With the year drawing to a close, we put out some questions to the healthcare community, exploring reflections on 2022 from a health tech perspective. We asked what digital progress has been made in the NHS in 2022; what teams have achieved; and what are the projects, programmes and strategies that people think will bring real benefit to the health service and to patients.
Firstly, we heard from Beth Johnson from Health Education England’s NHS Digital Academy. Beth shared some end-of-year stats from HEE’s work in developing a digital workforce.
More than 700 digital change leader’s have undertaken HEE’s focused development programmes:
- 99 people joined the fifth cohort of the Digital Health Leadership Programme in 2022, taking the total to 500 participants over five cohorts.
- 50 Topol Digital Fellows received time and funding for digital innovation projects in cohort three, with 100 now having taken part.
- Two cohorts of the Digital Futures Programme provided team-based learning for 60 ICS leaders across health, education and social care/local government.
- 20 delegates are currently piloting the Health Innovation Placement Programme, run in parallel with the Clinical Entrepreneurs Programme.
- 16 places have been funded on the Florence Nightingale Foundation Digital Scholarship for nurses and midwives, taking the total to 30 scholarships.
Another key aspect of HEE’s work has been the Digital Boards development Programme, which is designed to support boards in leading the digital transformation agenda to build board understanding of the potential and implications of the digital agenda; increase confidence and capability of boards to harness the opportunity that digital provides; and embed digital skills and awareness across board-level senior leaders.
HEE has supported the future health and care workforce by partnering with University Technical Colleges across England to ensure that future professionals have the digital skills and knowledge required for their career, and are supporting the FastFutures programme to bridge the gap between education and employment, with the aim of filling data and digital vacancies within the NHS.
“We are promoting digital learning and development by supporting the setup of eight Informatics Skills Development Networks (ISDNs), across all regions in England,” Beth said. “ISDNs provide a wide range of learning, networking, sharing and accreditation resources to support digital health practitioners across regions and promote the use, application and readiness for digital across the whole workforce.”
Then there has been the Phillip Ives Nursing and Midwifery Review; this aimed to ensure the nursing and midwifery workforce is equipped to deal with technological challenges now and in the future, Beth noted. It was launched virtually in May 2022 as the result of a collaborative year-long programme, and has seen engagement through roundtables, expert reference groups, a consultation platform, surveys, social media, and interviews.” The final report is to be published in May 2023.
Finally, Beth highlighted work in the Digital, Artificial Intelligence and Robotic Technologies in Education (DART-Ed) sector, particularly two reports which have been published in partnership with the NHS AI Lab: ‘Understanding healthcare workers’ confidence in AI’ and ‘Developing healthcare workers’ confidence in AI‘.
Next, shining the spotlight on a project taking place within Leicestershire Partnership NHS Trust’s Digital Health Transformation Service, we heard from Laura Serra. Laura described how the trust have delivered prescribed health information via a secure online portal, to patients who are receiving specialist care or have been diagnosed with long-term conditions.
“HealthGuidance was launched in January 2021,” she said, “and health professionals can offer patients access by sharing unique access codes to unlock relevant topic libraries for their conditions. It replaces the need to attend face-to-face group sessions or be handed a mass number of leaflets to learn how to manage their condition.
“Now, in 2022, HealthGuidance hosts 15 online health information libraries, which offer guidance and health information on a range of topics such as children’s sensory issues, coordination, continence, sleep and anxiety, along with guidance on supporting specialist needs for children with autism and ADHD.”
Each topic library consists of high quality video, audio and written content, produced and curated by specialist teams of health professionals at Leicestershire Partnership NHS Trust. “More than 3,000 users have accessed HealthGuidance in the last year and made over 5,000 visits to view content about the latest guidance and support available to them,” Laura shared.
Looking to the ways in which HealthGuidance can bring benefits to the NHS, Laura highlighted a case study on using HealthGuidance to support children newly diagnosed with autism. The case study is available to read in full here. It “demonstrates the benefits of switching from in-person workshops to online content to share important health information and guidance with patients,” Laura said, noting advantages such as elimination in waiting times due to immediate access to information, freeing up professional time, and financial benefits too. “They are making a saving of £13,000 per annum on the cost of delivering in-person workshops, enabling them to redistribute funds elsewhere,” she said.
Finally, Laura shared some feedback from a clinician working with HealthGuidance, who says it “has done wonders for our service! It has given us extra staff capacity, deliver targeted interventions, reduced waiting times and families are now receiving information faster for their children diagnosed with ASD.”
