‘Underspending’ on NHS digitisation is easily solved, give it to social care
The UK government are currently investing in technology to help the NHS. However, Annabelle Sanderson, an industry-expert, examines whether authorities have miscalculated and could provide extra investment to social care.
When the Chancellor of the Exchequer announced £3.4bn of new investment in digitisation of the NHS, I wonder if he knew that Trusts in England had underspent on tech funding this year, despite a desperate push from NHS England.
According to the HSJ, the NHS is on course for a significant underspend in its ‘Frontline Digitisation Programme’, although NHS England have refused to set out the exact amount. The reason for this is said to be the complexity in applying for funding. Who would have thought it?
The digital investment announced in the budget is part of a capital investment programme ‘to help unlock £35 billion in productivity savings over the next Parliament by harnessing new technology like AI and cutting admin workloads’ and which will replace the existing fund; The same sort of well meaning, generic aims which have been in existence for years.
The NHS signed up to substantial productivity improvements in exchange for the money to upgrade antiquated tech – which hopefully includes basic wins like sending out appointments to patients digitally rather than by slow, unreliable post. But if money is lying dormant right now, the question I have is, why aren’t we making the process easier, more transparent or asking why Trusts feel that outdated, inefficient working methods are good enough for their patients and staff?
There is absolutely no doubt that the NHS is not making use of technology which is available, but it is using record amounts of taxpayers’ money. Paper based records should be consigned to the dustbin of history. EPRs should have been in place years ago and why are hours a week being taken up per ward on managing patient discharge when tech exists both for bed management and to expedite discharge home?
It feels like the NHS is using the trope of ‘more money needed’ as an excuse for low productivity instead of jumping on what is available and piloting ideas which will end up being used in other parts of the world before they are used here.
Just look at hypertension, which is undoubtedly one of the simplest ways we can check large numbers of the population quickly on an important clinical observation.
The latest campaign by the Department of Health and Social Care to get people to have their blood pressure checked is to harness the collective power of Gloria Hunniford and Graeme Souness. It’s a comms campaign from the 1990s. What influence will Gloria Hunniford, glamorous as she undoubtedly is, have on a 50-something, overweight Asian man at high risk of metabolic diseases? And will it be better than using technology to identify at risk patients and contact them directly, allowing them to book an appointment from their phone or pop to the local chemist? I’ll answer that for you: No. But it’s what the DHSC opted for when given the choice.
Will Graeme Souness appearing on a poster cut to the heart of the risks high blood pressure carries in a way which an experienced healthcare professional running group consultations cannot? The latter has been proven to work in conditions such as diabetes. Graeme Souness played football, not the sphygmomanometer.
But such a campaign looks flashy and comes with an easy to cut and paste press release. Since our health service is a political football, by our own choice since it is state run, we will be subject to decisions being made with ‘optics’ in mind, rather than health outcomes.
Another problem comes down to the huge difficulties of getting in contact with anyone in an ICB. Apparently some ICBs are expecting their staff to work at least one day in the office, as if this is some kind of unfair demand. It’s not.
The near impossibility of people with great ideas being able to speak to decision makers, whether they are in ICBs or government departments, cannot be underestimated when we look at why the NHS still lags behind with technological developments.
But there is another option. If healthcare doesn’t want the money, give it to social care.
Better technology and funding in social care can lead to a greater quality of life for patients and can help avoid them becoming patients, in the traditional sense of the word. It can also dramatically increase efficiency in social care, delivering better outcomes for people at a lower cost. The average wait time for social care across 85 councils was around 50 days. In Bath and North East Somerset, it was 149 days. Tech can help alleviate that – the data shows it.
People with early and mid-stage dementia can be monitored with GPS tracking and geofencing. People living independently can be supported through smart devices like sensors on kettles, hydration mugs or doors which can pick up changes in behaviour. Pilot projects have demonstrated success in expediting hospital discharge by using technology enabled care, freeing up beds and avoiding frailty from unnecessarily immobility.
Like primary care, it’s a fundamental part of preventative medicine, yet it ranks way down the list in order of priority.
According to the latest report from the TSA, some 97% of leaders in adult social care said they are planning to increase their use of TEC in the next 12 months, with 90% saying supporting hospital discharge has been identified as the top priority. It’s a win-win for the NHS and social care and most of all, the patient.
The saying goes that you don’t know what you’ve got ‘til its gone. I suspect part of the reluctance is because they expect the money to always be paid, regardless of health outcomes. After all, there is an inverse correlation in recent years between spending on the NHS and patient satisfaction.
If they can’t get their act together to draw down on available funding to bring themselves into the 21st century – and perhaps even if they can – give it to a sector who wants it. I bet the return on investment will be manyfold.
Images: Alex Knight and Braňo
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