Last week at HTN we focused on the Department of Health and Social Care’s new digital health plan. You can read our summary of the plan here.
We wanted to know what healthcare experts thought of the plan, so we sent out a call for comment to share some of the reactions, views and opinions from across the industry.
We received plenty of comments from across the industry, nearly 50 in total!
Here’s what people had to say…
Chief Clinical Information Officer at Hampshire Hospitals NHS Foundation Trust, Tamara Everington, said that “the aspirations in the strategy are laudable and highly relevant to modern times. It is however important to note that it is the effective introduction and maintenance of highly usable digital solutions, rather than digitisation itself, that will see us progress.” It is vital, Tamara said, that “digital improvements are well thought through in partnership with frontline staff so that we develop sustainable, affordable and above all, time and safety-efficient solutions. We also have to ‘get real’ about the additional costs involved in change of this scale, particularly when there are so many other vital priorities in restoration of health and social services right now.”
It was refreshing to Matt Cox, Managing Director UK and Ireland at Better, who focused on some of the areas needed to realise the ambitions of the plan. “A digital revolution is what is needed if we are to truly capitalise on the momentum of the last two years,” said Matt. “I’m looking forward to seeing the investment announced alongside the plan being used to provide the infrastructure and open platforms to enable transformative data-sharing nationally, regionally, and locally. I’m pleased to see the plan state that open standards will be enforced to avoid vendor lock-in and ensure care providers only buy technology that meets the standards for interoperability, usability, safety, security, and sustainability.”
Grace Gimson, Co-founder and CEO for Holly Health, commented that the plan has come at a critical time. “It’s exciting to see the interest on several core areas that have needed more focus for some time,” said Grace, “including prevention, personalised health, self management and increased efficiencies for health and social care staff. We’re particularly supportive of the new approaches coming in to support prevention, including blood pressure management, vaccine bookings and reminders, targeted digital health checks, all via the NHS app. However, some of these features are not due to go live for two to three years which feels like a very long time!”
Grace added: “There also needs to be a clear delineation between getting the absolute basics right in all geographies, like having interoperable systems and electronic patient records, to then moving forward with new innovations and approaches that can boost prevention, diagnostics, and increase access to care… If there’s any hint that the budgets for basic digitalisation of services and true innovation are coming from the same place, there’s a risk that neither will advance at the rate that they should.”
How will broader usage of the NHS App be driven?
For Martin Bell, Independent Consultant at The Martin Bell Partnership, the plan is good but “as ever, it is about the money and the execution.” In particular, Martin picked up on the section in the plan about the NHS App. “We know the NHS App has seen massive uptake on downloads, much of it driven by the need for people to show their COVID passport so they can go on holiday, rather than actual usage of the broader health applications,” he said. “How will that broader usage be driven? Where are the stats on that? What does a more central role for the NHS App mean for the main similar suppliers of such solutions in the market?”
Martin commented that it was “great to see the prominent mentions of social care” along with emphasis on workforce and skills, and “some very sensible suggestions on simplifying procurement and supplier access to markets, and setting standards… there are also some noticeable absences in terms of sectors, solutions, transformational change support itself, etc. And there are significant gaps in terms of what might be achieved, when set in the context of other government policies that really need to be in place.”
Kevin McDonnell, CEO for Datalla Group commented: “I like the idea of the NHS App being at the heart of these plans, but it should be the front door only for those users that find it suitable and can use it. The ability to successfully transform the NHS will be strengthened if organisations tasked with delivering these plans are monitored on their compliance and actively prioritise budget allocations to invest in the resources and leadership required to make digital change happen. I believe that digital transformation must start with people (not the technology). We must advocate, educate, and support if we want people to be part of the journey, develop organisational readiness and build cultures that have an appetite to change.”
Kevin also praised the focus the plan places on digital leadership. “Digital leadership will be crucial, and part of good digital leadership is being data-driven,” said Kevin. “Digital leaders will need to understand how data can help their organisations drive decisions, make improvements to the delivery of care and plan for the future. This means of course that the fundamental requirement for the plan is removing data silos and sharing data. On this topic, the plan talks about “enforcing standards” for the sector and technology product suppliers and I believe this is a must because if valuable data remains in silos, then we will fail in our efforts of digital transformation.”
