30 October 2018

Technology, not just funding, is the key to a successful NHS


Operating systems which are years out of date, insecure paper-based systems for patient records, and the dubious title of being the world’s largest purchaser of fax machines. This is not a description of some ex-Soviet country’s healthcare system in the early 1990s, but rather the modern day NHS.

“The digital revolution has largely bypassed the NHS” was the damning conclusion reached by one independent review of the state of the NHS. The review found that “many records are insecure paper-based systems which are unwieldy and difficult to use”. It also uncovered evidence of doctors, frustrated with the system, using SnapChat to send patient scans to one another.

Not only is this hindering the work of medical professionals and endangering patient safety, it is also emblematic of a healthcare system which has failed to embrace the use of technology. There was, of course, the unsuccessful attempt to transform the IT system back in 2002. What is more, successive health secretaries have been promising a paperless NHS for years.

The UK spends far less on healthcare IT than other countries. For example, 1.5 per cent of total hospital spend is allocated to healthcare IT compared to the European average of 1.8 per cent, while the Netherlands spends 4 per cent. This reluctance to invest in IT jeopardises patient safety and, as last year’s WannaCry cyber attack revealed, has the potential to bring the NHS to its knees.

It also means that it is failing to meet the expectations of those it supposed to serve: the public. 90 per cent of patients would prefer to book their appointments online, but only ten per cent have been able to.

There is a real appetite among members of the public for managing their healthcare digitally. Research conducted by the Nuffield Trust found that 60 per cent of respondents would monitor their chronic condition using a mobile app. Eighty per cent would like to view medical records online, 90 per cent would use a service allowing them to ask a clinician a question. However, despite this enthusiasm, only a tiny proportion of the population have had any digitally enabled transaction with the NHS.

Improving and upgrading the IT systems used by the NHS would increase patient safety, increase efficiency, bring huge savings, and provide the type of service which people expect from a healthcare system in 2018 and beyond.

This is why, in a forthcoming paper, the TaxPayers’ Alliance is calling not only for an improvement in the IT systems, but also for an acceleration in the adoption of new health and social care technology in the UK.

Health and Social Care Secretary Matt Hancock has repeatedly set out his vision for a system which utilises the many benefits of automation and new technology. With the extra £20.5 billion available after yesterday’s budget, steps can be taken to make this a reality.

Automation in any area can improve quality, efficiency, and drive down costs. Health and social care is no different. Productivity and quality will increase as staff are freed up from performing repetitive tasks and so can focus on patient care. This has the potential to save billions of pounds as processes are undertaken in a more efficient way. Most importantly, the quality of care received by patients will improve dramatically.

Over the past few years, there have been exciting developments in medical technology and automated systems. For example, Google DeepMind has started using artificial intelligence to analyse CT and MRI scans from cancer patients which can distinguish between healthy and cancerous tissue. The technology brings substantial savings and a more accurate diagnosis, therefore potentially increasing cancer survival rates in the UK. Similar technologies also have the ability to read echocardiograms, improving the speed and accuracy with which heart disease is diagnosed.

Then there is the technology which allows patients to take control of their own health care. For example, one app provides patients with real time information on local services and waiting times. This has over 125,000 users and reduced the burden on A&E services by 11 per cent.

There are countless apps such as this which allow patients to do anything from receive pregnancy advice, reduce surgical complications, and aid recovery following orthopaedic operations. There is even a device which turns a smartphone into a dipstick and securely shares the data with their doctor.

In yesterday’s budget, the Chancellor quite rightly made funding available for mental health. What is more, the government has committed to achieving true parity of esteem between mental and physical health. Many patients suffering from mental health conditions are at risk of harming themselves.

It is therefore vitally important that they are assessed and receive treatment as soon as possible. However, this is not the case in the vast majority of situations. The British Medical Association has found that long delays for treatment are common in the NHS, including for patients with very serious mental health conditions.

Long waits for treatment are highly distressing for patients and their loved ones. The pressure on mental health services continues to mount, with many patients not getting the help they so desperately need.

This is where investing in automation and new technology will make a real difference. Thanks to advances in technology, patients can now receive cognitive behavioural therapy in real time and in a secure way from a registered therapist through their own smartphone, tablet, or computer. Where this technology has been trialled, it has resulted in improved recovery rates for patients.

There have also been advances in technology which have allowed therapists to provide treatment through the use of low-cost virtual reality goggles. This means that patients who are suffering from a range of conditions such as anxiety, depression, and phobias can receive high quality care in a low cost way and in a safe and controlled environment.

Yesterday the NHS received guaranteed extra funding. It should use this to invest in automation. Doing so will bring significant savings, increase productivity, and, most importantly, ensure that patients receive world class healthcare.

Ben Ramanauskas is a Researcher at The Taxpayers' Alliance.