The UK’s National Health Service (NHS) published its NHS Long Term Plan on 7 January, in which it laid out its commitments for the next ten years, including becoming ‘digital first’, improving data integration and sharing, focusing on prevention and early detection of diseases, as well as better support for research and development.
Formed following a merger of CSC and Hewlett Packard’s enterprise service businesses, DXC is an end-to-end IT services company, which has partnered with the NHS on a range of projects in the past few years.
For example, its Lorenzo tool, a cloud-enabled patient-centred Electronic Patient Record, has been rolled out across 21 NHS trusts to improve the efficiency of patient care.
DXC also partnered with the NHS to realise the plans for the Trafford Clinical Commission Group’s coordination centre, which aims to rectify issues including variation in referrals, inefficiencies and complex care challenges.
The technology company’s director of healthcare and life sciences in the UK for the UK, Ireland, Israel, Middle East and Africa (UKIIMEA) Colin Henderson and chief medical officer Dr David Lee discuss how the plan builds upon foundations already in place and what is necessary for its success.
Allie Nawrat: What are the most exciting aspects of the NHS Long Term Plan?
Colin Henderson: It is great to see that digital is woven throughout the plan; it even talks of ‘digital first’ in terms of making the most of technology. Things have been evolving and progressing towards this point, but this has been validated in the Long Term Plan.
It is really nice to see that digital and technology is no longer a back office consideration, it is a board level consideration.
Embracing factors like standards and allowing information to flow seamlessly around the organisation, creates a backdrop for doing more preventative health, population health and analytics.
David Lee: The plan recognises the importance of digital clinical leaders and giving them a high profile. We know from our work with hospitals that where we see effective clinical leadership, we see really effective use of digital too.
From a patient point of view, being able to integrate plans for care is a massive advantage in the sense that everyone knows not only what has happened, but what the plan is and what is going to happen next.
We know from research that if you empower patients to contribute and review their own records, then they behave very appropriately and actually reduce their involvement with the healthcare system. They often behave entirely in line with what they see in their records, and therefore know when to contact the doctor.
As a clinician who currently works in general practice and has worked as an out-of-hours doctor and in urgent care centres, the idea of having access to a plan for a patient in front of you who you maybe don’t know is a major advantage.
It is exciting to have empowered patients, carers who are supported and clinicians that have information. We are starting to paint a picture of a very attractive health service for treatment, but also to work in.
AN: How will the plan transform the UK’s approach towards healthcare data?
CH: A lot of information has already started to become digitised, such as patient records. We are going to see a move towards systems of insight. This means really making the most of the information to spot gaps in care and spot outliers. We can use that information to focus our capacity in the health service to open up particular services in particular locations, which is informed by data.
We need to use technology to highlight data that can prompt someone to intervene, contact an individual and help to keep them well. The more information we have, the more we can reason against the data.
DL: One of the most important things that will underpin the situation that Colin has just described is building the right information governance, so members of the public are confident about how their data is being used. People must be able to consent to it being used for their benefit, but equally able to understand how else it might be used in anonymised ways to provide analysis to help others.
AN: How can better organisation of data help to improve prevention-based care?
CH: Artificial intelligence and machine learning can surface outliers and flag up alerts in news ways.
This offers excellent opportunities to inform how the health system can be designed. This might be having the right staff to treat specific diseases in the right areas. For example, in New York we were able to use data to show diabetes hotspots, which allowed planners to place resources geographically closer to people with diabetes. So, you are co-locating people with expertise next to areas where the majority of the population has the disease.
AN: What are the main benefits to the NHS of embracing emerging technology?
CH: It is really important to embrace the technology at the start of the journey. If you have technology as the foundation, you have got a good platform and data feeds from different sources and you can build a digital core, you can deliver services in better ways.
When embracing emerging technologies, one of the biggest challenges is staffing shortages; even if we could afford to build lots of new hospitals, we couldn’t staff them.
So technology can take on more of the burden. Technology like robotic process automation do routine tasks very well and very quickly; you don’t want the nurses doing routine tasks that could be automated, you want them to focus as much as they can on care. I think the technology can bring a lot of efficiency in that sense.
DL: At the moment, the health service is not on a level digital playing field. I am a GP and we have been using technology as a vehicle to support consultations for three decades now, but then if you go to hospital, there is still a heavy reliance on paper.
For me, this plan offers a real opportunity to make a quantum leap for hospitals to enter a digital world. With the right vision and the right leadership, hospitals can actually hit the level of digitalisation that will be required to support great doctoring and nursing.
AN: How optimistic are you that the NHS will be able to fully implement this plan in the next decade?
CH: I am less concerned about the maturity of technology to support this plan and I think we have a good understanding of data and how we can put it to work.
The challenges are more likely to be around leadership in the health service to drive all of this forward; real success so far can be attributed to proper leadership at a clinical level.
This will be supported by initiatives like NHS Digital Academy, which has a focus on educating and skilling up the workforce so they can really use digital technologies. The exemplar programmes are also coming through, which are designed to say here is something that is seen as a good exemplar region or initiative, let’s fund that and allow them to blaze a trail and others can follow on.
It is really important for organisations to build awareness of those who have already made good inroads. There can be a lot of re-thinking things through and people starting from a blank slate, but I don’t think you need to.
DL: There are definitely gold standard developments that excite us in our day-to-day job. I think it is a deliverable plan, but we need to recognise there will be challenges along the way.