Digital health and social care: what to expect

Released at the end of June, the government’s policy paper “A plan for digital health and social care” sets out the national digital goals and investments for digital health and social care and the strategies needed to achieve them. Health Business looks at the benefits and potential challenges

The digital transformation of health and social care is a top priority for the Department of Health and Social Care (DHSC) and NHS England.
    
According to the new policy paper, learnings from previous attempts to digitise healthcare, along with advances enforced by the pandemic have provided a good foundation for digital change.
    
The paper is aimed at leaders in health, social care and technology with the hope of creating a “a brighter digital future”.
    
There are four goals set out for the health and social care system. These are: prevent people’s health and social care needs from escalating; personalise health and social care and reduce health disparities; improve the experience and impact of people providing services; and transform performance.
    
The paper aims to consolidate the goals and investments in different sector strategies and guidance into a single action plan to achieve the goals on four complementary fronts.

Digital Health Records
The first of these fronts is equipping the system digitally for better care. One priority here is digitising health and social care records, with all Integrated Care Systems (ICSs) and associated NHS Trusts aiming to have core digital capabilities including electronic health records by March 2025. For social care, the aim is for 80 per cent of CQC-registered providers to have digital social care records by March 2024.
    
Electronic health records make it quicker and easier for clinicians and NHS staff to find records and to update and edit them. It also means that all staff involved in a patient’s care have access to the same information, without relying on paper notes that could be out-of-date, delayed or lost. It is hoped that staff will be able to spend less time on administrative tasks and more time delivering care.
    
Another priority of digitally equipping the system is the creation of a life-long, joined-up health and social care record. This means that by March 2025, all clinical teams in an ICS will be able to (where appropriate) access and contribute to a complete overview of a person’s health and social care record. Where appropriate, non-clinical staff in social care will also be able to access and amend patient records.
    
A life-long, joined-up health and social care record should mean patients are treated quicker and more efficiently each time they are seen by NHS staff. They shouldn’t have to repeat their medical history and answer several questions each time a new medical issue presents itself.
    
Digitally supported diagnoses
Digitally equipping the system also involves digitally supported diagnoses, meaning using new diagnostics capacity to enable image-sharing and support clinical-decision making. This technology should streamline pathways, help triage waiting lists and provide faster diagnoses.
    
Another front of the action plan is supporting independent healthy lives. This is to be achieved by enhancing national digital channels to give people more control over their lives. It should make it easier for people to interact with different health and social care providers and access more health and care resources where and when they choose. Traditional services will remain for people who cannot or choose not to access digital services. This front includes increasing the functionality of the NHS App and website.
    
The plan also includes the adoption of proven tech, along with the aim of developing transformative technologies and distributing them quickly through the health and social care system. This includes systemising tech research and development partnerships, and helping NHS organisations in commercial negotiations with industry and funders.

Better Tech
The health and social sector also aims to buy better tech, that meets the needs of staff and patients as well as standards.
    
Finally, the action plan aims to align oversight with accelerating digital transformation.
    
This involves using regulatory levers, with any changes in the regulations aiming to signal to the health and social care sectors that digitisation is a priority, as well as identifying the essential and non-negotiable standards of digital capability.
    
Standards will also be enforced, though it is not yet clear what these will be.

Government funding
The digital transformation will be supported by government funding to connect data and enable secure, transformative data-sharing, including investment in data infrastructure at national, sub-national and ICS levels to support day-to-day care, population health, planning and research and to transform pathways, especially to support the recovery of services post-pandemic and make the NHS App a “front door” to the NHS. £2 billion will be provided to digitise the NHS with at least £150 million to support transformation in social care.

Risks
Despite the benefits listed above, there will be some concerns around the digital transformation. The recent shutdown of Guy’s and St Thomas’ hospital due to the heatwave will raise concerns about a digital NHS’s capability to face similar challenges in the future without shutting down and cancelling services and urgent treatment.
    
Furthermore, cyberattacks, such as the recent ransomware attack that affected NHS 111, will pose a threat to the delivery of services. Though disruption after the latest attack was minimal, a major cyber attack could paralyse a digital NHS, and cause significant problems and delays to patient care.
    
Digital records also pose the questionof privacy, both in terms of which NHS staff will have access and whether these could be stolen. With a digital and lifelong health record, patients may be concerned about who will have access to the personal data, with potentially many members of staff being able to do so. Again, with regards to privacy, there is the threat of a cyberattack and personal information being stolen, sold and ending up in the wrong hands.
    
In order for the digital plan to succeed, the right foundation needs to be in place, particularly cyber resilience, as illustrated by the heatwave and the ransomware attack. Furthermore, the infrastructure needs to be in place – remote locations will not benefit from a digital NHS, if they don’t have the internet services to provide it.
    
Finally, NHS staff will need to be trained and upskilled in digital skills in order to work with and progress the digital transformation.
    
All of the above are mentioned in the plan, though they will need to be major components in order for the plan to succeed.
    
Improved digitisation will be a major benefit for the NHS with improved efficiency and reduce costs. However, it must be ensured that the right infrastructure and safeguards are in place to operate efficiently, with next-to-no downtime and important security and privacy measures.

 

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