Blog 25 March 2022

How can the NHS balance long-term digital transformation goals with more immediate and mounting pressures?

by Richard Farrell

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Liberty Automation for Health

The government recently announced plans to merge Health Education England (HEE), NHS Digital and NHSX into NHSE/I, bringing digital transformation into the heart of the NHS and creating a health and care sector fully equipped to face the future and deliver for patients. The rationale was to better support the recovery of NHS services, address waiting list backlogs, and support hardworking staff, all while “driving forwards an ambitious agenda of digital transformation and progress”.

While these longer-term goals are admirable, the NHS faces more immediate and mounting pressures. For example, delays to NHS 111 are thought to be adding strain onto ambulance services, with people who are unable to get through to the service dialling 999 instead. In fact, last month saw the highest number of 999 calls for any November on record – an average of around one every three seconds. It was also the second busiest November on record for A&E, with more than two million patients seen at emergency departments and urgent treatment centres – up by half a million on the same time last year.

We know that the pandemic has also created a growing waiting list backlog. Figures released in September for 2020-21 reveal that there were 101.9 million outpatient appointments – a decrease of 18.4% from the previous year, reflecting the impact of COVID-19. Additionally, there’s been the increasing threat of the Omicron variant and pressure to provide a booster jab to 1.2m people per day to meet the latest government targets.

Amid this ‘perfect storm’, we’re seeing the NHS struggle to balance short term pressures with long term digital transformation goals, i.e. juggling the immediate challenges of COVID-19 while working towards delivering the NHS Long Term Plan or 10 Year Plan.


Investing in the future through transformation funding


Thankfully, there’s funding to ‘digitise, connect and transform services’ – the strategy for technology in health and care – including funding to address some of the more immediate needs highlighted above. For example, in this financial year alone, up to £250m from the elective recovery tech fund – a £700m Targeted Investment Fund – has been made available to Integrated Care Systems (ICSs) to improve patients’ experience and health outcomes across planned care, or elective, pathways – this includes tackling waiting lists.

We’ve already seen appetite from trusts for technology to do just that; in 2020, University Hospital Southampton (UHS) co-developed and adopted a management solution to support patients on disrupted waiting lists due to the pandemic. With NHS England demanding up-to-date information from trusts, hospitals were having to contact patients to check if they still needed their operations to determine waiting list priorities. Previously, this would have been a time-consuming and expensive process with printed letters sent to patients, patients phoning the trust to provide the information requested, or the hospital making a follow-up call.

Developed within a week using low-code, the management solution used SMS messages which prompted patients to visit a personalised and secure online portal to provide responses. This significantly reduced the number of calls the trust would have had to make and captured data in the shortest possible time, freeing up over-stretched staff to focus on patients that needed attention most. No patient app installations were required for a modern and straightforward user experience.


Make patients part of the solution, rather than the problem


Similarly, Leeds Teaching Hospitals NHS Trust used technology innovation to reduce call waiting and call abandonment times by creating a streamlined triage system. As one of the UK’s largest and busiest acute hospital trusts with over 1.3m outpatient appointments delivered every year, like many others, the trust felt the strain of growing waiting lists.

Leeds adopted an omnichannel contact centre and customer engagement management solution to work through its backlog, allowing flexible, remote working, freeing up infrastructure that could be used elsewhere. General Manager of Outpatients Richard Moyes said that by using the triage system, the team could more effectively put calls through to the right place after finding that “60% of our patients just want to amend a booking so we can action it there and then…[meaning] we only forward calls to specialist teams if it needs specific clinical expertise.”


Play the long game but embrace innovation ‘quick wins’


A low-code application platform enables citizen developers to build bespoke solutions to meet specific requirements and, by automating routine or mundane tasks such as contact centre triage, as adopted by Leeds Hospitals, staff are freed up to deal with more complex value-add work.

But, most significantly, the ability to design and build iteratively with low-code enables healthcare providers to commence and continue their digital transformation journeys at pace – making multiple innovation ‘quick wins’ – without having to determine exactly what their end destination looks like in 10 years.

For example, as challenges evolved for UHS, the solution, i.e. the technology, remained the same. The Global Digital Exemplar (GDE) went on to use the same low-code platform to support a COVID-19 vaccination programme amongst staff early in 2021. The application enabled staff to easily provide consent to receiving the vaccine and sharing data with NHS England. And, due to the flexible and agile nature of low-code, the application took just five days to complete – from design to creation.

By using intelligent automation solutions that support enterprise composability, users can select and customise modules of pre-packaged business capabilities as diverse as pharmaceutical labelling – to managing socially distanced queues. The use of App sharing communities also means that NHS Trusts needn’t start from scratch when looking to innovate. There is a wealth of applications already out there that can be customised according to varying needs.


Balancing future needs with meeting today’s demands


Whilst the pandemic has created huge challenges for healthcare, it has also forced trusts, and ICSs, to be more agile and transform at speed. With the formation of ICSs set to remove traditional divisions between hospitals, GPs, social care and council services to offer a more user-centric service – technology, and interoperability across previously siloed bodies, will need to be at the heart of future transformation.

The use of composable technologies (for contact centres), low-code application platforms, robotic process automation (RPA), and messaging not only play a pivotal role in improving operational efficiencies and freeing up resources, but has also enabled healthcare providers to build on existing processes, to introduce new ideas and improve patient care and outcomes.

But we mustn’t forget that digital transformation isn’t just a long-term goal or 10-year vision – something that can be put on the backburner while healthcare workers focus on the latest crisis – it’s essential to ease the current pressures faced by our under-pressure NHS today.