After humble beginnings in 1948, founded on the belief that good healthcare should be available to all, our NHS has grown to be one of the largest and best public health systems in the world.
From inception, it became apparent that technology in its various formats over the years would play an instrumental role in shaping this journey. For instance, the development of the transistor at the end of the 1940s then became a vital component for medical devices such as the pacemaker - which would otherwise have not been possible due to size and scale. The same technology lent itself to development of much faster computer systems whose importance would increase more and more in the decades that would follow.
The symbiosis between health and technology would only increase over time, being cemented in the 80s and 90s with improvements and affordability of the Desktop PC, and further the World Wide Web (WWW), in what became known as the dot.com era. Much of what happened thereafter in terms of health digitisation can in many ways be attributed to the rise of internet.
Investment in IT
At the dawn of the new millennium, and into the so called “noughties”, a significant step change occurred in the mindsets of stakeholders in that digitisation offered great potential. The NHS invested in large scale IT projects, teams of experts and developed an entire department which focused on digital products. This period welcomed developments including nhs.net, the NHS spine and patient summary care record (SCR). Towards the end of the decade, the widespread availability and use of Smartphones and other flexible technologies marked a further significant change in the relationship that users have with digital products.
The current decade has seen the pace of change really accelerate, with significant progress in digital technologies and innovations, apparent in all industries from retail to health. In many ways digital uptake within the NHS waned behind that of other major industries, particularly in the first half of the decade largely due to austerity. But, in the last couple of years we have started to see a renewed focus on digital and the benefits it brings. We have introduced advanced SCR, Electronic Prescribing Service (EPS) and intelligent telephony, to name but a few. We have been working to address the changing needs of patients insofar as the channel offering available when seeking advice or help, recently introducing NHS online app across the entire country – improving capacity and supporting the aim of ‘first contact resolution’.
The future NHS
So, what does the future NHS look like? There is significant amount of traction in the digital development space presently, aligned to both a rapidly changing digital landscape and changing patient needs. The focus is now to place patients at the centre of their own care through a ‘digital-first’ approach – achieved through a patient app which gives full access to their medical records and the ability to co-ordinate care from within. In DigItal Urgent and Emergency Care, programmes will continue to underpin three key areas; managing demand, supporting flow and optimising discharge across the urgent and emergency care system.
Further down the line, we see integration with home and other technologies as a key precursor to address population demands and needs. Our work will focus on the omnichannel experience; with wide ranging possibilities including voice biometric recognition, voice and speech recognition, determination of intent and personalisation of channels (depending on patient medical need or relevant history) – this could be, as an example controlled by a home system such as Amazon’s Alexa device. We see artificial intelligence and virtual reality as important components of the patient journey, being supplementary to the point where a patient sees a clinician. In terms of bookings, it may be that our scheduling capabilities develop into a similar format to websites like ‘Skyscanner’, providing patients with choice – but ultimately improving overall utilisation and reducing wastage against clinician time, whilst at the same time gathering data and information that informs predictive analytics. Genomics will play a critical role in treating or managing illnesses, and it may be that we see entirely new treatments and technologies, with an increased focus of ‘self management’.
The last 70 years have been fruitful for technology in the NHS and the next 70 years could be even more exciting with the emerging opportunities.
Sam Shah, Director of Digital Development, NHS England
