Modern medicine and treatments deserve a modern healthcare system in which to thrive. New technologies, data and digitisation all have a role to play in updating the National Health Service and social care frameworks, which are tasked with supporting the United Kingdom’s ageing population on perennially stretched budgets. But the cutting of costs is just part of the motivation to modernise; long-term patient experience and outcomes can be improved and enhanced through the transition to digital and mobile solutions. Last year, at an event in Westminster, Virgin Media Business and the New Statesman brought a group of policymakers and experts together to discuss the challenges and opportunities in delivering digitally empowered health and social care.
William Smart, the chief information officer at NHS England, noted in his opening address the potential of more mobile and remote technologies in “managing patient flows”. He explained: “From the research that we’ve done, we estimate that around 25 per cent of people who are in hospital for longer than three weeks don’t actually need to be there. The figure that gets bandied around – that we are 4,000 beds short a day in the NHS and struggling to meet the demand – does not necessarily translate to a need to build more hospitals. Being able to treat more patients at home, with technology, seems a very logical way to go.”
Smart suggested that a digitally empowered health and social care system “should put citizens at the heart of every decision. I welcome [Secretary of State for Health and Social Care] Matt Hancock’s vision for more personalised care. We need citizens to have access to the tools and data that will help them to have a stronger understanding of their condition. We need the infrastructure in place that allows this to happen.”
The Labour Party’s Dr Paul Williams, a member of the health and social care select committee and a practising GP, said that the NHS “needs to take more steps towards being a preventive rather than reactive organisation”. He said: “I would welcome a culture that encouraged data exchange. Information sharing is crucial from a patient’s point of view. Perhaps, in the NHS, we need to step away from the traditional model of medicalisation and the decision-making power being exclusively with doctors or clinicians.
“We have to remember that the NHS is a people-first industry and our greatest asset is our patients. There are too many instances, I find, where doctors have trouble accessing social care information… the two of these things are inextricably linked.”
Williams said that “understanding the health of the population” could help to better inform decisions when it comes to treatments. He added: “We should be making the most of the fact that everyone is carrying around a smartphone. There is an opportunity for patients’ data – about their exercise, their diet, and their allergies – to be presented to a doctor more readily than is the case presently.”
Peter Dowd MP, the Shadow Chief Secretary to the Treasury, agreed that more seamless exchange between health and social care professionals should be the aim for the future. “I’ve been to a doctor’s [surgery] and seen fax machines. When was the last time anyone used a fax machine? I think that is symptomatic of the problem. If we want an effective, responsive NHS, then data needs to be available to doctors in real time.”
Keith Smith, business development manager at Virgin Media Business, was keen to point out the advantages of a far-reaching Health and Social Care Network (HSCN) – the wide area network service delivered by multiple suppliers that a growing number of health and social care organisations, both public and private, are connecting to. HSCN is replacing the previous N3 single-supplier contract that all NHS providers were previously tied to and has, according to Smith, “opened up the market place”. He explained: “What you have now with HSCN is flexibility for health and social care providers to choose a technology partner that suits them. The new competition could not only drive cost savings, but incentivise technology partners to innovate and think about how to deliver things differently. We should be asking what we can do to make them think outside of the box, and what we can do to make them think differently about data sharing and information exchange.”
Health and care organisations connecting to the HSCN, Smith said, would require “strong leadership” and he praised the network for “logically bringing health and social care into the same sphere”. His point was echoed by Virgin Media Business’s senior segment manager for the public sector, Alison Brown, who said that HSCN could offer the perfect tonic to the “fragmentation” of health and social care. “For too long, health has been viewed as the NHS in and of itself, but the HSCN gives us the chance to logically, at last, bring health and social care into the same environment. There is an opportunity to put the citizen, who will use multiple public services, at the heart of it. If organisations can show that strong leadership to sign up to the HSCN, then they have the chance to deliver a more personalised and bespoke experience to the citizen.”
Martin Bell, an independent consultant on healthcare and business and former director of ICT at North Bristol NHS Trust, said that the HSCN could be extended to include wider “voluntary social enterprises”. Nodding to Matt Hancock’s pledge for £4.5m’s worth of investment in “social prescribing schemes”, which are a range of community-led support activities to improve people’s physical and mental health such as arts and crafts groups or sports, Bell said that the HSCN had the opportunity to recognise “once and for all” that “health and social care are not different issues, but the same one”.
While the transition to a paperless NHS is underway, Virgin Media Business’s head of public sector Martin McFadyen said there is still “a long way to go”. McFadyen argued that “mobilising the workforce” was crucial to cutting out inefficient uses of staff time. “I am encouraged that technology is now a boardroom item,” he continued, “and to see CTOs and IT directors in a greater position of influence is a step in the right direction. I have a daughter and I remember when my wife and I were in the maternity suite awaiting her arrival, I was astonished by the number of times that the midwife had to write out various bits of information, on duplicate, sometimes triplicate forms. The time spent bent over a desk with handwritten notes has to be eliminated. Improving connectivity within a department or ward, so that notes are transferred digitally, via efficient and reliable Wi-Fi, on mobile devices, will save time. And staff can then use that new time on what really matters: the patients.”
Baroness Masham, a crossbench peer and co-chair of the all-party parliamentary group on health, was left physically disabled after a riding accident when she was younger. Drawing on her experiences of having to deal with different specialist doctors at a variety of hospitals and clinics, she highlighted that, while the idea of “open data” was “undoubtedly a good one”, the challenge in turning this vision into a reality was largely related to privacy and information security. “At their worst, I suppose you could argue that confidentiality concerns are a cop-out. It’s easier not to share the data. But the fact remains that, when you have multiple conditions or a complex condition such as mine, then you will need more than one person to be kept in the loop. I had a situation recently when I had an MRI scan in Yorkshire [where Masham lives] and the results were never sent down to the consultant I was seeing at Charing Cross. All the while, it’s been left up to me to inform my GP of what’s going on. I think what is needed, beyond the will of health and care organisations to share data, is actual policy that sets out that need in clear terms; otherwise you run the risk of ending up with a very disjointed patient experience.”
Ultimately, the round table agreed, the future of the NHS and social care in the UK hinges on a willingness to think about the two things together. Technology, as NHS Digital’s director of strategy James Hawkins put it, can deliver a “people-first service where a bricks and mortar organisation may struggle”. Mobile and remote services can provide support and guidance on location, a paperless hospital frees up staff time, and, if a clear set of standards can be agreed on and managed accordingly, a culture of data exchange and inter-working could drive efficiency of care. Hawkins added: “I think, as a point of necessity, we’ve got to invest in IT – services should be designed around patients’ needs.”