New Hospital Programme: New tech and new buildings both key for better care?

National Transformation Director for NHS England, Dr Tim Ferris, says collaboration through the New Hospital Programme will foster more effective use of digital technology in service of better patient care and reduced staff work and, as he told the New Hospital Programme Industry Day, the spaces in which we provide care will need to change if the NHS is to deliver real transformation in patient care

I’m a GP and before coming to the UK, I delivered primary care for 30 years in Boston, in the United States. I’m also a professor of medicine at Harvard and have been working on digital tech and its implications for improving the delivery of healthcare. ?

I started working for the NHS to bring together improvements for the data and digital policy side and their execution within NHS Digital. I’m honoured to work for the NHS with so many amazing colleagues. ?

While the challenges are immense, the prize is worth the fight. The prize that we're searching for is better health and a sustainable delivery system. I think we're going to arrive at that through transformation and the use of digital data and technology for new ways of working, new organisational designs and very importantly, some new buildings. ?

Digitise, connect and transform ?

One of the frameworks we use a lot in digital healthcare is digitise, connect and transform. This works really well, but you can't do much with tech, digital and data if the information isn’t digitised to begin with. ?

That's a big deal in healthcare, it is challenging to digitise workflows, to digitise the information – there's so much information, organising it, inputting it – but it turns out inputting the data can be tough for clinicians. ?

It also and takes them away from the important personal interaction and caring role that they have - that's not helpful when it happens, and we have to mitigate that. ?

We also know it is critically important that when you digitise the information, that the people caring for you, for me, for my family, they have access, not only to the information they need, but access is also limited to only the information they need and only those people who need to see it. ?

So, access controls around data are critically important and that has been well managed locally and has worked out pretty well. As we start sharing more data among clinicians all caring for the same person, we must agree on the rules for access and availability of data. ?

Implementing technology so every clinician has access to information they need is what we call Shared Care Records. We need to make sure these records are up-to-date and complete and have all the information one needs but just the information one needs. ?

Even though these records exist, we still have more work to do. The situation reminds me of that old expression about innovation – the future is here, it just isn’t equally distributed. There are places in England that are sharing information well and some are only just starting out. We want to make sure we level up that connectivity. ?

On the transformation side, for example, patients should be able to see their records – it is their legal right to do so. We should be able to honour that legal right without a lot of bureaucracy in a digital age so patients should be able to see their records and test results on their home computers or on their phones. ?

Again, the technology exists and there are lots of examples of it being used, but it's not sufficiently widespread. ?

Sharing patient information well is transformative because it puts the power of the information in each individual's hands and that is clearly an integral part of the future of healthcare - we just need to make sure we deliver on it. ?

Good examples of digitise, connect and transform ?

We all know that we can do things differently especially around simpler transactions in healthcare. For example, in Birmingham they've got a dermatology programme where people with skin lesions can come in, get their skin lesion photographed, have those photographs run through AI (Artificial Intelligence) software and that software reads the skin lesion and suggests to a dermatologist: dangerous or not dangerous. ?

If it's dangerous or problematic then it goes to the dermatologist, but 30% of those lesions are not dangerous and they're not a problem. So immediately we're having the physicians, the dermatologists, focus all that education and clinical experience on the high-value targets and providing rapid feedback to the patients to say this isn't going to be a problem with a very high degree of accuracy. ?

That is the kind of thing where it's rethinking the way healthcare is delivered, that has huge potential to be transformative, but it fundamentally means that the way we think about the process is different and the spaces we need to design for that process are different. ?

Delivering transformation in a resource constrained environment ?

I've been so encouraged by how in a resource-constrained environment, we can still get an enormous amount done. Sometimes what we get done is better in a resource-constrained environment because it requires us to work as teams more.

We have to do joint problem solving, rather than solving those problems separately because that's so inefficient. I'm encouraged that the way forward seems more stable and therefore we have a greater ability to plan, greater ability to implement the kinds of changes we all want to see for our patients and for those delivering care. ?

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