The app was also highlighted by Paul Jarrett, Managing Director at Sonin App Development: “By their nature, mobile phones provide people with a comfortable and private way to access data regarding their health. Therefore, it’s inevitable and appropriate that users should be empowered to have insight into their own healthcare information through mobile apps.” Overall, Paul called the plan “a proactive and essential step towards a more patient-centric and efficient system.”
The focus on the App and website, along with focus on EPR and investment in digital professionals, pleased David Corbett, Director of Client Engagement for Apira. “These national services have proven to bring real benefit to patients, offering great personalised user experience and convenience, allowing patients to self-care, and to control how, when and where their care is delivered, and helping to reduce pressure on the NHS.”
The consolidation of existing strategies and plans was good news in David’s eyes. “I’m hoping by bringing existing strategies and plans together with some new additions it will help to provide clearer and more joined-up direction for regional ICS and local NHS organisations on how digital tools and technologies will support the NHS to meet the challenges over the next few years,” said David, “including COVID recovery, increased demand on services, challenges in recruiting and retaining staff, and reducing health disparities.”
Paul Landau, Founder and CEO at Careology, noted that whilst the focus on enabling patients to take a more proactive role in their own care is positive, care must be taken around personalisation. Calling the rapid expansion of technology that can facilitate real-time remote and personalised care a “welcome priority”, Paul said: “Developing care pathways, such as digital cancer care, will help nurses and clinicians be more connected to their patients and free up time to provide more personalised and responsive care in between traditional appointments…. Improving access to information and to care teams through the NHS App is a great start, but for people such as those living and dealing with cancer, digitally-enabled services need to be even more personalised, as everyone’s cancer story is different.”
The focus on the NHS App was welcome for Matt Brooke-Smith, App Rail’s CEO. “Providing the basics such as access to a health record via a centralised App makes complete sense,” said Matt. “At the same time we expect demand for advanced app experiences such as augmented reality and virtual reality to manage recovery, mental health tracking, and more complex pathways to continue to grow and be provided by separate apps.”
Data, standards and execution…
Dr Tom Oakley, CEO, Feedback Medical Limited, said that data is key. “Getting the right data in front of the right people at the right time, in the way that they want to receive it and removing duplication of effort is what will help to make significant efficiency gains,” he said. “Streamlined diagnostic workflow and better communication for cross-provider care must be prioritised and can only be achieved with the right digital infrastructure in place. If clinician access to patient data is prioritised, then enabling patient access through the NHS app is a natural next step.”
Civica’s Steve Brain agreed, commenting that whilst our services can deliver a digital revolution, “the catalyst for that revolution will be data… From digitally supported diagnoses, to real-time patient records at the click of a button, we’ve already got the digital tools we need to radically transform services for patients and clinicians alike. Joining up data, however, is the game changer which will ensure those digital technologies are delivering the best possible outcomes for the largest number of people.”
Chris Scarisbrick, UK sales director for Sectra, commented that it was positive to see the need for digitally supported diagnoses highlighted in the plan. “The ability to share patient imaging seamlessly is key to this,” said Chris, “and we are already seeing significant progress. Though imaging data silos do remain in some places, these are becoming ever less common as multi-trust consortia and NHS imaging networks continue to emerge. Working towards high levels of maturity, these networks often cover millions of patients. They will help to move the NHS to a situation where images are shared and reported across geographical boundaries, improving access to specialist expertise, opening the potential to address workforce and capacity challenges, and creating the environment for AI supported diagnostics.”
Dr Owain Rhys Hughes, founder and CEO at Cinapsis, called the plan’s emphasis on improving the procurement process “encouraging”, adding: “We already have excellent digital technologies delivering huge value and benefits in the NHS, but what we really need now is to accelerate the adoption of the proven solutions so their impact can be scaled.”
