In a speech delivered last week Secretary of State for Health and Social Care Matt Hancock said “better tech is not a ‘nice to have’ but vital to have for the NHS”. He spoke about the importance of people, standards, leadership, culture and scalability in order to achieve digital transformation across health and care.
In this two part feature sponsored by CCube Solutions we asked industry experts for their opinion, reaction and comments on some of the key themes of the speech.
Contributors include: EPIC, Difrent, BJSS, X-on, TPP, ANCILE Solutions, CCube Solutions, ORCHA, Northamptonshire Digital Team, Inhealthcare, Sectra, The Martin Bell Partnership, InterSystems, Alcidion, Draper and Dash and Healthcare Communications.
Kirstie Watson, Northamptonshire Digital Lead
Matt Hancock is absolutely right better tech is not a ‘nice to have’ but vital to have for the NHS. We need to recognise that IT is a crucial enabler for the health service. We need to support and resource all organisations to making these changes, through ongoing revenue for IT as most modern IT solutions don’t align with the large upfront capital investment models any more. We need to plan to invest in IT capacity if we want to increase the pace of change.
Lynette Ousby, General Manager, Alcidion
Matt Hancock’s words on the urgent need for modern technology in the NHS need to be heard and met with action. This has already started to happen with the immediate announcement of a £140 million award for artificial intelligence initiatives. But many other big areas must be addressed to change the status quo, so clinicians are not left with old technology.
Action is needed to open the minds of those who think big electronic patient record systems are their only route to digital maturity. This means engaging with the wider market where there is a huge amount of capability and passion for delivering technology that is open and that makes an immediate difference to staff and patients. Our NHS customers, who don’t want to wait years for clinical benefits, certainly get this. Whether that’s those having a big impact on clinical problems like sepsis, acute kidney injury, cardiac arrests and mortality rates. Or whether it’s trusts like Dartford and Gravesham NHS Trust referenced by Hancock for embracing modern technologies like AI and applications geared around automation.
But if we really want innovative technology to spread, procurement processes must change to make it much easier for newer entrants. New platforms are now emerging that can make it easy for the NHS to buy technology that will really make a difference, that don’t treat benefits as an afterthought, and that overcome historic problems around integration, interoperability and clinical adoption. This is about providing the environment to allow innovation to flourish.
Orlando Agrippa, CEO, Draper and Dash
The integration of technology into health services is something we’re gradually beginning to see more and more of every day, and Secretary of State for Health and Social Care Matt Hancock’s recent speech was an encouraging push to the forefront of the issue of adoption.
Every partnership we’ve built has started with one key person who has fought the case for the need to bring new technology to the front-lines of patient care within their organisation. My hope is that, with the Secretary of State’s talk of incentivising adoption to reward a tech-forward culture, we will indeed begin to see more and more “digital leaders on every board” alongside an increasing uptake of digitisation, AI and ML into the workings of every department.
His focus on the need for substantial cultural change to ensure that digital transformation really begins to take off within the NHS is something I myself have seen time and time again. Throwing a new platform or algorithm at the problem is certainly not enough to create and sustain change, and one of the key points clients raise is the need to ensure that the team on the ground are fully able to make the best use of any new tech, as well as having full ownership of it.
Understanding what is being done and why is crucial, and as the Secretary of State discusses, this goes beyond just the IT department, relying on the full engagement of clinicians and the healthcare teams themselves. It is therefore always of upmost importance to us as a company that we deploy a team to support and train our partners in extracting the full potential from our modules, establishing day-to-day and lasting changes. Indeed, one of our most successful platforms in providing real world improvements within NHS trusts is one co-designed by clinicians, for clinicians; something I believe sets the stage for further future involvement and collaboration between digital firms and healthcare teams.
David Hancock, healthcare executive advisor at InterSystems and industry co-chair for the standards and interoperability group at INTEROpen
Matt Hancock acknowledged an important truth in his January speech to the Health Tech Alliance: it takes too long to change anything in NHS technology. He is right.
Fundamentally this comes down to the difficulty faced in the health service in effecting change and doing things differently. The NHS must realise that implementing technology is not a technical problem but a social and cultural problem. This means that a great deal of leadership, cultural cultivation, time and courage are required to successfully deliver digital transformation.
I learned nearly 40 years ago in the first term of my computing degree that “old process plus new technology equals extremely expensive old process”. To avoid making that mistake, every CEO in the NHS needs to play their role in leading digital transformation, something Hancock points out. Digitalisation is not something that happens around you, but instead your organisation has to be leading it from the very top because transformation can affect every part of the organisation and organisations that interact or collaborate with it. The NHS is no different to any other type of industry in this respect and it now has an opportunity to take control of how digital transformation is done.
Martin Bell, Independent Consultant, The Martin Bell Partnership
Matt Hancocks words in support of technology, leadership and the scaling of solutions across the NHS are welcomed. The £140M investment into AI is also another welcomed investment into moving healthtech forward in the NHS. As ever however, there needs to be a full 360 take on how improvements in healthcare services can be made, and these are only a few parts of the answer.
