Northern Ireland: The Goldilocks of Health Tech Innovation?

BT Health was privileged to support the NHS Confederation’s Northern Ireland Annual Conference and Exhibition. Richard Eccles , Senior Business Development Manager at BT Business Health, reflects on an event that recognised that digital is vital to addressing pressure on healthcare services while empowering patients.

We were delighted to have the opportunity to attend the NHS Confederation’s Northern Ireland Annual Conference and Exhibition this autumn and to hear from Dan West, the Department of Health’s Chief Digital Information Officer, about the ambitious digital solutions for Northern Ireland. After two years online because of Covid-19, it was great to be back in person at NICON22 and to be able to engage with so many inspirational leaders and frontline staff.

Most of us would probably be delighted if the word “pandemic” was never mentioned again. But if there was one good thing to come out of those two years it was proof that digital solutions can be deployed at speed and at scale to address big challenges – just think how fast GPs moved to online video consultations to maintain care for their patients.

Big challenges need digital solutions ?

Not surprisingly, “digital” was the big word of the conference. The Northern Ireland health and care system went into the pandemic facing significant challenges and the Department of Health (DoH) has recognised that it has come out of it facing “extreme pressure.”

The system needs political support for re-organisation, investment to increase capacity, and new ideas to improve efficiency and reduce demand. That means finding ways to help patients in hospital to get home, and to stop them ending up in hospital in the first place, by improving access to primary care and to services that support self-care.

Digital is the only way to do that, and Northern Ireland has impressive digital ambitions. Dan West updated the conference on the Encompass programme, which is a country-wide initiative to introduce a digital, integrated care record to Northern Ireland.

In fact, it’s probably the biggest, most ambitious electronic patient record programme in Europe, with the potential to make Northern Ireland one of the most digitally advanced healthcare economies in the world within a decade.

Dan used NICON22 to launch an implementation programme that, he joked, comes with the “spreadsheet from hell” – more than 160 projects that have been costed and taken account of the capacity of providers to implement them.

Co-design is critical to digital success

Joking aside, digitalisation is significant because it recognises that technology is useless unless it is designed and developed with those who are going to use it. That means co-design needs to be a core focus for technology companies; and it’s certainly a focus for BT Health.

We have asked some of the leading clinicians in the UK to join a clinical advisory board to sense check our work and ideas, we have asked some leading healthcare providers to join us on our vanguard projects to co-create solutions that we can scale to the wider healthcare market.

Northern Ireland is the ideal testbed for this new way of thinking. Around 1.9 million people live in Northern Ireland, most of them in and around the Belfast area. That’s about the size of a typical English integrated care system; but we already have integrated care in Northern Ireland, with health trusts running everything from acute to social care.

Colleagues call Northern Ireland the “Goldilocks” healthcare system – not so big that communication becomes impossible, not so small that innovation is impractical, but just the right size to co-operate on solutions to problems and then scale them.

Plus, as NICON22 showed, there is a real appetite in Northern Ireland for taking an entrepreneurial approach to solving the biggest problems. It is willing to take investment and expertise from BT Health to create things that we can take elsewhere.

A vanguard for primary care access

The Encompass programme is incredibly ambitious, but it doesn’t do everything. Most obviously, it doesn’t cover primary care, which is the focus of our vanguard programme in Northern Ireland. As things stand, there are around 320 GP practices in the country.

They’re all working very, very hard, and some are doing great things – but they’re also experiencing extreme pressure. To help practices make the best use of their most valuable resources, BT and the DoH have been working on quantitative and qualitative analysis to help measure the demand on primary care and match it with capacity.

Improved telephone and digital access to primary care services are an essential part of that picture. Many GP practices in Northern Ireland have a telephone first model for primary care; you don’t get to see a GP without calling first. So, we’re looking at how we can extend that system and help callers get faster to the service they need.

The really exciting thing about projects like this is the data they generate. By using this data, we could, for example, identify the value that community-based specialists such as pharmacists, physiotherapists and mental health practitioners could bring to alleviating the demand on GP practices. Or, we could deep-dive into the number of patients who could self-care with some advice or over-the-counter medicine.

We should also be able to assist in signposting pathways, so people are directed straight to those alternatives if available. Or, we should be able to start applying the same thinking to providing virtual care for patients who would otherwise be in hospital – this successful approach has led to the adoption of virtual wards by NHS England. Informally this has been dubbed the one point five care level in Northern Ireland (because it sits between primary and secondary care).

Collective challenges, collective solutions ?

There are significant challenges ahead. Conference delegates rightly highlighted the issue of digital inclusion, or how we can make sure that the most deprived in society, who are most likely to need healthcare services, but least likely to own expensive technology, can access care that is delivered digitally.

In response, Dan made the interesting observation that another of the lessons of Covid is that people who don’t have computers or laptops can often get online via a mobile phone. Some 90% of adults in the UK now have a smartphone; and developing services and apps that use mobile phone technology is another area in which BT can contribute industry expertise.

Overall, there was a real sense of optimism at NICON22. The Northern Ireland healthcare system faces significant challenges, but there is a recognition that society, public services, and business need to work together to answer. These are problems we all face, and we need to work together for solutions.?