He added: “One of the key takeaways from the plan is that regulatory reform and the implementation of the highest safety and data protection standards will be pivotal to its success. We cannot risk trust in digital solutions being knocked, or progress stalled, owing to compliance not being properly monitored or supported.” Another key area, he said, is interoperability: “This is no longer a feature which is a ‘nice to have’ for new technologies – full interoperability is absolutely essential for efficient, streamlined, collaborative and joined-up working that will help beat elective care backlogs and reduce the burden on frontline staff.”
The plan is long-awaited and welcome, according to Liz Ashall-Payne, founding CEO at ORCHA, noting that also although the pandemic left us with “unprecedented backlogs”, it also “reminded us that necessity is the mother of invention.”
However, Liz warned: “A scattergun approach to the implementation of digital health, with dozens of different products and systems introduced by different NHS providers, without a sound infrastructure to support it and minus knowledgeable frontline staff, will cost the NHS more and cause enormous confusion. At the very heart of this, there’s also a very significant patient safety issue, highlighted in the past few days by problems with period tracker apps in the US potentially sharing private data… For digital health to be safe and sustainable, we need to view digital in exactly the same was as we view medicines. We need rock-solid and universal standards in place and we need doctors to be able to prescribe products exactly as they prescribe medication, with a product recall system in place.”
It’s great to see the promise to rapidly expand technology use
Commenting on the opportunities the digital health strategy presents for the use of robotic process automation (RPA) in healthcare, Russell Lawrie of Endpoint Automation Services said that “advances in the understanding of artificial intelligence means that RPA does have a place at the heart of the strategy”, noting that RPA “can now carry out much more sophisticated tasks and can be central to improving efficiency.” Russell highlighted the benefits of RPA in freeing up staff time, such as delivering clinical simple information, handling administrative tasks such as organising diaries and bookings, and programming appointment reminders.
Jacob Haddad, CEO and Co-Founder of Accurx, commented that it is “great to see the plan’s promise to rapidly expand the use of technology to deliver faster and more personalised healthcare for patients across the country”, adding that “improving patient access to information about their care will play a key part.” For ICSs to really meet expectations in transforming healthcare and empower staff to deliver truly integrated care, Jacob said, “we need to transform the way they’re able to communicate and give them the means to record all patient information and conversations in one place, so they can work cross-functionally across services to deliver effective and well-informed patient care. Technology should be built alongside frontline staff to support their needs and provide them with software that genuinely improves their day to day work.”
Ian Carr, Head of Health Systems at Silvercloud, applauded the plan’s “bold and broad ambitions”, particularly when it comes to “learning from past digital transformational programme failings. We fully support the vision for a health and social care system that will be much faster, more effective and deliver more personalised care. We too share the opinion that the long-term sustainability of the NHS depends upon the ambitions laid out in this new plan.”
For Vijay Magon of CCube Solutions, NHS England’s role in supporting technology suppliers and the new framework for NHS action on digital inclusion are welcomed. Vijay added: “The funding announced, while greatly appreciated, must also be strictly channelled to address the digital objectives and how it can be accelerated to reach the frontline.”
Ruth Bradbury, Interim Head of DigitalHealth.London, agreed that the plan represents an important moment in the industry. “It shows that embedding digital as an intrinsic part of the transformation of the NHS and care sector is one of the country’s top priorities and sets the scene for a huge shift in the way our healthcare is currently delivered,” said Ruth, noting that many of the key opportunities identified in the plan align with the findings from their own company report, including “acceleration in the approval and uptake of well-evidenced digital technologies, empowering patients through access to records and digital tools, AI-enabled diagnosis and improving interoperability.”
Sonia Neary, CEO and Co-founder of Wellola, said: “We are already seeing how fundamental good digital technology is to supporting the NHS to tackle the elective backlog, so it’s encouraging to see the government’s new plan recognise this and commit to reimagining outpatient services over the next three years. We are particularly supportive of the ambition to increase the use of digital pre-assessments to help free-up outpatient capacity. This is a simple solution to elective recovery which is already having a significant impact at some NHS hospitals, supporting them to carry out assessments more efficiently at home with digital, while freeing up capacity for those who still require face-to-face care.
“However, the NHS is facing unprecedented pressure and onboarding new technology has to be easy for providers if it is going to be implemented and used effectively. If commitments in the plan to scale technology are going to be a success, then healthcare providers must be provided with the right information to select simple yet highly interoperable solutions that will start having a positive impact as soon as they are implemented.”
