Looking to the year ahead, Tom Cowen, Head of Vertical Strategy for Healthcare and Life Science, Conga, shares his thoughts on the digital future for the NHS.
The ‘paperless plan’ has been a long-term ambition of the National Health Service (NHS). This plan would see the traditional hardcopy methods of storing data be swapped out for digital databases. As more social care providers adopt digital records, the Department of Health and Social Care (DHSC) is imploring them to ensure they comply with national data standards. However, recent reports on the Digital Transformation journey of the NHS have been somewhat mixed, implying that there are wider issues affecting this transition.
Indeed, in 2013, Jeremy Hunt announced that all health and social care trusts would be completely paperless by 2018, including paperless referrals and fully electronic health and care records. This has since been delayed multiple times, most recently to 2023 but today the plan remains unfinished. In 2022, the health and social care secretary at the time, Sajid Javid, set a target of 80 percent of all social care providers to have digital records in place by March 2024. However, this too has been delayed. This situation is indicative of the wider issues the IT teams have experienced when it comes to the NHS’s digital transformation plans.
Why the delay?
Whether healthcare departments have the appropriate digital maturity to undergo these changes is questionable. Whilst 70% of registered adult social care providers have now made the switch from paper to using digital records, many are still reliant on manual processes and multiple systems of record. In fact, some healthcare units are using up to 400 different IT systems, adding unnecessary risk and limiting the ability to scale to meet increasing demands.
A British Medical Association (BMA) report found that doctors in England lose 13.5 million working hours a year as a result of the ‘inadequate IT systems and equipment’. Perhaps this is a result of how the ‘digital plan’ has been implemented or approached in the first place.
Most blame a lack of investment, a stop-start approach to digital transformation and the fact that project leaders likely underestimated the complexity of the project itself. Project leaders have encountered a situation where each practice, hospital or healthcare unit is at a different stage of digital maturity. Therefore, rolling out a ‘one-size-fits-all’ Digital Transformation programme is not going to be effective. Healthcare morphs in the lifecycle of a decade long project. Today, mental health and remote and holistic care are emerging as important drivers
Adding to that, many public sector leaders lack experience when it comes to managing programmes of this size. Many overlook the most important part of the project – the organisation’s data infrastructure. In most cases, data is siloed and there are many systems, each of which require their own ways of working and most are incompatible with each other.
How the NHS’s paperless plan can be successful
Before there is any further investment, there is a primary area of concern that needs to be addressed. The project seems to have lost its way by missing the voice of the customer, in this case the healthcare professionals. The one login per department, non-connected printers and non-integrated systems seem indicative of a project that has not been fundamentally influenced by the primary users. With this failure in place, the results fail the end user, in this case patients.
By establishing a unified data model – one stream of data that is easily shared, visible and accurate across all practices – project leaders can continue with a more comprehensive digital plan. Focus should be placed on processes that touch patients, onboarding and check-ins provided by the communication method that best suits them. This plan will address the direct needs of health and social care staff, as well as their patients. In turn, the NHS and each of its practices will streamline their operations and unify all systems of record.
Over time, all data will be accounted for and, with this extra insight, carers and doctors will be able to make more informed decisions that will improve outcomes. This will enable teams to adopt other digital tools far more effectively, saving time, improving financial viability and overall staff experience – which are listed by the NHS as immediate priorities.
The paperless plan should still be the end goal for the NHS. The benefits will outnumber the effort and financial costs that teams will have encountered with a digital transformation project this big. With all the challenges the NHS faces it pales in comparison with the US multi-payer model. It takes years, multiple acquisitions and divestitures in the US to create a single sustainable ‘onboarding’ process with a General Practitioner before each visit.
Teams must start by reviewing internal operations and simplifying the data cycle. The NHS and social care leaders will be able to identify areas of improvement and where technology would be better suited. By approaching the digital plan from the ground up, considering the needs of the primary users and how best to work the digital transformation around them, the paperless plan can be a success.