Is technology the key to the survival of the NHS?

Jan 10, 2019

As expected, the NHS Long Term Plan recognises the necessity of an increased use of technology in improving and sustaining the NHS. Indeed, there is a complete chapter dedicated to it; Digitally-enabled care will go mainstream across the NHS. While much of the focus in this chapter is on health records and access to them, there is also a strong emphasis on the ways technology can be used to take a more proactive approach to healthcare and, empower patients to manage their own health.

This, of course, is something I heartily welcome. Since his appointment as Health and Social Care Secretary in July, Matt Hancock has made numerous speeches describing his strategy for transforming the NHS using technology, describing it as a ‘tech revolution’. Certainly, what the Plan describes is more revolution than evolution, with a ‘digital first’ primary care offer for every patient in England by 2023/24, and every patient with a long-term condition having access to their health record via the NHS App by 2020. For me, this ambitious pace of change is essential for our health and care systems to catch up with the ways technology has transformed almost all other areas of our lives. Use of technology in the NHS is in many ways still limited; one of Mr Hancock’s first steps on the road to a fully digital NHS is a ban on the purchase of fax machines and, their elimination by April 2020.

Technology provides an essential platform for the future of the NHS. Without it, the new service model the Plan describes, which is more proactive, person-centred and integrated, is simply not achievable. Going digital enables care to become focused on the patient, rather than on location, by facilitating out of hospital care. It can provide insight for both patients and clinicians that changes behaviours, improves decision making and avoids the need for more complex interventions. Additionally, it helps care to be targeted where and when it is needed most, increasing capacity and making best use of resources.

The treatment and care of the 15 million people in England with long-term conditions absorbs 70% of acute and primary care budgets.¹ Little wonder then that the Plan includes specific mention of using technology to improve support for them by ‘interoperability of data, mobile monitoring devices and the use of connected home technologies over the next few years’.

At Tunstall, we’ve seen in practice how this technology can transform the management of people with long-term conditions. Just one example, is our work with Tameside & Glossop Community Healthcare Long Term Conditions Management Team, which uses telehealth systems to monitor patients remotely and reduced hospital admissions by 38%. Daily monitoring of vital signs in their own homes gave patients evidence of the ways their behaviours impacted on their condition and, the tools to manage their health more proactively. Any deterioration in health was detected earlier than would otherwise be the case, enabling timely intervention and often avoiding hospital admissions. Home visits were reduced as patients were more stable and clinicians can view data remotely, improving caseload capacity. Feedback from patients reflects how telehealth has changed their lives, for example “Telehealth has been a great benefit to me. It helps me manage my condition daily whereas before if I became unwell I would wait another day to see if my condition improved. Sadly, it never did, and I would end up in hospital for long periods of time. I now know when I’m becoming unwell and it’s acted on immediately.”

Impressive as these results are, it is only by embedding such technology within clinical pathways across the board, that the NHS will fully realise it benefits. And this is where the Plan’s ambition that ‘Digitally-enabled primary and outpatient care will go mainstream across the NHS’ could really transform healthcare in England. As the Plan says, ‘the way we deliver care remains locked into the service model largely created when the NHS was founded in 1948’. The next ten years could prove pivotal to the survival of the NHS, and digital technology might be its lifesaver.

¹https://www.england.nhs.uk/ourwork/clinical-policy/ltc/house-of-care/