Technology should help to make the right thing to do, the easiest thing to do
Lynette Ousby, UK Managing Director for Alcidion, was glad to see the plan recognise technology as an enabler to improve efficiency and free up staff time. “It is important that these systems are designed to respond to clinical needs, in order to deliver the most impact. Efficiency is part of that, but it is also about alleviating cognitive burden through automation of administrative functions. The new strategy describes some of the potential of clinical decision support, but this must be embedded in modern EPRs if technology is to reduce the need to remember and manually carry out thousands of actions. Technology should help to make the right thing to do, the easiest thing to do. And with that in mind, it is reassuring to see a re-emphasis on the need for vendors to conform to standards and interoperability requirements.”
Dr Peter Fish, CEO at Mendelian, was pleased to see the plan’s commitment to digital transformation. “We welcome the focus on rapidly expanding digitally-supported diagnoses and the implementation of clinical decision support tools,” he said, adding that, “the plan must empower healthcare staff to swiftly and efficiently integrate innovative technology into their daily working lives.”
Simon Tobias, Commercial Director for OLM Systems, called the plan “a sign that our leaders have listened to experts in the health and social care technology space [and] have recognised the enormous strain being placed on service directors, operational and care teams, and of course, the individuals and families they serve, and are now embracing technology and innovation as the relief and remedy to that strain.” The four main goals “certainly seem to have been designed with real-life understanding of the challenges faced by both service providers and end users, and if implemented as planned, we could really see technology making true positive impact to people’s lives in the coming years.”
The funding made available for virtual wards was described as “a positive step to improving patient outcomes” by Jim McNair, Director at Lenus Health Ltd. “However, we believe monitoring that integrates care data from the patient, community, primary and secondary sources can be used to help keep people with long-term conditions, which account for five of the top ten causes of emergency admissions, out of hospital. Integrated solutions along patient pathways must be the focus for digital funding, rather than creating further silos of care.”
Steve Sawyer, Managing Director at Access HSC, commented on the “undeniable need to improve efficiency and reduce backlogs”, calling the commitments and budget allocated in the plan “reassuring”. Steve added: “We are also pleased to see the publication of the National Digital Workforce Strategy, and its focus on improving digital capabilities across all levels of the health and care estate. From embedding digital skills into university curriculums, to providing a digital learning offer for adult social care staff, it will no doubt help bridge the digital skills gap that exists between health and social care, and help put it on a par with other industries, aiding recruitment and retention by making the sector more attractive to the best talent.”
It is encouraging to see a spotlight on preventative and patient-led care, said Robbie Huddleston, Co-founder and Chief Medical Officer for Sapien Health, noting that it “aligns with our belief that the key to overcoming the challenges faced by the NHS today is recognising the resourcefulness of patients at the heart of healthcare.” Robbie also said that the strong emphasis on industry standards and regulatory oversight is important: “Building trust in digital health technologies is critical to successful adoption of solutions that address so many of the issues faced by the UK health system, and it is clear that the development and implementation of a robust regulatory framework is key to that.”
Patient-led care was also a key point for Kerstyn Comley, Co-founder of MeeToo. “We are encouraged to see the focus on helping people to manage their own health and early intervention digital tools must be part of this plan,” Kerstyn said. She identified a gap in the plan’s focus: “While initial prevention priorities are around blood pressure management and vaccine bookings and reminders, mental health should also be a priority.”
Speaking for Antser, Serena Hadi, Head of Service, said: “We are pleased to see that the plan will include helping providers to purchase appropriate technology solutions.” She highlighted the role of the pandemic in proving technology’s role for the future and said: “We look forward to a promising future where people are more in control of their own health and wellbeing needs; and where technology solutions can reduce pressure on health and social care services.”
