On the NHS Confederation blog, Roz Davies recently looked back at NHS activity on digital health in 2015 and saw new progress in central programmes and in pockets of innovation across England. But the kind of care enabled by new technologies remains out of reach for most of the NHS.
There are policy developments afoot that aim to change this; some new for 2016 and others building on existing work.
NHS test beds
The first of these new developments came last Friday, when Simon Stevens, Chief Executive of NHS England, announced the identities of successful ‘test bed’ applicants – a new set of partnerships between NHS providers, commissioners, academic health science networks and a mixture of both new entrants and established NHS technology companies. They are designed to develop, implement and test new care pathways based on combinations of multiple innovations. Each is focused on a specific clinical challenge, set during the nine-month selection process the successful sites have just emerged from. So they are narrower in scope than the integrated care pioneers, pilots and vanguards, but like these, their success is also being measured based on their impact on the whole system. So at this stage, serious thought and planning about the kind of outputs and lessons potential copycat sites want and need will pay off in the long run.
Creating an effective flow of information is one challenge facing the new test beds. Many digital technologies use information that flows from patients and their devices into the hands of professionals and back again, in a safe and timely manner. At the moment, these information flows are difficult to set up and use in the NHS – primarily for regulatory, cultural and economic reasons. Test beds will need to work with their patients and staff to get to grips with these issues, as some plan to deploy analytical expertise to large datasets generated through remote monitoring.
There are already some important events that test beds will be keeping an eye out for in 2016. The first will be in February, when Dame Fiona Caldicott is expected to publish the results of her review into the security standards for patient information-sharing across the NHS. This could have an important influence on the experience for both patients and clinicians using information held by the NHS for the purposes of direct care. But the headline-grabbing elements of the review will doubtless concern its impact on the care.data programme.
The second is the publication of the Wachter review looking at the use of digital technologies in secondary care, where information is currently fragmented and siloed. Robert Wachter, author of The digital doctor, will bring expertise and experience with US hospital electronic health records (EHRs) to an English context. The review will draw lessons from a recent study in the US which raised concerns that the US ‘has missed an opportunity to achieve health information exchange rather than just adoption of EHRs’. Robert Wachter will share his findings and answer questions at our Digital Health and Care Congress in July, just after his review is published.
Other key milestones for those interested in digital technology in the NHS include the publication of the final report of the Accelerated Access Review covering access to digital technology, and NHS England’s continued response to Martha Lane Fox’s recommendations for wi-fi in every NHS building and for new targets for GPs around digital access.
2016 probably won’t be the year we see widespread adoption of the technologies covered in our paper. But the beginnings of a framework that supports both local clinical teams and patients to use these technologies could emerge.