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The National Health Service (NHS) has a distinguished history of innovation. Since its beginning in 1948, the NHS has delivered some of the world’s most ground breaking developments, including the first test tube baby born in 1978, the first heart, liver and lung transplants carried out in 1987 and the introduction of MRI scanners in hospitals which have made the detection of tumours and other cancers possible.
The recent launch of the 100,000 Genome Project, a £300million investment to support ground-breaking genetic research into cancer and rare diseases, is a paradigm shift in modern medicine and will transform how diseases are diagnosed and treated. However, the NHS is yet to harness the true potential of the information revolution. While other industries have become digital by default, health has yet to fully grasp the opportunities presented by advances in technology, and delivered them at scale.
A future of change
In October last year, the Five Year Forward View revealed a shared desire amongst patient groups, clinicians, local communities, frontline NHS leaders and national organisations to lead and support change, committing the NHS to further use of technology to achieve this aim.
Less than a month later, the National Information Board (NIB) released Personalised Health and Care 2020. This is a framework for action which provides the first blueprint that all national bodies, clinical and civil society leaders have agreed on, suggesting how the NHS should push itself into the digital age.
Its proposals are ambitious. It targets real time digital records for all health and care services by 2020 at the latest; patient access to all their records online by 2018; a new kite marking service for health apps and giving all people at their end of their life the opportunity of a mobile digital record which will record their preferences for treatment.
Our hope is that the commitments on the use of technology and information, outlined in the Five Year Forward View and Personalised Health and Care 2020, will create the right conditions for locally-led transformational change to occur. There has been some fantastic work happening at both a national and local level which, taken together, has helped to quietly ensure the kind of far reaching adoption of modern technological services that has eluded us in the past.
Nursing technology fund
As the Director of Strategic Systems and Technology at NHS England, my job is to create the vision and strategy for use of technology in the NHS. It’s not all about technology of course, but it is an enabler that helps us to deliver improved outcomes for individuals and allow greater access to health and care services. We want to encourage and empower our dedicated care professionals to engage with technology in a way that is both meaningful and helpful to them, which is why we are delighted there was such a positive response to the Nursing Technology Fund.
In October 2012, the Prime Minister announced dedicated capital investment, or, the ‘Nursing Technology Fund’ to support nurses, midwives and health visitors to make better use of digital technology in all care settings. This will help deliver safer, more effective and more efficient care. The fund was first launched in December 2013 and invited NHS organisations to bid for money to buy technology to facilitate staff in providing compassionate and personalised care.
The first round of applications saw 74 Trusts awarded funding totaling almost £30m. This funding has enabled them to put in place some really exciting and innovative initiatives. This includes voice recognition technology for a Paediatric Intensive Care Unit; an Electronic Observation System that allows nurses and clinicians to record clinical data at the bedside on electronic devices in real time and the deployment of digital pens to community and district nurses and midwives – which allow for captured data to be integrated into back office patient systems.
Buckinghamshire Healthcare NHS Trust won the largest amount of funding, £1 million, to allow them to buy mobile devices and a supporting software solution to integrate directly to the EPR. This will allow community nurses and community midwives to work more efficiently.
Approximately half of the successful applicants from the first round have reported that they are at least 80 per cent of the way through implementing their projects which have delivered £3 million of benefits to date. This is a brilliant achievement in a short space of time and we expect the benefits to continue to roll out as these new ways of working become fully embedded.
The second round
The focus of the second round of the Nursing Technology Fund applications shifted from technical solutions to technology-enabled capabilities. Eligibility for the second round of applications was also expanded and 62 organisations including Local Authorities (LAs) and Voluntary, Community and Social Enterprises (VCSEs), as well as NHS Trusts and Foundation Trusts, have been awarded funding totaling almost £35 million to be spent across 2014/15 and 2015/16.
Successful applicants of the second tranche of funding include Marie Curie Cancer Care who were awarded £1million for their Connected Nursing project. The project enables mobile access to digital care records, digital capture of clinical data at point-of-care and resource scheduling software. Also benefiting from the second round of funding was Milton Keynes Hospital NHS Foundation Trust who were awarded £646,000 for their project to enable the monitoring of vital signs and Early Warning Scores at the bedside in real-time. Also recognised was the Devon Partnership NHS Trust, who were awarded £204,000 for their Video Consultations for Nursing Staff project to equip patients and develop proper therapeutic environments for remote consultations in a community mental health care setting.
Croydon Health Services NHS Trust (CHS) received £967,000 to invest in mobile technology to enhance clinical care in community and community maternity settings. This included digital pens, laptops and tablets which will improve the timeliness and quality of data capture and provide visibility of the whole patient record enabling greater coordination of care.
Safer drug dispensing
Also benefiting from the second round of funding was Homerton University Hospital NHS Foundation Trust, who received £512,000 for powered clinical trolleys for drug rounds.This project will deliver a versatile powered clinical trolley solution which will enable nurses in the acute setting to document clinical information about medicines they have or have not administered to patients during drug rounds, data that will be stored in the patients’ electronic medical record (EPR). The solution will store medicines securely in a highly portable trolley with a PC (and power supply) connected to the Trust wireless network to enable direct recording in the EPR system.
Northumberland, Tyne and Wear NHS FT meanwhile was awarded £640,000 to implement a state of the art ward-based automated medicines management system.The overarching effect will be the delivery of safer clinical interventions and a reduction in patient safety incidents involving medicines administration and medicines management. The combination of automated storage cabinets and intelligent trolleys will minimise the risk of mis-selection and mis-administration of medicines as well as releasing significant nursing resource to deliver more direct patient care.
Smart technology choices
With more technology available now than ever before, the NHS must make the smart choices. Nationally, we are focusing on IT systems to provide the ‘electronic glue’ to enable different parts of our health and care service to work together. Locally, commissioners will look for systems that solve their problems, but it is key that all these technologies meet with the nationally specified security, interoperability and data standards.
Having a digitally enabled workforce and getting away from paper will allow our clinicians to have constant access to meaningful information – such as medications, allergies and medical history – available immediately across all care settings.
While the NHS is a world leader in primary care computing, progress on hospital systems has been slow and the NHS is not yet fully exploiting its comparative advantage as a population-focused national service. The bringing together of patient data and enabling comprehensive transparency of performance data will help patients make informed choices and help the NHS commission better quality care.
Looking to the future
The NHS is not one monolithic organisation. It is made of thousands of caring, clever and committed individuals, many of whom have an insatiable appetite for new technology. This is not just the IT staff – we’re talking about nurses, GPs, admin staff. Everyone is becoming more adept at using IT on a day to day basis and more aware of the potential for technology to transform services and help the NHS evolve in order to meet the changing needs of the patients we serve. Looking to the future, we know that globally the population is living longer yet have more complex health conditions. As a nation we remain committed to providing a high quality healthcare system for all our citizens and have recognised the need to take advantage of the opportunities technology has to offer in order to support the care delivered by esteemed care professionals.