Workforce challenges need to be addressed in an honest and sustainable way, not just words in headlines. Social care needs to be addressed, as with a sustainable, future proofed social care solution, the NHS will always struggle. And funding needs to be raised, generally, but specifically for digital, with a shift from “capital lumps” and “initiative” monies, that are nearly always unevenly spread, to an increase in revenue spending, at sustainable levels, across the board.
Specifically on leadership, Hancock and Gould could do worse than tap into the work that the likes of Andy Kinnear have led on around the BCS and FEDIP, as well as looking at how to expand the Digital Academy to reach a wider audience.
There is much to do, and whilst announcements and pronouncements are welcomed, they need backing with hard cash to make them happen.
Jane Rendall, Managing Director, Sectra UK & Ireland
Matt Hancock has rightly singled out leadership as a matter crucial to digital success. The NHS needs to examine its leadership structures to ensure they support modern digital ambitions.
In the digital imaging space specifically, the emergence of chief clinical information officers has made a substantial difference to embedding the clinical strategy and clinical buy-in into imaging and other digital programmes from the very beginning. But the CCIO is just one role in a changing healthcare landscape that needs evolving leadership to match. Increasingly, we are working with CIOs who are expanding their leadership to a domain once owned by radiology, playing a driving force in digital imaging strategy with paralleled importance alongside electronic patient record strategies.
NHS organisations should now ask themselves where other roles need to evolve, or where entirely new roles are needed. One trust recently appointed the new post of an enterprise wide lead for digital imaging – someone who is able to look into silos of crucial imaging data and break them down. And as AI proliferation continues to expand – does the NHS need dedicated chief artificial intelligence officers, similarly to other industries?
As Hancock points out – CEOs must too be a driving force for digital adoption and the opportunities that come with it. In my view, if such individuals don’t do this, they shouldn’t be a CEO.
Liz Ashall Payne, CEO, ORCHA
Matt Hancock made some very important points. We welcome that Matt Hancock highlighted the importance of standards. We agree they are crucial in helping the NHS to identify and prioritise the ‘better tech’ in the first instance. For example, in our evaluation of almost 6,000 health apps, only 15% meet our quality standard.
Our experience and published research, questioning NHS health professionals, also supports the huge influence people and culture have on technology adoption. Technology needs to be embedded into practice and within the scope of everybody’s role and ambition. Investment in the Digital Ready Workforce Programme makes good sense, as it will also be essential to ensure our existing healthcare professionals have the skills and confidence to use the new tools adopted. The programme should also consider our future healthcare professionals, ensuring they enter their career already armed with digital health knowledge.
Although strategy will be led centrally by NHSX, to achieve scale, we must be mindful of regional procurement decisions creating a postcode lottery, leading to patients in only certain regions benefiting from a technology. To achieve digital health at scale, national tariffs are required. The NHS London Procurement Partnership’s Dynamic Purchasing System is a good example of efficiently sourcing digital health apps for its 46 member orgainsations across London and the South.
To efficiently achieve the scale desired it will also be important for the NHS to work in true partnership with private organisations, harnessing and directing the talent from across both public and private sectors to best meet the goals and ambition of the NHS.
Vijay Magon, CEO, CCube Solutions
It was a positive speech from Matt Hancock and very encouraging to see health tech higher on the agenda than ever before. I think we all agree healthcare professionals need access to patient data and documents within a click of a button and organisations want this information in a modern, structured, electronic form. No healthcare professional should wait 3 minutes to access information on a patient and holding records in a warehouse will hopefully soon be a thing of the past.
At CCube this is exactly what we have done for many organisations, through strong partnerships and careful application, we help trusts achieve digitisation to a structured, modern application. We recently documented a project with North Bristol NHS Trust, where the trust held over 1.2m medical records off-site. Thousands were delivered to the hospital each day. We supported the trust implement a modern system to provide information at the point of care and make significant cost savings. Over the last few years, we have helped several other trusts achieve the same and the cumulative savings run into tens of millions of pounds!
I believe we’re now all pushing in the right direction and over the next 12 months I feel the industry can make some real progress. I’d encourage anyone considering a project like this to visit sites like Bristol and speak to the team, learn about the projects like this and hear their advice.
Bryn Sage, Chief Executive, Inhealthcare
When the Health Secretary talked about the restructuring of NHS IT systems as “probably the world’s biggest public sector digital transformation project”, those with long memories might have recalled the last time the health service attempted a national technology programme.
This time though I am confident the outcome will be different.
The development of effective standards for digital, data and technology products within the NHS should set the bar for quality and efficiency. Creating trust that products are safe, cost effective and meet the needs of all users could unleash the innovation in health and social care we see taking place in pockets across the country.
To work, the standards must be relevant, updated and mandated.
Then Mr Hancock will have a good chance of achieving his vision of NHS technology “giving clinicians back the gift of time and allowing them to care”.
