Transforming healthcare in the digital age

Ahead of the launch of the Long Term Plan the Chief Digital Officer at NHS England considers how digital services and technologies which put consumers at the heart of healthcare are key to transforming the NHS:

Established 70 years ago this year, the NHS has been transformative in tackling wide-spread diseases and pioneering advances in surgery, screening and gene therapy.

Now, as technology rapidly advances, the way people interact with services is changing. We live in a digital age, where people manage much of their lives through their smartphones.

We have made progress supporting people to manage their health online. Already 15million people are signed-up for digital services through their GP practice, giving them access to online appointment booking, ordering repeat prescriptions and viewing their GP record.

The NHS website provides high-quality advice and information with around 40million visits a month*. We’ve created a library of health apps which are NHS assured as secure and safe to use. NHS 111 Online is live across 100% of CCGs, enabling their populations to access the same urgent medical help and advice as the NHS 111 telephone service, online.

A private beta test of the NHS App, which will provide a core suite of services that allows people to manage their interactions with their NHS services more effectively, started in areas in England in September 2018, and will be rolled out publicly from early 2019.

The NHS App is underpinned by a single NHS login to enable secure connection to NHS digital services, enabling people to authenticate themselves online, rather than still having to go to their GP in person to do so. NHS WiFi now provides free online access to over 50million people, and our widening digital participation programme seeks to ensure that nobody is left behind by increased digitisation.**

However, with advances in medicine and people living longer and with more multiple occurring conditions, there is ever growing demand placed on the NHS. That’s why I believe we need to re-think how health and care is delivered – around how people live their lives today, and into the future.

We need to move from the traditional ‘one-size-fits-all’ approach we’ve had to healthcare, towards much more personalised and targeted interventions that meet the needs of individuals in a way that is right for them. For example, people will know the top things they can do to manage their health, and are motivated and reminded to do so, and services will be suggested for people based on their lifestyles and preferences.

This can be achieved through a ‘digital first’ approach to care, and a digitally enabled healthcare system. A system where people can access and interact with services seamlessly across digital channels and physical settings; where the online healthcare experience is so good that people choose to use digital services as a first port of call to meet their needs. A system where people don’t have to repeat their story multiple times because we have a single view of the individual across health and care settings.

To enable this, healthcare systems will use analytics and digital tools to target prevention activities, manage population health, and develop deeper relationships centred around the person.

Care needs to be designed around people and their communities, rather than around the bricks and mortar locations. And people who choose not to, or who can’t use digital services themselves, will benefit from others using them on their behalf. Digitally enabled monitoring and targeted outreach will also free up clinicians’ capacity for face-to-face care where it’s most needed.

We must work effectively across national and local organisations, focussing on delivering a common ambition which is centred around citizens, and organised around products and services rather than existing programmes of work.

We need to move away from the paternalistic, clinician-led culture, to using a targeted mix of partnership approaches and encouraging personal responsibility for health where appropriate.

We need to embrace the skills and expertise from sectors such as industry, charities and social enterprises; building on the successes we have already had – such as reaching 1001 partnerships with our new APIs.

We need to change the way that we talk about and prioritise technology across all areas of our healthcare workforce so it’s not about IT, but it’s about service transformation enabled by technology.

And we need to include digital training for all staff so that they are confident and motivated users of digital health tools, who buy-in to the benefits and champion their use to their patients.

I know that delivering meaningful, personalised health and care interventions which help people live well for longer – and which maintain a sustainable NHS – requires whole system transformation. But given how fundamentally transformative the NHS was in 1948 and where it has already taken us, I wholeheartedly believe we can get there.

* This figure was corrected to 40million visits a month from 40million visitors a month on 12 December.

** this sentence was updated on 12 December to reflect the fact the NHS wifi is now available to 50million of England’s population rather than that 50million people are using NHS wifi as previously implied.

Juliet Bauer

Juliet was previously NHS England’s Chief Digital Officer. Tara Donnelly is due to take over the role of CDO at the beginning of February. She will oversee a portfolio of digital services including the NHS website, NHS ‘assured’ apps library, and the development of digital services to empower patients to better manage their health and care, including long-term conditions such as diabetes.