Your first question may be ‘does the NHS really need saving?’, and I would have to answer with an emphatic ‘Yes’. April this year sees the official start of Clinical Commissioning Groups (CCGs), the key component of The Health and Social Care Act, one of the biggest changes the NHS has seen. Amongst other things these organisations are tasked with saving the NHS £20 billion in the next 3 years by means of ‘efficiency changes’, despite the Institute of Fiscal Studies saying that the NHS needs to be spending £20 billion more each year by 2020. A daunting task but even more so in the light of the recently published Francis Report, where failings at Stafford Hospital have highlighted the need for compassionate patient care to be at the centre of all decisions. All of this has to be achieved in the largest publically funded health service in the world, which employs 1.7 million staff and serves more than 62 million people, with an annual budget of £106 billion (2011/12).
Clearly technology cannot be the only solution to this problem but I believe technology is pivotal in achieving the ‘efficiency changes’ desired. This might be direct use of technology to improve efficiency or may indirectly provide the intelligence that can drive non-technology based efficiencies; and if technology can be used to save clinicians time this can be reinvested into improving patient care. The NHS already has or is working on a number of national scale IT projects that could bring efficiency savings such as choose and book, electronic prescription service and map of medicine to name but a few. Newer and more localised projects include telehealth, clinical decision tools, remote working, the use of social media and real time patient data analysis. Yet many of these ideas, though new to the NHS, have been employed in business for many years. The NHS needs to catch up and then to further innovate. We need clinicians, managers and IT developers to work together if we are to be successful.
Such change is not without its challenges and the size and complexity of the NHS makes implementation of change difficult. Patient safety and confidentiality has to be paramount but these create practical and technical barriers to development. I have just completed Connecting for Health’s Clinical Safety Training and there are some formidable hurdles to development and implementation of new IT systems in the NHS (ISB0129 and ISB0160). Procurement in the NHS is a beast of its own that I wouldn’t claim to understand but the processes are complex potentially making it difficult for small developers. The necessity of financial savings means the best solutions are not always chosen, even though that can be false economy in the long run. Yet we must not let these barriers stop us from seeking to employ technology for the good of clinicians and patients. We must not let them stifle innovation or be frustrated by what can be a slow process at times. The NHS recognises some of these issues and is working to try to help small businesses negotiate these obstacles.
I hope in a series of posts in coming months to look in more detail at some of the technologies currently being used in the NHS, as well as emerging projects, and the opportunities and problems that surround them. I may stray occasionally into statistics or politics if you can cope with that! I am a practicing clinician with fingers in many pies so the frequency of my postings is likely to be inversely proportional to the workload I face! Comments are always welcome but I may not always reply in a timely manner.