The NHS must augment clinical toolkits to ease backlog pressures
The NHS has a new mountain to climb, in the face of a waiting list which has grown dramatically during the pandemic.
Numbers of people waiting for treatment in England are at a record high of over six million and the long-term impact of Covid-19 continues to place a huge strain on the healthcare sector’s operations.
Still in the wings are the ‘missing’ referrals, estimated by the National Audit Office to be between 7.6 and 9.1 million, which are yet to materialise.
Those living in disadvantaged areas already experience poorer health outcomes and are more likely to have to wait longer for care, further deepening inequalities.
In the context of a tax levy to fund elective recovery – which will naturally be accompanied by expectations from the public, and therefore politicians – the NHS elective recovery plan focuses on ambitions to eliminate waits of over 2 years by July 2022, and waits of over a year by March 2025.
If these and other ambitions are met, the NHS will be delivering 30% more elective activity by 2024/25 than before the pandemic.
All of this depends on staff. The NHS workforce, still under pressure after years of tackling the pandemic, isn’t going to be boosted by additional funding for training and recruitment.
Neither is it possible to get the same people to work harder. Digital innovation will be key to sustainable care delivery, through innovative new care models which work for both staff and patients.
Simplifying the provision of care
While the NHS is a complex organisation, now, more than ever, its provision of care must not be. Whether a patient turns up at A&E, is scheduled for an operation or is relying on mental health services, it is crucial that they receive a joined-up experience at every touchpoint, to ensure they receive the best care possible.
Key to this is levelling up the basic infrastructure across the NHS, in line with the recent announcement that 90 per cent of all trusts should have Electronic Patient Records (EPR) in place by December 2023, and social care providers by March 2024.
Although technology is not a panacea, it can support clinical practice in innovative ways and give time back to healthcare staff.
For instance, moving from paper to digital forms, which in turn are automatically fed into referral letters, health records, triage processes or reporting dashboards, can free up staff to focus on what really matters to them and their patients.
Technologies to support remote monitoring can improve patient outcomes and support the reduction of waiting lists, for example, by enabling connected care from anywhere and providing clinicians and patients with the data to facilitate preventative care.
Augmenting the healthcare professionals’ toolkit with technology such as AI-powered speech recognition and digital dictation, can reduce data-entry demands while improving the quality of clinical data.
Still, it takes an investment of time to make transformative change, at a time when staff are coping with addressing the backlog.
Wise investments in staff time for innovation can, however, give back in multitudes – a benefit experienced by NHS workers who saved nearly 3 million hours by using Microsoft Teams – and will be the only way to deliver a sustainable service in the long term.
Augmenting clinical toolkits
Enabling more effective consultations is one of the ways that technology can play a role in improving collaboration and proactivity within the NHS. For example, Addenbrooke’s Hospital in Cambridge became the first hospital in the world to pioneer the use of InnerEye, a cutting-edge artificial intelligence technology that could improve survival rates for some cancers.
InnerEye works using AI models that use the hospital’s own data to automatically highlight tumours and healthy organs on patient scans. These highlights will then be checked and confirmed by a clinical oncologist before the patient receives treatment.
It could be a game-changer, due to its shortening of the lengthy treatment planning stage which is crucial for cancers of the head and neck, which can grow fast if left untreated.
Across the healthcare sector, technologies such as AI and data analytics have been applied to improve operational efficiency and connect disparate data sources, to save time and improve resource allocation.
Alder Hey Children’s NHS Foundation Trust has modernised its data and analytics infrastructure, meaning that it can now predict how many patients are at different severity levels, how critically ill they are, and how many need admission. These insights are used to decrease unnecessary waiting times through more effective capacity management.
Elsewhere, NHS Glasgow & Clyde has harnessed AI to remotely spot trends in patients suffering with chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD).
This has allowed the Trust to transform the planning of patient care and reduce unplanned hospital admissions for vulnerable patients, by predicting changes in their condition.
The trial, with 400 patients, equated to an NHS cost saving of £1.2 million per year and could be equally applicable for the treatment of other long-term conditions such as certain cancers and diabetes.
Investing in and applying innovative technologies enables the NHS to embrace the challenges of its future and boost the care patients receive, at the same time as protecting hard-working staff from burnout.
There are huge opportunities for improvement at every stage of the patient pathway – from digital triage in primary care and digital pre-operative assessments, to new models of in-hospital patient flow and remote monitoring from home.
These changes can be delivered, by committing to a modern data infrastructure and the collaboration tools now available, to support the sector to become truly sustainable.
