Without technology, the important ambitions of the NHS long-term plan are simply not achievable, writes health tech chief medical officer Dr Shaun O’Hanlon.
In a recent survey, more than half of community nurses questioned said they couldn’t access a patient’s GP record when caring for them at home, and a third wasted time on multiple data entry because their IT system doesn’t talk to others involved in the patient’s care.
The statistics are taken from the digital chapter of the NHS long-term plan and they neatly illustrate one of the most fundamental challenges facing the health service – how to join up different care services into a seamless whole.
Connecting care is a major theme of the new NHS plan. It promises a £4.5 billion investment in the next five years to break down the boundaries between primary and community care.
Via new integrated care systems, a wider range of joined-up local services will be offered, with the aim of reducing the burden on hospitals and making life better for patients.
It’s a no-brainer but joined-up care needs joined-up data to succeed, and that is a major challenge for NHS technology in its current state.
Joined-up care needs joined-up data
Interoperability is at the heart of the health secretary’s vision. Tech exponent Matt Hancock recognises the power of information sharing to transform care and deliver major efficiency savings – that’s why he’s committed to making interoperability mandatory within IT procurement.
He has made it crystal clear that future NHS IT systems must be open and modular.
So instead of being locked within their own system and seeing only part of the picture, community nurses would arrive at a patient’s home with an iPad or laptop giving them secure access to all the relevant information about the patient – no matter which system it comes from. Equally they would be able to communicate with other care providers to ensure a seamless and safe care pathway for the patient.
Critically, this would give them an up-to-date record of the patient’s current medications – a common stumbling block to integrated care. Confusion over medication is not only a huge time-waster in the NHS (all those calls and faxes to GP surgeries) – it is also a major clinical safety risk. Statistics show that prescribing errors cause 22,300 deaths a year and account for an annual litigation cost of £1.6 billion.
It’s an exciting picture – clinicians who are empowered with all the information they need to treat a patient safely and effectively and to have a more productive working day.
The good news is that it’s already happening. For example, community teams in North Manchester are using a single shared patient record that gives them a complete picture of the patient’s care up to the moment they step through the front door.
As Matt Hancock says, there’s a lot more to do to embed interoperability across the whole of the UK but it will form the basis of a paradigm shift in integrated care.
Benefits of cloud computing
How will we achieve this? Moving data on to the cloud will be part of the solution.
Cloud computing offers huge opportunities – providing a more scalable, resilient and cost-effective platform for the healthcare systems of the future.
Moving IT systems onto the cloud – underpinned by shared standards and open APIs – will allow data to flow more freely across the complex health and care system.
This will make it easier for providers to join up data to support a seamless care pathway, and clinicians can access the data they need where and when they need it.
It will also fast-track innovation, allowing smaller providers with niche solutions to more easily link to larger established providers via open APIs.
Digital care is going mainstream
With such a tech-aware health secretary, it’s perhaps no surprise that digital patient services are a central feature of the long-term plan.
Online appointment booking, access to a digital patient record, online and video consultations are just some of the ways in which patients can be empowered and the health service can work more efficiently.
The evidence speaks for itself. An East London GP practice piloting online triage found that, of the 2,500 patients in the trial, 25 per cent did not need a GP appointment after completing the process and were instead given other ways to manage their health. GPs were able to use their time more efficiently, dealing with nearly twice as many patients via online consultations compared to face-to-face.
Embrace and transform
Technology provides an essential platform for the future of the NHS. Without it, the ten-year plan is simply not achievable. The coming decade will be pivotal in the long-term health of the NHS and technology is set to provide a much-needed shot in the arm.
Dr Shaun O’Hanlon is chief medical officer at EMIS Group. Follow him on Twitter @drshaun and the organisation @EMISGroup