A key piece of guidance from the last year was highlighted by Lianne De Vera for NHS England’s Commercial Directorate. Lianne said that the NHS is “committed to delivering further efficiencies” and noted that current supplier spend is around £30 billion, with a national buying team that buys £3-4 billion of national contracts and oversight of buying over 200 trusts”.
“In support of its aim to transform how procurement is delivered across NHS England, digital and technology procurement framework strategy recommendations have recently been published,” Lianne said, adding that it is intended to make the procurement process easier for both buyers and vendors, removing duplication and reducing costs.
For Dr Chris Wheeler from Royal Brompton and Harefield Hospitals, the benefits that can be found in digitising outpatient care and follow-up are worth noting.
“Decades of clinical research have helped inform these tools to track clinical trends, observing clinical deteriorations and responsiveness to treatment. And when appropriately used, these have the potential to personalise outpatient pathways and care prioritisation,” he said.
Sharing a vision for the future, Chris added: “The hope is that clinicians will continue to innovate and collaborate with the tech industry in 2023, to respond to growing pressures on the system, and in time, move to a position of being able to prevent them in the first place.”
Chris Carlin, Consultant Physician at NHS Greater Glasgow and Clyde, commented on the power of co-design and described how NHS Grater Glasgow and Clyde has worked alongside a supplier to support patients with COPD.
“Together, we’ve built a seamless pathway for patients that automates PROs, wearable and device data consolidation and enables two-way messaging,” shared Chris. “With improved access to our patients and they to us, we are able to provide a more robust and proactive service. The impact so far has been transformational. During the RECEIVER trial, the 12-month mortality rate for patients on the pathway was 17 percent, versus 33 percent in the control. It also resulted in a 54 percent reduction in respiratory-related admissions, and 4.5 fewer occupied bed days per patient per year.
“Naturally hospitals are looking for innovative ways to free up bedspace, while improving outcomes for patients with long-term conditions. Tools like these which provide actionable clinical insights can have a transformative impact, and I have no doubt this approach can improve long-term condition pathways across the NHS.”
Bringing a supplier perspective into the mix, Zosia Bolisęga for Generated Health noted that “there have been many positives in 2022, and as the pandemic has abated, we have witnessed the benefits that digital health technologies bring to the table. However, with political instability and economic uncertainty, it’s fair to say 2022 has been challenging for industry and health systems alike.
“After a turbulent year, commissioners are facing increasing challenges in managing competing priorities with limited resource and budgets. With the national push towards reducing health inequalities, including the focus on the NHS Core20PLUS5 framework, the importance of collaboration and alignment has never been so critical. Industry must work alongside national priorities to provide evidence-based approaches that address health inequalities across demographic groups, reaching those most in need.”
On that note, Zosia continued: “Interoperability in healthcare is challenging and represents more than technology; facilitating better and more efficient ways of working across the health system with collaboration at its core. This improves workflows, cuts cost, improves clinician decisions and provides health information exchange for all stakeholders involved.”
Reflecting on 2022 as a whole, GP and Clinical Director at Eva Health Technologies Dr Richard Pratt said: “It has been a turbulent year for the health and digital health sectors. When external conditions are challenging, whether it be the 7 million people on hospital waiting lists, wars between nation states, group A strep surges, or cost of living crisis, ripples are felt widely. Sometimes the trajectory of progress needs to be adjusted in light of these factors in the wider world.
“Holding ground rather than forging forwards with transformational change has been the priority in clinical practice. The gains that have been made during the pandemic need to be sustained. The rapid pace of tech implementation galvanised during the pandemic has certainly slowed, but that is probably a healthy course correction. It was time for a phase of consolidation. Staying safe and staying on course becomes a good outcome.”
Richard added: “There is a creative tension between the mass uptake of triage solutions and the prioritisation of face-to-face consultations. Triage is widely recognised as a crucial tool to help manage the gulf between need and provision. Face-to-face consultations are often perceived as being the gold standard of care.
“Though an essential part of our mix, face-to-face ceased to be the default in the pandemic and this was a positive development. It should remain part of our tool set, but being able to adjust the urgency, time allocated, clinician and channel (face-to-face, text message exchange, online consultation etc) has to be the most flexible, responsive way of delivering healthcare for the future.”
Jacob Haddad, CEO and co-founder of Accurx, shared praise for the hard work that has been seen across the NHS in 2022. “The NHS has battled huge headwinds this year,” he said, “from patient access, to the elective backlog, declining patient satisfaction and a workforce crisis. Despite this, we continue to see daily innovation and digital progress across the health system, amongst frontline staff and entire organisations. This deserves spotlighting, especially in these difficult times.”