The first attempt at an NHS Covid-19 Contact Tracing App was abandoned after months of delays and £11m+ spent. A more ambitious attempt, to create a national Electronic Staff Record (ESR) system for managing NHS staff records, was expected to cost £662 million over 10 years but ended up costing £1.8 billion by 2021. High-profile defeats may draw attention and column inches, but there are success stories. For example, on its fifth birthday, the NHS App has twice as many users as Netflix, with pensioners the largest active user group. It is front and centre of the NHS Long Term Plan and the continued commitment to improving health outcomes for patients. The maturity of digital health provision, and an ability to do it at scale is central to the delivery of health and care goals. These are just some of the key opportunities.
Cutting waiting lists through digital tools
Waiting lists for hospital care have reached record levels. The number of patients waiting for NHS treatment in England hit 7.75 million as of August 2023. The figure was up more than 100,000 than the month before and nearly 9,000 people in England are estimated to have been waiting more than 18 months to start their treatment. To drive down waiting time, the NHS is maximising efficiency and capacity by developing digital tools like e-consultations, virtual wards, and surgical hubs, which are already demonstrating success. We’ve built apps to connect patients with major healthcare providers – notably for Terveystalo in Finland (read about that here) – and we understand the complexity of designing experiences that work for all. The NHS operates on a different scale, but still – digital transformation that incorporates similar person-centred principles has never been so important.
The NHS needs sustained investment in similar digital infrastructure and tools to replicate these types of efficiency gains. Without online consultations in the current core feature set for the NHS App, ICBs will look for alternative solutions.
Supporting workforce retention and development
The NHS is also facing a workforce crisis, with an 8% vacancy rate in England. Digital tools cannot replace staff, but they can support healthcare workers through automation of administrative tasks and on-the-job decision support. A 2021 NHS survey found that 59% of staff reported new digital tools saved them time, while 53% said these technologies helped reduce stress. One of the most frustrating challenges we hear about, when talking to NHS staff, is that they are working on systems designed 10+ years ago that are not fit for purpose.
Getting the basic IT system right takes a lot of capital investment, which the NHS is short of. Continued investment is essential to further modernise NHS workstreams, help prevent burn-out and retain staff. The roll-out of cost-effective online digital skills training will help to fully leverage technology investments and ensure staff are ready, capable and empowered to use new tools. We helped PHHYKY, a public provider of social and primary healthcare services in the Nordics by co-creating a customer- and employee-centric operating model and service offering, boosting the digital maturity of the organisation by 20% (read about that here).
Leveraging Data and AI for service recovery
Additionally, there have been major advances in AI, data depth and availability which have helped to drive healthcare service recovery coming out of the pandemic. NHSX, for example, developed a National AI Lab to drive rapid adoption of AI-enabled decision-making and resource allocation across the health service. One regional lab, based in Manchester, has deployed AI to predict demand surges for ambulances, reducing wait times. Ongoing work – some experimental – is needed to find and scale similar innovations, harnessing NHS data to enhance clinical pathways, operate facilities more intelligently, and improve patient access. Our approach to AI – in healthcare and beyond – has been to establish feasibility and build consensus through workshops with wide groups of stakeholders, leading into scalable proofs of concept. For example, a recent project to match those in need of healthcare with doctors who have the right expertise.
Digital transformation at scale is critical for the NHS to achieve the government’s priorities around waiting lists, workforce support, and post-pandemic recovery. As we’ve seen with some service-wide initiatives, a full-scale approach is fraught with difficulty. Realising national objectives requires consistent, long-range backing to maximise returns on platforms, infrastructure, and innovative data use cases. A smaller, tailored approach that tackles problem ‘slices’ but keeps the long-term, full-scale view in mind can be part of the solution.
- https://www.bbc.co.uk/news/health-67087906, accessed 3 Jan 2024
- NHS England. Case study: Online consultations – Bedfordshire, Luton and Milton Keynes. July 2022.
- The Health Foundation. NHS staff shortages: why are staff leaving and what can be done to keep them? November 2022.
- NHS England. 2021 NHS Digital Technology and Data Survey. August 2021.
- NHSX. Four regional centres collaborating to realise the power of AI technologies. March 2021.
- NHSX. Manchester’s AI Lab develops ambulance demand predictor. January 2023.
- NHS App reaches record users on fifth anniversary, December 2023.
- Matthew EdwardsManaging Partner, UK