could see in a day. With the advent of online consultations during the pandemic, the patient’s overall experience – how they felt after surgery, or how invested their doctors were in their wider health – was sacrificed in favour of efficiency. But digital innovation could also be a way of building back that bridge between disease treatment and prevention and patient care.
Practitioners often don’t have the time to focus on patient care. It’s not that they don’t want it, it’s just the simple fact of not having the hours in the day. But technology, built into the system, can provide targeted information so doctors know more about what to ask for, or offer digital monitoring after a patient is discharged.
Another well-known issue is the silos the NHS works in. Different parts of the system don’t talk to each other, and patients get ping-ponged from one specialist to another, often with no clue about what’s making them feel sick. This erodes trust in the organisation. Javid wants to create a new digital strategy to ensure every patient has a “life-long digital care record”, available at every point of care. Patients won’t have to repeat themselves, doctors will be able to understand the problem better, and time will be saved. In an emergency, a patient’s medical history is crucial information, more likely to lead to more successful care. Inherent in this proposition is trust. Trust in how the data is used, how it is collected and how it is shared.
Patients will “need to understand the purpose of sharing their data”, says Badri Wadawadigi, Chief Digital Officer of pharmaceutical company Pharmanovia. The NHS must convince its patients that it’s worth the trade-off: by giving up information, a patient makes their treatment easier.
But the UK is not the first to try this approach. In 2009, Australia created an e-health record, to the tune of more than £1bn (AU$2bn). 12 years later? Almost no one used it. Just 2.69 million of the 23 million people registered for the record accessed it in 2020-21. A year on year increase of 14 per cent was largely due to the need for vaccine certificates.
Takeup in a post-pandemic era might be an easier sell. But there is still a critical question surrounding accessibility for older people or those with disabilities or language barriers. The NHS has always been built on the principle of care for everyone. “People working in digital health don’t focus on usability as much as (we need)”, says Wadawadigi. Disease-targeted apps will have to be built with the conditions of a person with that disease in mind.
Digital transformation could have the potential of saving the NHS from its current downfall. But, for the moment, it is still a pipe dream caught up in the chaos of the 2.48 million people on waitlists, the 40 minute waits for an ambulance in cases of a suspected heart attack, the many, many people pleading “please, just let me see my GP in person”. Javid’s vision is much needed, but it needs buy-in from across the government, health chiefs and the staff working in the system.