Comment / Does the NHS take a strategic enough view of technological innovation?

While many would assume that money is the main resource constraint on the minds of finance directors, the focus is usually on workforce. These concerns are usually discussed at length at board meetings and are the focus of NHS bodies’ strategies.

It is generally accepted that using digital and technological advances will help NHS bodies make the best use of their limited resources - including staff, finance, and estates, to provide the best possible service to patients. But digital and technological advances are many and varied and it is sometimes very difficult to work out where to start. As the NAO’s recent report on digital transformation in the NHS makes clear, the track record is not good and the attempt at large scale digital transformation between 2002 and 2011was ‘both expensive and largely unsuccessful’.

So, perhaps, taking a different route that delivers good outcomes one step at a time would be better. There are lots of examples of small initiatives and local programmes where technology has been successfully used to solve a specific problem. For example, at the start of the pandemic, one trust used robotic process automation to read the levels in the large oxygen tanks on a regular basis – replacing the need for a staff member to go and do that reading.

While these initiatives are successful, looked at in isolation, the overall benefit may seem limited – a staff member is released from a task and the appropriate managers get regular, accurate readings. The question becomes how do you scale up the impact and benefits realised? You could apply the  same technology in a similar context to maximise the investment. This could involve, for example,  monitoring other consumables in addition to oxygen or undertaking automation of other processes.

The gains can be calculated at multiple levels. There are examples of intelligent automation being used to take people out of existing manual processes and give them more time to focus on adding value rather than simply managing a process. For example, a specialist midwife was spending around two hours a day transferring blood test results from one system to another. Intelligent automation was used to automate this process and allow the midwife to use the additional time to apply her expertise to review the results.

Again, this example illustrates the positive results for one staff member, but the potential is far reaching.  Digital workers can work 24/7 across all services, multiplying the benefits exponentially. So, to maximise their impact they need to be planned into new processes – as part of system redesign. To get the most of technology, a strategic, high-level view needs to be taken and a new breed of technological solutions need to be considered at an early stage in all developments.

Blue Prism has undertaken a review of FTSE 350 companies’ annual report and accounts over a number of years. This analysis has identified that an increasing number of those companies are reporting that intelligent automation is driving strategic innovations, closely followed by cloud computing and then artificial intelligence. The fact that they are reporting these initiatives in the annual report indicates that boards are taking an increasingly a strategic view of the potential for using these technologies to shape their future growth.

However, it is not clear if this trend is also being followed in the public sector or specifically within the NHS. Working together with the HFMA, we are looking to undertake the same type of analysis for NHS bodies. Work done to date suggests that, although NHS bodies are planning to use digital and technological innovations, the detail is not being reported either at board level or in annual reports and accounts. We have yet to find any examples of references to robotic process automation (RPA) or intelligent automation in NHS bodies’ annual reports and accounts.

This does not mean that this work is not being undertaken, but it may indicate that it is not being considered at strategic board level. And this means that the full benefits are not being released. To support the analysis of a small number of annual reports and accounts, we are also undertaking a short survey to determine whether this is the case.

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