What Everybody Ought to Know About NHS IT

Last Friday, I picked up my usual copy of the i newspaper. It formed part of its week-long investigation into changes to the UK's National Health Service (NHS). This edition focused on the impact that technology could have on the NHS from a patient and cost-saving perspective.

From virtual appointments to an app to detect if your vitals are falling, it's a stand-out piece of tech journalism. In case you missed it, here are the highlights:

"Patient, heal thyself: plan to help the NHS by reducing face-to-face care"

Apps, monitoring devices and video-link surgeries could all bridge the £22bn NHS funding gap, according to the i paper.

Investigations from the paper and its sister publications found 44 Sustainability Transformation Plans (STPs) produced by regional NHS bodies to meet this five-year target.

The move is met with scepticism by some who are concerned that technology can never fully replace a trained medical clinician. For example, the planned increase in home alarm devices by some councils 'lacks humanity' and cannot pick up on cues that a person is struggling in their own home, according to the paper.

Yet, Hampshire County Council has trimmed £4.7m from its budget since partnering with telecare provider PA Consulting. And Northamptonshire County Council has agreed to cut £24m from its adult care budget and plans to use more home alarm systems to achieve this.

Prevention not cure

Self-management of your conditions through technology is also highlighted. "Many NHS blueprints around England promise to deliver savings by putting the onus on patients to improve their health before receiving treatment," according to the i. It claims the Vale of York Clinical Commissioning Group had planned to make smokers and those with a high BMI (classified as obese) wait for elective surgery so they could improve their health.

Do-It-Yourself NHS

​DIY clinics are another option, where patients take their own blood pressure or oral chemotherapy treatments at home, for example. South Yorkshire is named as one region 'pinning its hope on benevolent Big Brother equipment' by the paper. Another tech option is "telehealth", where patients with long term health complaints use technology to send such information to their GPs.
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Apps dispensing real-time medical advice are being considered in London over the next five years to uncluttered doctors' surgeries, according to the newspaper.

And A&E admissions could also be reduced through apps. Sounds unfeasible? Well, chronic respiratory patients in Portsmouth already use an app linked to clinicians so they can chart symptoms and watch videos to monitor inhaler usage and exercise.

Others argue that such technologies can never fully replace medic-led care. Speaking to the i, Declan Hadley, digital health lead for Lancashire and Cumbria change programme, said:

"In times of crisis, you are always going to need to see someone. A computer can't hold your hand."

Telehealth, for example, could mean 'a disabled person can be a prisoner in their own home', according to Carlo Salvatore, a member of Disabled People Against Cuts.

Another diabetes patient points out that everyone is different and no one should be forced into phone- or Skype-based conversations.

"Hi-tech injection offers an early-warning that can transform patient care"

Could an app save your life? Yes.

The Patienttrack technology highlighted in the i paper is one step towards more proactive and time-efficient treatment. Staff at a hospital in St Helens use the tech on their acute wards to record vital signs on their iPads. The Patienttrack system then calculates an early-warning score and alerts clinicians if a patient deteriorates, enabling a rapid response.

As a result, high-risk admissions to critical care were reduced and the amount of time spent recording patient observations cut by two-thirds. "This is allowing nurses and other clinicians to spend more time with their patients, and focus on those most in need," according to Roman Pritchard-Jones, a consultant plastic reconstructive surgeon.

A sticking plaster solution?

From a tech perspective, the opportunities for the NHS are fascinating. But medical technology can only go so far to address a very human problem. We are an ageing population and, as such, preventative medicine is not the solution, as Dr Chris Moulton points out in his column:

Technology's biggest enemy

Let's not forget that the NHS does not have the best track record when it comes to technology. For example, NHS 24 dubbed the transformation project to replace its IT system as a "systemic failure around project governance”.

So, could technology save the NHS?

No.

Humans must first upgrade their approach to technology. It's a two-way street where we must work as hard as we can to see technology implemented in the most effective way. We must address fears of alienating and dangerous tech-based medical practices with patients. We must also address the fears of another NHS tech initiative that spirals out of financial control.

Why?

Because humans need to wholeheartedly embrace technology for any future NHS tech initiatives to ever succeed.

How?

Technology must complement the care given by human clinicians, not replace it. 

Human health bosses must learn from the mistakes of past tech projects to stop the NHS flat lining.

Technology is constantly adapted to meet the needs of humans. Now, humans need to adapt to the technology on offer to the NHS. We must innovate our approaches and methods or we will fail technology and, ultimately, the NHS will fail too.


To read all the NHS articles in full from the i newspaper, click here. ​