Bytes and bandages: the role of tech in elective care recovery

In January, the latest NHS elective recovery plan was published, an initiative designed to address the ongoing challenges and long waits for routine care. The government’s flagship aim is to meet the national standard of 92% of people being seen for planned treatment within 18 weeks of referral by March 2029, with an interim target of 65% by March 2026. The plan outlines actions and commitments active until March 2029, and aims to deliver transformative reforms by focusing on four key areas: empowering patients by giving them more choice, reforming care delivery, providing care in the right settings, and adjusting incentives around finance, performance and delivery standards.

Central to this strategy is the use of technology as an enabler of change and recovery. Many people report issues booking, amending, following up and cancelling appointments, and there are frequent stories of letters lost in the post and clunky telephone systems that make choosing timeslots that work around people’s lives difficult. The plan recognises that there is clearly scope for digital technologies to improve how patients experience their care.

Improving patient empowerment is a key aim of the plan. This is primarily through providing better information and improved choice. The plan sets out that the NHS app and the Manage Your Referral (MYR) website are intended to become the default routes to improving access to information on waiting times, the next stages of an individual’s care journey, patient experience through increased information and choice, and other important areas. The app will also enable elective care appointments to be rescheduled, offer people the option for patient-initiated follow-up, and support more communication, including hospital discharge letters.

Alongside the plan, a new agreement was published which set out an expansion of the use of the independent sector for elective care to increase capacity, paid for by the NHS. It is good to see the NHS app will make any patient involvement with the independent sector visible so that care can be joined up around the patient. The website and app will also incorporate digital questionnaires to improve patient insight before an appointment, check waiting lists to remove duplication or unnecessary scheduling, and monitor patients remotely. The plan aims that by March 2025 patients at over 85% of acute trusts will be able to view appointment information via the NHS app, and by March 2026 at least 70% of elective care appointments will be available for patients to view and manage through the app. However, with only 8% of appointments currently managed through the website or app, there’s a long way to go before these tools become the default, and it’s essential to engage with patients to optimise the technology around people’s needs.

Remote monitoring and remote consultations feature heavily in the plan. These technologies are part of the approach to reforming care delivery and ensuring care is delivered in the right place. The plan is to expand remote monitoring to become a standard choice for all long-term conditions where clinically appropriate, such as for respiratory infection, and use remote consultations to offer patients convenient access to specialists. For this to have the desired impact, it is necessary for leaders to facilitate cross-organisational collaborative working and ensure all staff have the skills and confidence to support patients.

The target for the Federated Data Platform – software that brings together the data from multiple siloed systems – is for 85% of NHS trusts to have adopted it by March 2026 so that it can be used to reduce administrative burden, improve co-ordination across trusts and reduce waiting times. Currently, it’s taken 12 months for 89 NHS trusts to start using the platform. These early adopters are likely to be the easiest to onboard so achieving this target could pose a challenge.

Despite the recent hype around AI, what’s surprising is how little it features in the plan. Instead, the plan focuses on leveraging and expanding existing tools and technologies, enabling what’s possible today not new technology development. Where AI does feature in the plan, it is identified as a tool to streamline administrative tasks, enable automated appointment scheduling, and support surgical productivity. AI is also intended to help identify people at high risk of missing appointments so that they can be supported to receive accessible care, and patients who would be suitable for patient-initiated follow-up.

The plan also identifies a number of additional innovative approaches for scaling up, including wider sharing of test results and images, as well as automated patient scheduling, with notifications to better suit patients’ needs and the option to manage their care.

It is good to see that the plan addresses digital exclusion, such as offering accessible and alternative languages, and tailored communications being made available, particularly in areas of highest inequalities. The plan also sets the expectation of improved digital inclusion through working with people to develop digital services. Our recent research identifies the importance of digital services being co-designed with patients and the public so that they can be inclusive and trusted by those who use them. Alongside digital developments, it will be important that non-digital alternatives are still provided for those who prefer this method of communication, and that patients at risk of digital exclusion are identified. Providers need to work within their region to support patients to have the technology, skills and confidence to use digital services if they wish to.

The recovery plan includes ambitious use of technology to reduce the number of people on the elective care waiting list and indicates what are likely to be the important technologies in the upcoming 10 Year Health Plan. AI adoption remains modest, but a phased approach ensures that foundational technologies are well established before pursuing more sophisticated solutions.

What I hope to see in the 10 Year Health plan is existing technologies developed into building blocks for platforms and services in future. The system has many siloed technologies and systems, and the 10-year plan needs to use existing initiatives to build expandable technologies that wrap services around people. The success of the 10-year plan will depend on the implementation and scaling of solutions. In the elective care recovery plan new tariffs and payment models are being tested that should help scaling. These should be leveraged in the 10 Year Health Plan, but there will still be a requirement for investment beyond the funding for tech tools. This means investing in staff skills and education alongside leadership development while addressing the stubborn and complex issues of interoperability, fragmented systems and variation in digital maturity, so that all patients can benefit from the use of technology.