Shaping the future of UK healthcare

Despite numerous strategies, programmes and reports looking at how UK healthcare can improve and standardise digital transformation, change has been slow and fragmented. Our survey of 1500 frontline staff, rated the current state of digitalisation as ‘Slow, Expensive and Challenging’. Similarly, the consensus from our interviews with 65 senior healthcare stakeholders was predominantly negative, and included concerns over the wide gap in digital maturity within and across different sectors of care.

Indeed, the results from the 2018 National Information Board (NIB) digital maturity self-assessments of NHS trusts in England ranged from a low of 18/100 to a high of 93/100. Yet funding to support digital transformation has been concentrated on only 25% of the more digitally mature NHS trusts.

So how can UK healthcare move forward? Around three-fifths of the frontline clinicians we surveyed believed their organisations were reasonably well prepared to adopt digital technologies. Many of our interviewees viewed digital transformation as an opportunity, but two-thirds believed it would take more than ten years to achieve a fully digital, or ‘paperless’ NHS.

In response to the fragmentation and disparity across UK healthcare sectors and geographies, a new organisation called NHSX will become active in July 2019. It will lead the NHS digital transformation agenda by bringing together policy, planning, implementation and responsibility for driving change. NHSX will be crucial over the next few years to closing the digital healthcare gap and delivering the digital first NHS envisaged by policymakers.

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For UK healthcare to transform effectively, we believe there are five fundamental steps that need to be taken to close the digital gap. Without this, the current, fragmented system itself is the main barrier to delivery of the future of healthcare.

Create a robust health IT infrastructure - the current IT infrastructure faces numerous challenges including data storage, security and integration and network connectivity, without which information sharing, and adoption of new technologies is incredibly difficult.

Implement accessible, open Electronic Health Records (EHRs) – our survey of frontline staff rated EHRs as the top technology in helping to improve the efficiency of clinicians and in delivering patient care, but many different systems are in use, with widely varying functionality. This fragmentation has limited the ability of clinicians to efficiently share or use data both internally and externally.

Address challenges in interoperability – the ability to share data securely between multiple, bespoke IT systems is a massive challenge. Resolving this will need additional funding and support to create an information sharing environment including adopting open application programme interfaces (APIs).

Establish robust governance - away from the technical challenges, healthcare has to comply with numerous regulatory requirements on data security and privacy, as do any organisations handling data. Additional difficulties are the number of different operating trusts and services, and the sensitivities around patient data, privacy and consent. Initiatives to establish a framework include a code of conduct and guidance, clarifying the approach to data ownership, security, patient consent and patient education, so that patients know who is accessing their data, when and why.

Develop digital leadership and skills – Given the large number and types of staff working in healthcare, digital skills are bound to vary. Leaders need a clear understanding of the role and value that digital technologies can play, and clinical staff need to feel consulted, empowered and trained in order to get the best out of new technology. Indeed, the goal of any new digital technology should be to improve efficiency, safety and release staff time to care.

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A number of disruptive digital solutions are already having an impact in some areas. We’ve identified that these have a number of common ‘SMART’ characteristics that could help encourage adoption of digital technologies at scale.

Read our case studies on how SMART digital solutions are transforming healthcare.

By embracing digital transformation the healthcare system of tomorrow will look very different to today. New digital technologies that harness the power of data will underpin much of this healthcare transformation, improving the quality of people’s lives, and making the job of working within the health and care system more rewarding. Many devices and services that are breakthrough innovations now, such as predictive, preventative and personalised medicine will become mainstream.

Digital and access to health data will play a major part in the following trends that are shaping a predictive, preventive and personalised future.

Interoperability and open platforms

Similar to the current online banking initiatives, patients will be able to access their own health records via mobile devices. Digital transformation—enabled by interoperable ‘always-on’ data, artificial intelligence (AI), and open, secure platforms— is likely to promote closer collaboration among industry stakeholders and drive cheaper, more precise and less invasive treatments.

Genomics

Reduced cost through automation has allowed genome sequencing to become a mainstream application of healthcare. This will allow more precise clinical therapies and speed up drug development. In addition, susceptibility to diseases will be detected in advance allowing prevention and early intervention.

Diagnostics 4.0

Merging analysis of biomarkers and vital signs, with psychometric metrics such as tone of voice and gait, using AI-enabled tools will provide a more precise indication of an individual’s health status and an accurate diagnosis of any disease. Information from wearables will also be integrated with patient data, for a tailored detection of changes to an individual’s condition.

Population health management (PHM)

Gathering data and insights about health and wellbeing across multiple care and service settings, can help to identify the main healthcare needs of a community, and design services accordingly.

Value-based care (VBC)

VBC aims to optimise value for patients and payers by achieving the best outcomes at the lowest cost. The NHS RightCare programme, which aims to address the problems of overuse of resources that do not add value and of underuse of resources in tackling prevention or health inequalities, is a step in this direction.

The digital hospital of the future

The hospital of the future will look quite different from the hospital of today. Rapidly-evolving technologies and growing consumerism, along with demographic and economic changes, will transform hospitals. A growing number of inpatient services are already being delivered at home and in outpatient facilities, with hospitals evolving to become the preserve of acute, complex and very ill patients.

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Our report presents an analysis of the current state of digital transformation across the UK’s primary, community and secondary care sectors, and identifies what needs to happen to achieve the vision of a fully digitalised and integrated healthcare service. While our research focuses, predominantly on the changing policy landscape in England, our survey and interviews are UK focused; enabling compare developments in the other UK countries, where the devolved governments have developed their own, largely centralised, approaches and timelines for digital transformation. The report highlights strategic actions and case examples of evidence-based good practice to accelerate digitalisation of healthcare across the UK.

Our research is based on: