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Continuity in change

Simon Eccles reflects on the tremendous work that has gone into the development of the NHS’s Long Term Plan and the contributions from both internal and external partners.

Change without continuity and clarity of ambition can result in chaos and disconnection from the shared vision of care that drives successful organisations. With the recent government announcement of additional funding for the NHS, we have a genuine opportunity to plan for the next five years, confident of the level of budget increases we can expect. The NHS has been working at tremendous pace on a plan setting out our ambitions for improvement over the next decade, going beyond the five years of the funding settlement.

I am very grateful to the thousands of individuals that have helped Sarah Wilkinson, Steve Dunn and me shape a shared vision for digital transformation as part of this wider plan. Over the last few months, we have met people with learning disabilities, marginalised communities, young people, tech industry leaders, voluntary sector staff, Lords, medics, front line staff, chief executives and clinical leaders. Collectively we have created a roadmap for how we digitise health and care and a clear marker of the scale of our ambition for digital transformation. We have landed on five key groups as crucial to successful transformation:

  • Citizens need to understand their journey through health and care. We don’t just need to provide them with their record and a digital means of interacting with the service; but also with a range of digital tools that make their health information integral to improving their quality of life.
  • NHS and care staffs daily experience of IT is too often poor. Multiple systems that don’t talk to each other, inadequate hardware, multiple log-ons, and a glaring disparity between the quality of digital interaction in their home lives and in their work lives. We need to improve the working conditions of the three million staff dedicated to the health and care system.
  • The staff leading clinical programmes across NHS England, NHS Improvement and the wider NHS are increasingly aware of their digital needs and the opportunities that digital offers to transform the way we deliver mental health, primary care, urgent and emergency care and cancer. Working with each of the other 13 work streams in developing the long-term plan has been a collaborative and iterative process.
  • Then there is the research and innovation community, where there remains an overwhelming need to free data from the systems in which it is currently held. We need data to help the NHS to understand the quality of care it delivers in something approaching real time, without increasing the burden of collection of this information.
  • Finally, there are the ambitious, those who really seek to deliver the type of digital transformation (and therefore a digital dividend) that other industries have enjoyed over the last decade. The Secretary of State for Health and Care is clear about his “unsurpassable enthusiasm” and has recently laid out his own vision for the future of health technology.

But for all the ambition in the world, we can’t get there overnight. In order to ensure we can deliver the plan, we need to get the basics right and spread the learning and innovation faster.

In the short term, if the NHS enables free-flowing patient information accessible to all who need it to provide great patient care, the patient is no longer ‘owned’ by one clinician at a time. We can begin to centre care around the needs of the individual rather than NHS bricks and mortar.

In the longer term, we will springboard from accessible data, capable of being independent of the system in which it is held, into open APIs which allow brilliant, innovative apps to sit on top of existing products. We will allow staff and citizens to interact with healthcare in an intuitive way. Technology fit for use in every NHS organisation will enable face to face consultations to be complemented by virtual clinics. Natural Language Processing like that which underpins Alexa or Siri will support patients with online advice at home and hospital doctors with a true digital assistant that prevents multiple junior doctors having to sign into multiple systems and record information many times.

As part of this job I have been lucky enough to visit hospitals around the UK and have seen really clever examples of innovative use of existing technology. Staff able to see patient records on their own hand-held devices. Rapid log-ons with single sign-ons. If any single NHS organisation was to take the best in digital transformation from everywhere else, it would offer an excellent quality of life to its staff and I have no doubt that this would reflect in a better quality of care for the patients they serve. The short-term future is already here. It is just not evenly spread.

Simon Eccles

Dr Simon Eccles is the Chief Clinical Information Officer for Health and Care. The role spans the Department of Health and Social Care, NHS England, NHS Improvement and the arms-length bodies. He is accountable for delivery of the Personal Health and Care 2020 programme, and the whole of the central NHS IT expenditure.

Simon still practices one day a week as a consultant in Emergency Medicine at St Thomas’ Hospital.

Former roles have included: Programme Director for Emergency Care Pathways transformation at Guys and St Thomas’, including overseeing the building of a new Emergency Floor on the St Thomas’ site; joint Clinical Director for Urgent and Emergency Care for NHSE London; joint SRO for Urgent and Emergency Care in South East London and a reviewer with CQC, the MPA and NHS England. He has been SRO for Interoperability within the P2020 programme and for NHSmail, providing secure communication across the NHS.

Simon was a first wave graduate of the Major Projects Leadership Academy at the Said Business School, Oxford sponsored by the Cabinet Office. He was previously the Medical Director for NHS Connecting for Health, where he had responsibility for clinical engagement in health informatics as a driver for clinical quality and productivity improvement. He was the clinical lead for the NHS Information Strategy in 2011.

Simon Eccles qualified from the London Hospital Medical College in 1994. He has previously chaired the BMA Junior Doctors Committee; leading in addressing the challenges of changing doctors’ post-graduate training and the European Working Time Directive. He has held a number of strategy and policy advisory roles within the Department of Health, including clinical lead for the Hospital at Night programme.

Simon Eccles is co-author of the Oxford Handbook of the Foundation Programme and joint editor of the best selling careers guide ‘So you want to be a brain surgeon’.

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