Prevention rather than cure: transforming digital health and care in the NHS
The pandemic necessitated greater collaboration to achieve fleet of foot within the NHS. The change prompted numerous digital solutions to be developed with trusted ecosystem partners, but more work now needs to be done to empower patients
Fiona Edwards, accountable officer and chief executive, Frimley CCG and Frimley Integrated Care System
Steven Flockhart, director of cloud engineering and digital operations at NHS National Services Scotland
Will Owen, director of healthcare, ServiceNow
Helen Thomas, CEO, Digital Health and Care Wales
The UK is bracing itself for more restrictions to halt the spread of coronavirus, due to the emergence of the omicron variant. At the same time, a record 5.83 million people were awaiting non-emergency hospital treatment at the end of September, plus the drastically revamped health and care bill is on course to pass into law by April 2022. Addressing the challenges inherent in the sector with regards to digital solutions and transformation, ServiceNow sponsored a timely virtual roundtable that explored the challenges and opportunities in the future of public healthcare.
How has the pandemic transformed digital care for the NHS?
SF: It has pretty much changed everything, from mobilising our workforce to enabling them to work from home, and kitting people out with the technology required for that. Additionally, it has changed some of our fundamental primary healthcare systems, and we have built new systems – for example, to rollout vaccines – very quickly. We have done an enormous amount to protect citizens and frontline medical staff using digital technology, with the development of smartphone apps and other tools.
FE: The way we work together across all parts of the health service –
local authorities, hospitals, primary care and community mental health – has been transformed to achieve fleet of foot. We weren’t this agile two years ago, and this sense of team helps progress. In clinical practice, we have fundamentally moved to a mixed approach of virtual and face-to-face consultations. These changes and the deployment of more technological processes are not without their challenges. But we have been working with the public to help with the transition.
HT: Teamwork and collaboration have been critical in response to the pandemic. We met with key stakeholders almost hourly at the start of the crisis. There was a battle rhythm, and we used our collective powers to problem-solve quicker. Suppliers stepped up, too, making it possible to procure or develop services and systems at pace; not the normal circumstances you experience when procuring national systems for the NHS. You just had to get on with it. As such, we deployed a contact tracing system in only 40 days. Now, the demand for digital services from patients is evident. The pandemic moved the digital agenda forward a decade.
WO: From GP-level right the way through to multidisciplinary teams, there was a demand to implement and scale digital platforms at speed. It sparked some incredible co-creation and innovative programmes, such as track and trace and the Scotland vaccination programme, which ServiceNow delivered within six weeks. This partnership enabled 2.5 million vulnerable citizens to receive their vaccination in the first 14 weeks. We went from a state where programmes that would have traditionally taken years, now take weeks. There is now a digital front door, meaning the speed of adoption for digital platforms has been exponential during this time.
How are collaboration and partnerships with technology experts driving digital transformation for the NHS?
SF: The pandemic helped to break down barriers and drove collaboration and camaraderie. Fourteen local health boards in Scotland operate autonomously, but there has been no difference in opinion by taking a user-centric approach. At the start of the pandemic, perhaps we underestimated the country’s digital maturity. Uptake for apps – vaccine status, for example – has been massive. At the development stage, though, we have to adopt the ‘fail fast’ approach and learn from solutions that don’t quite work. We now have regular, healthy conversations with counterparts across all four nations to share knowledge and best practices.
FE: Clearly, tech partners are crucial. Our trusted partner, with whom we have built a relationship over several years, takes us into a more experimental domain with their expertise and competence. It is essential to give time, effort, and resources to build co-designed and co-owned projects that benefit all residents in our care. It is vital to have that mindset as a partner and a provider. We must be prepared to have an open and connected system that allows for more things to be built on top that will enrich and empower the lives of citizens.
WO: The secret is not to try and solve a complete problem; think small with tech solutions. Technology platforms can be the answer in most cases, but it’s really about use cases. As a first step, we sit down and engage with our customers and work out, from a patient experience or clinical productivity perspective, what it is we are trying to achieve. Work backwards from that. In most scenarios, strategic partners within your ecosystem will have the digital capability you need to deliver a programme successfully.
HT: For digital progress, it is all about creating that ecosystem. In Wales, we take a hybrid approach to solutions and services and use an open-architecture model. The big thing for me is that it puts standardised data at the heart of the architecture. Patients and clinicians can access that information in real-time. Before the pandemic, whilst lots of digitisation had occurred, not much had changed since the the 1948 NHS model, with a continued reliance on the paper record. We are moving to digitalisation, which starts with redesigning our services – and that’s an exciting dynamic – but its evolution relies on trusted ecosystem partners.
What will the digitally focused NHS of the near future look like?
WO: There has been success with remote consultations, but more needs to be done to create a similar if not better experience than face-toface meetings. There also needs to be better interoperability between video conferencing platforms and more robust, scalable solutions. We will also see more medical apps, which will help grow and create more experiences and services for patients. We need to expand those omnichannel capabilities and ensure we are reaching everyone within the care system. From a clinical perspective, there are so many manual, labour-intensive processes that can be automated.
FE: There needs to be a long-term ambition and a commitment to achieving that ambition. We have an opportunity to take a radical change in approach and test new services. If successful – such as earlier diagnosis of dementia, or remote monitoring – we should scale them. The banking industry is a good comparison. It was forced to change and digitise. Further, by creating a common data pool will support anticipatory care.
SF: Interestingly, we have been able to offset more than 20m miles of patients travelling to see healthcare professionals through our Near Me video conferencing solution. With the push for more sustainable solutions, this shows the direction of travel. Open banking is an excellent example of what is possible in healthcare. In terms of data privacy, recent legislation passed in Scotland, which gives power to citizens to opt in to sharing information, has made our lives easier. That authority allows us to innovate more.
HT: Government support certainly helps progress, and in Wales, there is a policy called Prudent Healthcare, which is very much about co-production and co-designing with the patient, so they take ownership of their health and care. Technology’s not a blocker to achieving this; for this to happen at pace, we need the development of standards to move data around and work in partnership with other areas of the UK. Once the right safeguards are in place, we can put the data and apps into the hands of the patients to empower them.
To find out how ServiceNow can enable digital transformation in your organisation, please visit servicenow.com/uk/healthcare