In October 2021, the UK government announced that it would be pledging £2.1billion to overhaul the IT infrastructure in the NHS. This funding is part of a wider £5.9billion package designed to help clear the record high backlog of patients waiting for treatment in the wake of the pandemic.
Sajid Javid told the BBC that the £5.9bn will be used to pay for physical infrastructure and equipment – not day-to-day spending – and that £2.3 billion of the money will be used to fund more diagnostic tests such as CT, MRI and ultrasound scans. While this announcement in the budget was certainly welcome, and will be transformative if used effectively, there are questions around whether this will be enough to fulfil the government’s ambitious plan.
The British Medical Association (BMA) has previously called for an increase to digital funding, with NHS England and NHS Improvement (NHSE&I) estimating that £2.9billion in capital funding would be needed for digital transformation. However, they have pointed out that without full mapping of NHS technical debt, it will be incredibly difficult to allocate this funding in a way that will maximise impact, while also ensuring parity between providers, in terms of digital maturity, and therefore parity in patient care.
The issue is further compounded by the reality that the NHS workforce is shrinking. Arguably the greatest asset that the NHS has is its staff. The doctors and nurses, health care assistants, clerical and maintenance staff that go to work every day to help those in need, even when doing so puts them in harm’s way.
However, around 1 in 10 NHS positions are currently vacant, with questions about fair pay, rota systems, and workplace pressure largely to blame. A Royal College of Nursing employment survey, published in December 2021, highlights issues of staff morale, sickness absence and the prospect of rising vacancies. This pressure, coupled with a 15% decrease in real terms in nurses’ pay over the last 10 years, makes recruitment and retention a challenge.
These issues show that it is of great importance to invest in the NHS, now more than ever. Allocating funding to updates that will improve working conditions and morale for front line staff will make a measurable difference.
The investment in IT equipment and infrastructure was hailed by Sajid Javid as one that will streamline processes and free up clinicians’ time to focus on patient care at a time when recruitment is particularly challenging. Additional resource being devoted to this will be welcome news for NHS staff, who will benefit from these updates with easier workflows and better access to data.
A key consideration in rolling out new technology is the impact on workforce capacity in the short term while staff undergo training and become familiar with the new systems. There are calls for clarity on whether individual trusts and organisations will be bearing the cost of this training or if allowances for training have been made in the new funding. Therefore, we should focus more on intuitive technology that will not require too much upskilling to implement.
Technology is designed to empower individuals by allowing them to make faster and smarter decisions. In a clinical setting, it has the potential to make real tangible improvements to the patient experience and clinical outcomes. With so many possible avenues and a real appetite for change, the question is how can the NHS best use the funding to ensure maximum gains? While there has been a lot of emphasis on digital transformation being rooted in AI and Machine Learning, I believe the starting point should be in hardware modification.
For example, giving clinicians access to high powered medical PCs that are interconnected to a central patient record system would facilitate immediate change in working practices. This would allow data to be uploaded from patients’ bedsides during check-ups straight into the system, which could in turn be accessed trust wide. This would eliminate hours of clerical work and the issues that come with a paper-based system, and become a catalyst for joined up care in line with the Information Governance Framework on Shared Care Records.
Patients would also feel the impact of this sort of change, as their records become immediately available to all clinicians who may be treating them. Easy access to their medical history will accelerate their treatment plans, and clinicians will be able to make more informed decisions. It will also enable multidisciplinary teams to work together remotely to treat patients several medical conditions or more complex conditions.
In the longer term this central storage of patient data will allow for detailed trend analysis over time. When clinicians have access to a big data they can clearly see where current treatment programmes are excelling and where they might need some improvement. They can identify which drugs and therapies, improve workflow and update policies accordingly, giving patients the best possible level of care.
Another smart investment would be in the application of digital signage. We have seen excellent results following the growth of digital signage in healthcare in response to the pandemic, empowering patients with self-check-in and wayfinding systems that allow them to find their destinations. These are excellent examples of ways that technology can make vast improvements for patients and staff with relatively little input or training required. With ease of installation and programming, no downtime is required, and this solution not only improves the flow of patients through all stages of care, but it takes the pressure off staff who would have been asked to guide patients around the hospital or medical centre.
The health landscape has changed immeasurably, and the tools clinicians need to do their jobs have also changed. While the availability of better and smarter technology offers great opportunity, it also requires significant investments of money, time and capacity to implement and maintain.
This funding will enable trusts to give NHS staff the tools they need that allows them to focus on patients instead of paperwork. I hope that this will signify the beginning of a long tradition of investing in technology for the NHS, meaning that every hospital, doctor surgery or medical centre will be able to offer the same streamlined patient experience and supportive work environment.