Agfa HealthCare’s Managing Director for Northern Europe, Roberto Anello, commented on the importance of placing focus on integration and collaborative work. “We very much see this as the way forward,” Roberto said, sharing an example of their work connecting trusts so that radiologists can see inter-regional studies from other trusts and ICSs. “We see this as what good looks like for others… We hear many cases where the accessibility of cross-site image sharing has been advantageous to the clinical community, and brought significant improvements to patient care. We know the strategy will help organisations further improve the accuracy of a diagnosis, bring tests closer to home, reduce the person’s wait for a confirmed diagnosis, and avoid unnecessary referrals.”
The plan’s intention to build on progress made during the pandemic is good, noted Paul Bensley, Managing Director for X-on. “It’s particularly good to see the strategy’s focus on using technology to support primary care and what it calls ‘urgent and emergency care’ – the services that help patients with an immediate care need that might range from a call to NHS 111 to a trip to the local pharmacy to a visit to A&E. The plan rightly recognises that phone, alongside online and in-person services, is an important entry point to the primary care and UEC pathways – and that the tools already exist to help clinicians to automate routine tasks and manage demand within them.”
Elliott Engers, CEO of Infinity Health, said that the NHS is “long overdue” in taking action on digital health. “I welcome the acknowledgement that the spread of good technology has been piecemeal and worryingly slow,” said Elliot. “In pushing the plan forward, the NHS should take care to ensure that innovation is not inadvertently stifled by trying to clone or replicate what others have done. There are many excellent technologies that already exist, poised to make a significant difference – fast.”
Halina Batsishcha, Healthcare IT Consultant at ScienceSoft, shared her thoughts: “I see it as a definite sign that digital solutions are actually paying off and bringing major benefits like decreased operational costs, lowered readmission rates, improved patient outcomes, increased staff efficiency and patient satisfaction. For healthcare providers planning digital transformation in the upcoming years, I suggest focusing on further improving your electronic health records. Comprehensive and fully digital records are the future of patient care: they promote accurate diagnostics and further care personalisation.”
The pragmatic approach from NHS central bodies outlined in the plan was welcomed by Gary Birks, General Manager for UK and Ireland at Orion Health. “It suggests they are determined to deliver a step change in digital capability, this time. It’s also good to see them assert so clearly that this is important because health and social care cannot afford to go on as they are.” Given the COVID backlog and capacity constraints, Gary said: “Better digital health provision, to join-up services, create more efficient and effective care pathways, and improve access is the only way forward.”
Gary also hoped that the plan will “accelerate the expansion of shared care records to care homes.” He said that shared key records are “key to the ambitions set out in the plan for population health management”, adding: “We have seen first-hand, through the experience of customers, that having a full view of their residents’ records empowers care home staff to deliver the best possible care and can prevent unnecessary hospital admissions.”
Andy Meiner, Chief Revenue Officer for ReStart, said that the plan “presents an unmissable opportunity in the coming years to provide better and more integrated care” but suggested that ICSs will “struggle to achieve the priorities outlined in the plan, such as virtual wards and integrated clinical pathways, without a fundamental change in approach.” Open technology must be the foundation for change throughout the NHS, Andy said, but trusts face challenges with this in reality. “Open technology interoperability is proven at all levels of NHS digital maturity. It leverages rather than discards investment in existing systems and reduces the need for expensive rip and replace programmes. Plus, by minimising disruption and upheaval, the entire process is not only cheaper, but also faster; allowing an acceleration of digital transformation programmes that will meet the objectives set out in the plan.”
For Michelle Blackmer, Chief Marketing Officer at Lyniate, the plan presents “a very positive direction for the health and social care system. It will be a welcome step forward for patients and health care professionals who expect to receive and deliver sustainable, high-quality care in this digital age. A world in which every person interacting in a health care or social care setting has access to the appropriate information aligns with our vision of empowering people with the data they need.”
The plan is aspirational, but “no easy feat” to achieve, according to Lisa Riley, Vice President of Strategic Product & Partnership Development/Sales for Vital Hub. “The technical bit is certainly doable, my fear is that the human factor may be what hinders progress at a rate we know is achievable and what was seen at the height of the pandemic. We need to ensure we acknowledge that there is no one solution that ticks every box. Sometimes the answer is a combination of solutions that are experts in what they do and have spent the time, effort and dedication to perfect something that they are passionate about. We need to ensure that big companies are mandated to integrate with other partners, that internal NHS teams don’t waste precious time and resources recreating what is already tried and tested, and most importantly, that the users of these solutions day to day are absolutely involved in the process from the beginning. Finally, we need to build trust – otherwise, all of this investment and change will be immaterial.”
