How can digital transformation create efficiencies in the NHS?

Under pressure

According to the BMA (British Medical Association) the NHS faces pressure from numerous directions including: 

• Chronic understaffing

• Poor retention

• Declining wellbeing

• Growing pressure on general practice

• Insufficient funding

• Inadequate space and deteriorating estates

• Outdated IT

• Falling NHS bed numbers

• Long waits and waiting lists for patients

Many of these areas have been made worse by the COVID-19 pandemic and subsequent lockdowns. The BMA has put forward a number of short-, medium-, and long-term proposals to help reduce the pressure on the NHS including taking practical measures (honest communication, staff retention, targeted resources), better collaboration between primary and secondary care, increasing the workforce, and increased funding, among other things.

One additional and specific call is for more funding with which to modernise the NHS’s IT estate. This, it argues, would free up clinical capacity and support data sharing in order to improve patient outcomes, manage staff workloads and create a sustainable future for the organisation. 

The Long Term Plan

The NHS Long Term Plan was published in 2019 and outlined the Government’s intentions to improve patient options and support, strengthen ill health prevention and deal with health inequalities, set priorities for care quality and outcome improvements, tackle workforce pressures and support staff, and upgrade technology and digitally-enabled care.

Since then, the Government's 2022-23 mandate to NHS England, which was published on 31 March 2022, looks to complement this plan. The document outlines proposals to accelerate digital and technological progress in terms of cyber security and digital maturity with particular focus on adult and children’s patient care, public health programmes, population surveillance, and planning and research.
It also highlights the importance of effective NHS leadership in order to integrate digital functions into NHS England this year, citing digital transformation as being ‘at the heart’ of national leadership. Finally, the mandate promises to embrace digital to improve patient experience, including offering digital appointments, increasing use of the NHS app, genome sequencing and coping with increased demand in A&E.

The mandate, published post-COVID-19 recognises that the NHS’s resources and staff members were stretched beyond recognition during the pandemic. However, it also accepts that the pandemic also accelerated the pace of digital transformation within the organisation, increasing digital access to services through necessity.

Where are we now?

At the moment the NHS is seeing strikes by ambulance and nursing staff, in part due to pay and conditions, but also because of the increased pressures faced by staff in all NHS departments. According to The Times newspaper waits for patients to be transferred from an ambulance to A&E staff were over an hour, affecting more than a quarter of seriously ill people, and causing the Prime Minister, Rishi Sunak to admit that the NHS was under ‘enormous pressure’.
This pressure is exacerbated by the government’s own plans to discharge elderly people into care homes which may be inappropriate, and who at the moment are what’s known as ‘bed blocking’ – people who are medically fit for discharge but need additional care, either at home or in specialist units.

How then, could digital transformation assist in alleviating this type of pressure? NHS Providers the organisation for NHS hospital, mental health, community and ambulance services already has a digital transformation programme in place. In it the organisation identifies why digital transformation matters:

1. It delivers multiple benefits – most importantly improved clinical outcomes, but also enhanced patient/service user experience and financial savings

2. Trust and whole system level realisation of digital benefits

3. The importance of organisational change in order to achieve and sustain medium- and long-term benefits – going beyond ‘quick fixes and technological upgrades’

Transform England, the body charged with driving the digital transformation of the NHS and social care recognises that digital technology can transform patient care as well as drive productivity and efficiency within the NHS and can result in time saving, cost lowering, waste reduction, data quality and analytics improvements. These, it explains, will result in higher standards of patient satisfaction and increased staff well being.

Let’s look at some examples. 

Robotic Process Automation (RPA) automates business processes using software robots that interact with both a system’s back- and front-end, and allows high-volume data to be transacted between systems, databases and digital forms, enabling human team members to focus on more important activities. Blackpool Teaching Hospitals used RPA to streamline and automate their Single Point of Discharge (SPoD) service, allowing staff to make a ‘single, simple referral’ to the SPoD in order to review, triage and forwarded to the most appropriate out-of-hospital service. This not only improved referral quality and accuracy, but also reduced discharge delays and hospital stays. 

Radio frequency identification (RFID) or Real Time Location Services (RTLS) offer health care professionals support with tracking medical devices, stock and inventory management and patient flow management, the latter is particularly relevant in today’s pressured climate. The system was implemented at East Kent Hospitals NHS Foundation Trust and has led to a reduction in locating medical devices, lower costs associated with over-ordering and lost items, fewer delays to patient care and an improved patient experience.  

Extended Reality (XR) Technologies merge the digital world with the real world and can include Virtual Reality (VR), Augmented Reality (AR) and Mixed Reality (MR) and its use in the NHS and Social Care to improve patient and experience and reduce pressure on care is becoming more extensive. North Lincolnshire Clinical Commissioning Group has opted for the use of virtual reality headsets in its treatment of patients with Chronic Obstructive Pulmonary Disorder (COPD) to boost their independence, treat them more quickly and reduce hospital visits. 

The NHS is the UK’s finest achievement and there are few people whose lives it hasn’t touched in one way or another. In order for it to last another 75 years and serve future generations the adoption of further digital transformation is essential. After a decade of  underfunding the choices facing the NHS are stark, and despite the clear benefits that digital transformation brings, the decision to utilise it to its full advantage or not is a political decision that ultimately depends on budget priorities.
 

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