TECHNOLOGY
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.” The report looks at the increased NHS use of technologies during the pandemic to reduce face-to-face contact and manage demand, such as video consultations, online appointment booking or remote monitoring at home. While most of those who used technology more during the early phase of the pandemic found the experience positive, half of these users aged 55 and older (50%) and nearly half of those with a carer (46%) – groups that may have higher need for healthcare – thought these technology-enabled approaches made for worse quality of care. NHS staff surveyed highlighted ensuring adequate IT and equipment and making sure technologies are safe and work for all types of patients, as among the top challenges for capitalising on recent technological progress. Furthermore, the report finds that while 49% of the public and 61% of NHS staff surveyed thought the NHS should be looking to use technology-enabled approaches more in future, a significant minority of both public (36%) and NHS staff surveyed (31%) were unconvinced about the long-term use of these approaches. The Health Foundation report outlined the key priorities for deploying healthcare technology after the pandemic, including the following:
Priorities for NHS provider organisations 1. Revisit aspects of development and implementation Front-line teams will need to revisit aspects of development and implementation that may have been shortcut during the COVID-19 pandemic. This could include rapid steps to put in place more local evaluation, to ensure new approaches are safe and work for all groups of patients. Identifying issues around digital exclusion and putting in place mitigating actions or alternatives to ensure technologies are not creating or widening health inequalities will be particularly important.
It might also include more consultation and MAY 2021
co-design with patients and staff to ensure new approaches are user-centred. Indeed, there may still be a need to develop and secure consensus about the future role of some technology-enabled approaches that were perhaps taken as a given during the pandemic. Other implementation issues may need revisiting too, such as training needs or activities like customising technologies and optimising ways of working, which begin at implementation but subsequently become part of the iterative work of continuous improvement. In short, though the speed at which technologies have been rolled out during the pandemic has rightly been praised, more work is going to be required to get the best out of them for the long term.
2. Think about longer term objectives Technology-enabled approaches will need to be re-oriented towards serving longer term quality and productivity objectives beyond the pandemic. For example, how can the recent deployment of devices for home monitoring develop from a useful way of monitoring health during a time of social distancing into a way of better supporting patients to manage their own health? How can the increased use of video consultations develop from a way of delivering health care at a time of reduced social contact into the vision for improving patient access, clinical productivity and use of the NHS estate outlined in the NHS long term plan? And how can we go beyond simply ensuring new technology-enabled approaches do not widen health inequalities towards the much more ambitious goal of harnessing the power of technology to ‘level up’ on health and make a particular difference for those who experience poorer outcomes? Changes such as these may require evolution of the interventions in question to focus on these longer term objectives.
3. Create the right environment for adopting and using technology Leaders of organisations and systems providing NHS care have a crucial role to play in creating a conducive environment
for adopting and sustaining innovation and technology. This includes engaging with their workforce to build a shared vision around technology-enabled care, and setting out how new uses of technology align with wider organisational strategy and values. More specifically, organisational leaders will need to support their workforce in reorienting and embedding new technologies rolled out during the pandemic by empowering them to design and test changes and allowing them the time and space to do so. This will happen most effectively if there is a learning culture within the organisation or system with a commitment to continuous improvement. The Health Foundation’s poll also highlights the need to ensure the right digital infrastructure and staffing are in place.
Priorities for policymakers and national leaders
1. Engage and consult the public and NHS staff
NHS leaders in the four UK nations should support public engagement exercises and consultation on the future of technology in healthcare, ensuring representation from underserved groups and patients with complex needs.
There were many positive findings from the Health Foundation’s surveys, but it is also clear that not everyone had a good experience of using technology during this period. Research is needed to understand why a minority of the public and staff reported negative experiences and why some – particularly older people and those with a carer – rated technology-enabled approaches as ‘worse’ than traditional ways of delivering care, along with evidence-based actions to address problems and concerns. It is also clear that the NHS has not yet achieved full support from the public as a whole on technology-enabled healthcare, with a significant minority appearing sceptical about its use beyond COVID-19. So there needs to be a meaningful conversation with the public and NHS staff to understand and address concerns, as well as to raise awareness and build confidence in these approaches. This will be particularly important for public-facing technologies,
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