The pandemic means the NHS has had its most challenging and transformative year ever. 2020 saw a combined effort and joined up ways of working between health and social care organisations and the supporting ecosystem of private and public sector organisations to fight coronavirus.
The wider backdrop of the NHS Long Term plan and the move to integrated care systems had already identified digitalisation and integrated solutions as key pillars to improve patient experience and support the drive for treatment closer to home.
The pandemic has driven the need for intelligent national data and improved use of technology, genomics, and artificial intelligence (AI) to track health risks, infection outbreaks and vaccination programmes. Data modelling is at the forefront of decision making like never before. This approach will be extended to enable digital technology and behavioural science to focus on tackling determinants of health and inequalities.
All these factors contribute to some key trends, widespread adoption of new ways of working, and the use of data to personalise care. Many of these elements will require significant initial investment to implement to reduce costs in future.
This raises challenges in relation to:
- how data is captured, analysed, and shared between organisations;
- the co-ordination between private services such as bio-technology and connected devices and NHS care records;
- the technological and IT infrastructure and investment required to embed new ways of working;
- recruitment and training of staff to upskill them in analysis of data and use of emerging diagnostic tools and treatment approaches;
- where services can be delivered from and the estate needed to facilitate increasing digital services;
- ‘open sourcing’ – making solutions available for the developer community to meet evolving needs; and
- more standardisation of collection and storage of data to enable more consistent/usable data provision
Focus on healthy ageing rather than health and care
There are two major drivers behind this;
- The pandemic has led to a shift in focus onto individuals taking action to prevent illness and disease (not only coronavirus but also other health conditions); and
- The significant advancements in accessible technology mean that individuals can regularly monitor their own health and care data effectively through apps, wearable technology and connected devices.
These developments encourage behavioural change, allowing people to manage their own health proactively. The creation of health and wellness coaches (chat bots or real-life people) has also supported this shift.
These developments mean there will be many sources of health and care data in real time at individual patient level. This will allow consistent monitoring, reduce routine appointments and enable more timely and personalised interventions. In turn, this will reshape patient pathways, allowing a holistic approach to health issues as opposed to treatments being driven by organisational structures and not patient need.
Health and care settings
The NHS was moving towards integrated care systems before the pandemic and this has accelerated over the last year. In addition, many general practice, community and mental health appointments have shifted to virtual consultations due to coronavirus restrictions.
This has proven the concept works and there will be a continued use of digital triaging to signpost patients to the most appropriate care setting. Primary care will shift its focus towards patient-centric health and care models and personalised care plans. Advanced connectivity, including personal health devices will allow real time monitoring, combining data from biosensors and enabling prediction and assessment of disease and treatments. It will also reduce the need for in-patient appointments and consequently the estate and footprint the NHS needs to operate.
New diagnostic and treatment paradigms
NHS organisations are now using AI and technology to help diagnosis. This trend is expected to accelerate with diagnoses and treatment being based on technological and scientific advancements including digital therapeutics, epigenetics, and AI. The implementation of AI, nanotechnology, quantum computing and fifth-generation technologies will enable faster, customed diagnostics and bespoke patient pathways. Clinicians will use these tools to combine clinical and behavioural data to offer evidence-based prevention and treatment. This has the potential to increase success rates for individuals and lower care costs for the health service.
Treatments will develop beyond the traditional clinical and pharmaceutical interventions to include 3D bioengineering of transplantable organs and skin grafts, gene editing and implantable microchips.
Training for clinicians and professionals will shift away from knowledge transfer to developing cognitive, digital, emotional, and analytical skills, helping professionals communicate more effectively across specialities and use the technology available to them.
A brave new world
All these digital developments could revolutionise the way health care operates in the UK.
To make the most of the current opportunities, the NHS has a huge task, against the backdrop of recovering from the pandemic, to ensure services are fit for the future. Every person’s health journey is different. Health care organisations should acknowledge this and design their services to elevate each encounter into a personalised health experience.
Coronavirus has ignited unprecedented collaboration across organisations and specialisms and demonstrated the value of partnering to deliver new solutions and improved outcomes for service users.
Deploying new digital tools and services has the potential to enhance the patient experience, treat them more safely, improve medication adherence and help consumers track and monitor their health.
While patients are more willing to share their data, health care organisations should ensure that the data serves consumers’ needs through adequate interoperability between the organisations. To maintain or even re-earn the trust of service users, organisations should demonstrate reliability, transparency, and most importantly, a sense of empathy in how they operate.
Data and digital technology will be at the heart of system working. The integrated care systems (ICS) will need a named SRO, with clear accountability for data and digital on the ICS partnership board, to develop a system-wide digital transformation plan. Digital transformation can help individual health care organisations and the wider health ecosystem improve ways of working, expand access to services, and deliver a more effective patient and clinician experience.