Johnathan Pascall, EMEA Sales Director, ANCILE Solutions
Increased support for the Digital Ready Workforce Programme will be a vital element of Matt Hancock’s vision for boosting the digitally literacy of people working in the NHS. By empowering users with the skills to use technology as part of the delivery of care, the NHS has a real chance to bridge the productivity paradox that digital doctor Bob Wachter reminded us can open when introducing innovation. Eric Topol noted that access to bite-sized, role-specific e-learning on health IT systems could be one part of that empowerment, and evidence is emerging that this can, indeed, improve the operational efficiency of training efforts and increase end-user proficiency.
Kenny Bloxham, Managing Director, Healthcare Communications
The Secretary of State has mentioned email as an innovative way to communicate with patients. We do really need to look further than this though, as there are other truly innovative channels, which are much more engaging and scalable.
Whether it be accessing a patient record, receiving an appointment letter to your smartphone, completing a digital PROMs survey, or receiving a health video via RCS, it’s time to capitalise on digital technologies to improve communication to patients and access to care.
The speed at which information is delivered digitally can literally save a patient’s life.
Dr Chris Bates, Director Research and Analytics, TPP
The closing message of the Secretary of State’s speech last week really resonated with us: we should focus on technology that gives clinicians back the gift of time and allows them to care.
It’s a very good mantra for everyone working in digital health. There are clearly some basic steps that will help here – improving hardware, upgrading operating systems, reducing log-on times etc. We’ll also get safer, more efficient care from improved integration via national interoperability standards.
The Secretary of State is also right to emphasise that we can focus on advanced technology in parallel – it shouldn’t be an either-or situation. We do need to remain true to the mantra though. Success will not be measured by what technology we deploy but by how it helps staff across the NHS to deliver better care.
Paul Bensley, Managing Director, X-on
Given the NHS is using technology to help it be more sustainable, it will need to ensure it is properly supporting healthcare professionals by advocating the right type of technology. There is no point, for example, in insisting on every GP offering online and video consultations, if the two thirds of the population who use a phone to get through to their surgery often struggle to get through. Done right, advanced telephony can give back more time to GPs, practices and patients, by reducing the need to search for information, providing multiple phone lines and call back functionality, and enabling people to manage their own appointments. It can even enable doctors to switch from phone to video consultation in the middle of a call, without the need for people to download an app.
This underlines the need to make sure that, whilst further prioritising adoption of the very latest and developing technology, existing technology whose benefits may not have been fully embraced is not overlooked.
Lauren Bevan, Head of Healthcare, BJSS
It was a pleasure to hear Matt Hancock deliver his speech in the Houses of Parliament and in my opinion, the speech covered a good deal of ground on the dual priorities of pushing on with developing and deploying the cutting edge of technology into the health service and helping to modernise those who have been left behind beginning with the digitising of patient records. A rising tide lifts all boats.
There are a few things which I think are still a challenge – the NHS estates backlog maintenance numbers for 18/19 shows that £3.4 billion needed to be spent on high risk repairs which is defined as areas which need repair ‘in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution’. Getting technology improvements on a par with these high order competing priorities is going to be a tough sell.
There’s also the localised issues which need some framing and consideration. EPR software has been around for decades and the reasons for non-adoption are not always financial but are often cultural, overcoming these issues will take more than money and will involve time, empathy and understanding. None of which are easy to legislate for.
The next thing which was touched on in the speech as a positive but I remain sceptical of, is the local innovations which have been developed. To be clear, I’m not against local innovation but, we have seen local innovations fail to scale and adapt to a new organisation and this will be a key challenge for NHSx to grapple with. The challenge is how to give the NHS the skills and capacity to share these innovations with others in the NHS family. Anyone who has worked in product deployment in the NHS will recognise that local configurations are a challenge and I don’t think it will be any different for those trying to innovate from within.
Lastly, I really welcomed the message on shared accountability across the board. The NHS Digital Academy has done great things but digital transformation is a team sport. If you don’t have the support and challenge of your peers, the outcome of the programmes are naturally less beneficial for staff and patients. As with the EPR implementations, there are reasons people haven’t got on board already and I hope there will be work done to understand this more fully and support people in learning how their jobs and accountabilities will change as a result of this announcement.
One of the key themes throughout the entire HTA event was not just innovation, but the uptake and adoption of that innovation.
It was refreshing, therefore, to hear the Secretary of State discussing ‘user needs’. For me, this holds the key to the current issues many NHS organisations face when trying to innovate.
Involving front line staff, patients and users in the innovation journey are absolutely essential: this would see reduced resistance to innovative change, increase the likelihood of the key behavioural change needed to support such innovation and ultimately increase adoption.
Mr Hancock gave an example of a call system that had been implemented at one hospital in the UK, which was designed by the nurses themselves and means that “the nurses only get buzzed by the patients under their care” saving time and money across the organisation. This is what we need to see more of.
While it’s clear there is a lot of work to do before we reach the user-led utopia we all dream of, this is a very promising start and it was wonderful to see a Secretary of State so passionate about technology and innovation, which as Mr Hancock quite rightly said, is crucial to the longevity of our NHS.
A spokesperson from Epic summarised
Information technology gives clinicians immediate access to patient data, and with standards in place and connectivity of that data between organisations, will make it easier to care for patients and will save lives.