The plan marks a “significant milestone in the journey to bring greater cohesion and cooperation, across health, public health and social care”, according to Alexander Ryan, senior director EMEA of Hyland Healthcare. “By recognising that digital transformation will be a key catalyst to shaping the future of a patient-centric service, strong foundations are being laid for highly connected and innovative health and social care. It’s a fundamental shift, away from competition and organisational autonomy, towards a culture and structure where organisations work together to integrate services and improve population health. Crucially, interoperability, based on open standards, must be at the centre of this process, alongside the support for unstructured content across the enlarged enterprise, and the abandonment of information silos. This will enable the aggregation and utilisation of data from sources within and outside the enterprise, as well as uniform access to relevant content, facilitating the delivery of personalised care.”
Collaboration will be fundamental
The plan to lay the groundwork to support digitisation across primary care services is encouraging for Craig Oates, Managing Director at Doctrin. “We also welcome the plan’s recognition of the importance of digi-physical care,” Craig commented. “Digital pathways aren’t right for everyone, and by providing a truly integrated approach we release time to providers to dedicate to those who require face-to-face care.
“But in order for the plan to be a success, leaders on the new Integrated Care Boards must be engaged, as collaborative working across ICSs can help support the sustainable adoption and spread of digital. They need to recognise essential role digital has to play in solving the headline issues in the NHS today, from workforce challenges, increasing demand and elective recovery.”
The focus on collaboration between NHS trusts and innovators will be “fundamental” in improving care, said Mathew Keegan, Head of Applications Engineering at Automata. “By introducing automation into NHS labs, patients and doctors can receive more accurate results at a faster turnaround time.” He noted that many diagnostic labs are currently facing difficulties with long backlogs of samples, and said, “The government’s strategy to encourage more NHS/industry partnerships is a welcome decision for these labs, helping them make the jump into the unfamiliar and understand the long-term gains that can arise from pushing the limits with automation.”
Robert Miller, CEO at Wellbeing Software, focused on the plan, in conjunction with the recently published data strategy and commitment to digital transformation funding, “provide[s] a solid platform to underpin the next wave of NHS modernisation, helping the health tech industry to continue collaborating across a coalition of willing partners to deliver resource optimisation at a site, trust, consortia and ICS level.”
Embedding technologies is going to be critical in equipping the system to deliver better care outcomes, said Kelly Hudson, Chief Strategy Officer at Lilli, “however, the potential of digital transformation can only be realised and truly felt if the right technology that meets the specific challenges of the system is identified and implemented correctly from the outset… if you haven’t identified what you are trying to achieve, then you can’t accurately validate the success, or the failure, of the technology that you are rolling out.”
Ultimately, she said, the plan has “created an additional stepping stone to help make these changes happen, but only through collaboration and proper implementation can we transform the system in a way that is built to last.”
For Ben Moore, Founder of vCreate, “it’s refreshing to see how ambitious the government’s plan is to revolutionise care management and the patient pathway using technology… the plan’s focus on remote support and diagnosis using image/video sharing is particularly exciting as it not only empowers patients and their families to take more control of their own healthcare, but gives them access to specialists who would otherwise be difficult to contact outside of lengthy appointment waiting lists. If we want to level-up our healthcare services and ensure we are at the forefront of innovation, the NHS must work with industry leaders to research, develop and scale-up proven tech-enabled service solutions.”
The plan has many important goals, noted Professor Michael Thick, Chief Medical Officer for IMS MAXIMS, “but its success is predicated on a number of issues being addressed”, such as workforce pressures. “Effort should go towards automating the more simple and repetitive tasks,” Michael recommended, along with “avoiding delayed discharges by understanding where social care resources are available”, “ensuring compatibility and interoperability” and placing emphasis on “giving opportunities for commercial organisations to bring new technologies into the NHS.”
Thank you to everyone who contributed their thoughts.