Resources and evaluation needed to build on technology gains

The call to back technology ambitions with resources was made alongside further recommendations to evaluate recent developments before locking in new approaches and to focus on longer term quality and productivity goals.

The think tank’s report– Securing a positive health care technology legacy from COVID-19 – highlights increased use of established technologies during the Covid-19 pandemic. Phone and video consultations have enabled the rapid adoption of virtual outpatients and GP appointments. Home monitoring devices have enabled virtual wards to be set up.

Newer technologies have also come to the fore with app-based appointment booking, the roll-out of videoconferencing and the use of artificial intelligence-driven analysis to help diagnose and monitor the progression of the coronavirus.

However, while the foundation said the speed of technology roll-out was ‘impressive’, there had been limited evaluation of the changes and many changes happened without much engagement with patients. As the NHS moved beyond the emergency phase of the pandemic, it would need to ‘revisit aspects of implementation’ to evaluate the approaches and develop them further.

It also pointed out that much of the technology was used to support social distancing or demand management. ‘But just because providers have implemented video consultations to achieve social distancing, it does not necessarily mean that they have yet achieved the wider quality objectives video consultations will need to serve over the long term,’ the report said.

While the vast majority of public and staff reported positive experiences of the increased use of technology, there were more mixed views on the impact on quality of care. More than two-fifths of the public and a third of staff surveyed said these technology-enabled approaches were worse than traditional ways of delivering care.

'Given the immense pressure the NHS has been under, it is impressive that so many patients and staff reported positive experiences as new technologies were rolled out,’ said  Tim Horton (pictured), the foundation’s assistant director of improvement. 'However, the fast pace at which they were introduced means that important steps – such as evaluation and co-design with patients – will necessarily have been shortcut. As we emerge from the shadow of the pandemic, the NHS must evaluate and improve these approaches before locking them in for the future.'

He added that ‘action is needed by the NHS and government’ to secure a positive healthcare technology legacy from Covid-19.

Rather than simply continuing with technological innovations introduced during the pandemic response, the focus should be on meeting longer term quality and productivity goals. But getting the most out of technology would also need resourcing.

‘The forthcoming multi-year Spending Review and the next stage of national workforce strategies should explicitly address the workforce, skills and infrastructure needs of the NHS in order to exploit new and established technologies successfully over the long term,’ the report said.

Having adequate IT and equipment was the top priority in the organisation’s survey of NHS staff. With capital spending in healthcare significantly lower than the OECD average through the 2010s, leading to a growing maintenance backlog, recent increases in capital spending would need to be maintained so that the NHS could keep pace with developments.

The foundation noted support for the more technologically advanced NHS providers in recent years, but it called on national bodies to also focus on building the capability of less advanced providers.

Dr Layla McCay, director of policy at the NHS Confederation, said that the targeted funding, support and co-operation that facilitated the ‘incredible pace’ of technology roll-out during the pandemic needed to be included in any long-term digital strategy for the NHS.

‘Innovations in digital care achieved during the pandemic have expedited opportunities to now embed a blended approach of both face-to-face and digital options where relevant in accessing care,’ she said. ‘This mix should be designed to best support patients to access care in ways that are right for them, and reflect the need for access to inclusive and appropriate services for everyone who needs them.’

NHS Providers deputy chief executive Saffron Cordery said that reports of staff and patients engaging with digital technologies was encouraging, but there were challenges in sustaining momentum. 

'Trusts must be enabled to fix basic infrastructure and support staff,' she said. 'This means access to funding – both revenue and capital – so trust leaders don’t have to reprioritise existing funds that are reserved for other investments.'

Later in the week, health and social care secretary Matt Hancock announced funding for the second wave of NHSX’s digital aspirant programme. Seven trusts including East Sussex Healthcare NHS Trust and Liverpool Heart and Chest Hospital NHS Foundation Trust will each receive up to £6m over the next three years to help deliver their digital ambitions. A further 25 trusts are being given seed funding of £250,000 to develop their digital strategies and business cases.

As part of the first wave of the programme, St Helens and Knowsley Hospitals completed its roll-out of telehealth across almost 50 specialties and introduced technology to digitise the handover of referrals between and within specialist teams.

‘We want to see all parts of the NHS join the digital transformation journey, and this programme is key to supporting those organisations that need a bit more assistance,’ said Matthew Gould, chief executive of NHSX.