TECHNOLOGY
such as online appointment booking or mobile health apps, which potentially affect all users of the NHS.
2. Evaluate impacts before ‘locking in’ new approaches Rather than rushing to lock in recent technological developments, policymakers should first ensure proper evaluation of their impact on the quality of care, including on health outcomes and patient and staff experience, and whether there have been any unintended consequences. While the overwhelming majority of respondents to the Health Foundation’s poll found their experience of using technology during the first phase of COVID-19 positive, the poll also raised questions about the impact and quality of these approaches that requires further evaluation. In particular, there is a need to better understand what and who these technologies do and do not work for, rather than thinking of blanket, one- size-fits-all applications of technology. This means having a strong priority within NIHR programmes for such evaluations, including through approaches that can produce rapid results, such as the work currently underway by the BRACE and RSET teams to evaluate COVID-19 virtual ward models.
3. Help providers to focus on longer term objectives
Through a refresh of the NHS long term plan, and equivalent strategies in the devolved nations, policymakers should put in place a strategy of ‘reorientation’ – helping providers to develop and optimise the use of recent technological innovations to meet longer term quality and productivity goals. This involves assessing which approaches are capable of serving longer term quality and productivity objectives – as has been happening through the Beneficial Changes Network in England, including work commissioned from the AHSNs and ARCs to evaluate and prioritise promising changes at a regional level – and then supporting providers to develop these approaches
The NHS has not yet ‘sealed the deal’ with the public on the future use of technology and further work is needed to address concerns and build trust in new technologies.
to achieve this. There is also growing awareness that critical to doing this will be understanding ‘what good looks like’ when it comes to technology-enabled healthcare. At a national level, this work will benefit from greater alignment of thinking on technology and quality improvement, as well as ensuring that centrally-led programmes do more to bring technology and improvement communities together in practice.
4. Address the NHS’s workforce, skills and infrastructure needs in relation to technology The 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. Ensuring the NHS has adequate IT and equipment to make the most of new technologies was the top priority in the Health Foundation’s survey of NHS staff. However, capital spending in healthcare was significantly lower than the OECD average throughout the 2010s, resulting in a growing maintenance backlog. So recent increases in capital spending, only partly a consequence of COVID-19, will need to be maintained if the NHS is to keep pace with developments. In addition, the staffing shortfall will need to be addressed if the NHS is to make the most of the opportunities that technology presents. Furthermore, while much support has been provided to more technologically advanced NHS providers in recent years, there is a need to focus on building the capability of less advanced providers as well. It is therefore important that funding recently
committed in England and Wales, as well as future funding allocations, can be used to assist these organisations. In conclusion Horton commented: “The NHS has not yet ‘sealed the deal’ with the public on the future use of technology and further work is needed to address concerns and build trust in new technologies. “While the speed of innovation has been hugely impressive, rushing to make these changes permanent without understanding more about their impact would risk holding back promising technologies from fulfilling their potential to improve care for every patient. “Action is needed by the NHS and Government, who have a critical opportunity to secure a positive healthcare technology legacy from COVID-19.” To support this agenda, the Health
Foundation’s Q Exchange programme is funding 30 front-line teams to embed and sustain positive changes that have happened during the pandemic, including several projects focused on virtual care. To find out more, visit:
https://q.health.org.uk
CSJ
References 1 Department of Health, Integration and Innovation, working together to improve health and social care for all, published in February 2021, Accessed at:
https://www.gov.uk/government/publications/ working-together-to-improve-health-and-social- care-for-all
2 Horton T, Hardie T, Mahadeva S, Warburton W, Securing a positive healthcare technology legacy from COVID-19, Health Foundation, March 2021, accessed at:
https://www.health.org.uk/ sites/default/files/2021-03/Securing%20a%20 positive%20technology%20legacy%20from%20 COVID-19.pdf
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