Introduction

In this POV, Responsiv will summarise and interpret key findings based on research done by PwC into technology in the Healthcare industry following the Covid-19 pandemic.

Due to the pandemic, healthcare providers have had to change the way things works and how they cares for people. For the NHS, the pandemic has demanded the increase in pace of technological change to keep up with these changing practices and requirements.

Figure 1: Survey conducted by HIMMS on behalf of PwC

These circumstantial changes mainly focused on moving services online including telephone consultations and outpatient follow-ups. The pandemic has catalysed and accelerated change. The department of Health and Social Care and NHS England have worked to fund a focus on helping patients in new ways, such as virtual GP appointments, barcode scanners to identify patients and virtual wards.

“GPs (accounting for 90% of patient contacts in the NHS) moved to online and telephone consultations – some making 85-95% of their contacts virtual in a matter of weeks, compared with around 10% previously. Surgeons conducted preoperative assessments by video call, and a national benchmark called for 60% of outpatient follow-ups to happen virtually.”

A technology revolution swept through the healthcare sector, and the NHS was not immune; ultimately, the NHS had to become more innovative with technology. Change and survival became a shared goal for all healthcare providers, and aligned the focus to something everyone wanted (and needed) to achieve. This environment nurtured the tech-revolution and allowed it to take root. It is now the role of the NHS and other providers to maintain the momentum despite the pandemic slowing down.

Technologies including robotic process automation (RPA), big data, and AI have the potential to change and improve the way the NHS provides healthcare, as has been seen with the move to online and remote treatment.

The technological challenges highlighted by the pandemic include the lack of interoperability between systems, legacy software, inadequate infrastructure, inconsistencies across digital platforms, and the lack of IT skills.

Key Findings

In this section, Responsiv will be exploring and interpreting what we believe are key findings from the PwC report on ‘Tech Powered Healthcare.’

1. The NHS needs to focus on innovation and manage the fallout of cultural implications
2. Providing a foundation for digital transformation will come from strategic funding and investment
3. Partnerships with technology companies will optimise project outcomes

The NHS needs to focus on innovation and manage the fallout of cultural implications

For digital transformation ‘success,’ change is required. Technological change has been propelled by the Covid-19 pandemic.

Technological change means changes in working practice; staff and patients will need to understand the value of technology, how it can increase efficiencies and positively impact both patients and their work. The NHS aims to provide a patient-centric approach to the way they treat people, and this should not be ignored with the advent of new technology, whether that be a software or physical change.

Enhancing patient and staff experience is the way forward with technology. Optimising slow and mundane processes will improve satisfaction all around, and allows care givers to focus on this patient-centric objective, instead of those uninspiring (but necessary) drawn out tasks.

Improving patient care is the main objective, and if technology is the way to do that, then it should be welcomed despite the cultural and behavioural impacts.

Of those surveyed, 54% state that overcoming cultural resistance to innovation is key to adopting technology in the NHS.

Staff, carers, and even patients will need to learn new skills to ensure technology is utilised to its full potential. This means the NHS will need to redefine their ecosystem and prioritise skills-building for staff so those involved can efficiently adopt any changes.

The NHS is staffed by a ‘highly skilled and well-trained workforce,’ and not training them in technology that will make their roles, and the overall health service, more efficient would be a wasted opportunity. Involving staff and stakeholders in decision making and process definition exercises will encourage adoption of any new solutions and technology. By involving staff and making them central to any change will show their importance in the shift and demonstrate their understanding of the day-to-day running of service provision.

Research by PwC suggests staff are starting to become empowered by technological change and adopt a new way of working alongside technology. With clinicians and staff engaging with digital solutions like digital general practices; instead of going into a doctor’s surgery, patients use online platforms like ‘Attend Anywhere’ to speak to medical staff.

The NHS is starting to embrace the changes propelled by the pandemic. However, there are still challenges to adopt and spread innovation quickly. The NHS will need to shift their focus onto redefining what they are currently doing and thinking differently with a future focused approach.

Providing a foundation for digital transformation will come from strategic funding and investment

To implement technological advancements, funds need to be made available to drive strategic and meaningful change within the NHS. Investing in technology is investing in care. Allowing staff to focus on the human element of care instead of repetitive and mundane processes will improve overall productivity and satisfaction, and ensuring effective collaboration can streamline the time to diagnosis and treatment.

Proper management of funding, and ensuring funds are not relocated to offset other financial pressures is imperative to pushing digital transformation projects to completion. PwC find that “current capital processes force trusts to choose between clearing backlog maintenance and upgrading computer systems – there needs to be room for both.”

Technical partnerships may be the solution to this, allowing the NHS to fulfil all their objectives. With technology being ever innovative, it is a never-ending cycle of upgrading and maintenance. Having a partner who can manage this for you (managed service) relieves the stress of doing so yourself, and may provide a clear pricing model to help manage budgets. New technology may also serve as a ‘two birds, one stone’ solution, clearing some of the backlog whilst providing new functionality.

“Of those surveyed working in the health service, 33% felt a risk-averse approach to investment in technology was preventing innovation”

PwC found that “following a government announcement of £4.2bn of technology funding in 2016, £250m remained unspent in the first year.” There are a variety of reasons why these funding issues arise within the NHS (and other government bodies); the ability to successfully manage technical projects; the availability of relevant, framework approved, suppliers; difficulties around building business cases; and drawn-out buying processes.

Risks associated with technology adoption are a factor to consider in procuring a solution, however, it should not be a stopper for innovation. With healthy budgets available, the NHS can find reputable and proven providers to deliver successful digital transformation projects.

The risks come down to: you try and fail (but learn from the mistakes and improve), or you don’t try and fail anyway.

Additionally, funding for improving digital skills must be prioritised too, providing education for those involved within the patient journey to ensure efficiency and productivity is not hindered due to human error.

Ultimately, the NHS (and any organisation) needs to understand and record their strategic goals before implementing any sort of solution. Diving in blind will never produce successful outcomes, no matter how much money you throw at the problem.

good technology is expensive but bad technology is more expensive

If the aim is to improve efficiency, you need to state where you want this to be, and how you intend to do so. For example, the aim is to improve how we store patient records so there is improved collaboration, nice, now you can start to build a solution that will address this, and know that a successful outcome can be measured against the initial aim. The solution can be designed to exact requirements and is not some out the box product that is not fit for purpose but seemed like a decent price and an ok idea.

Partnerships with technology companies will optimise project outcomes

The NHS cannot become a data and technology driven organisation alone.

PwC believe that if the NHS are unable to manufacture equipment like scanners alone, the same can be said for software. They do not have the scale of in-house technical skills required to successfully deliver on digital transformation initiatives, and should look outwards to acquire strategic technical partnerships that will deliver the desired project outcomes.

IT skills are in short supply globally, so finding specific skills to further digital transformation projects is a challenge in any organisation, even those that solely focus on technology. Strategic partnerships will provide access to high-demand skills at a lower cost than having them on the payroll whilst having them available when required (subject to contract).

Technology partnerships will give the NHS access to skills, knowledge, and expertise as well as providing uniquely shaped solutions that will benefit long term strategic goals. PwC suggests off-the-shelf IT solutions are not the right model for the NHS, rather customised collaborative solutions are the way to go.

Investing in scalable solutions will help manage insight into costs, and ensure consistency of the software and technology that is being implemented across the service. This should help in improving connectivity and integration between partners and other healthcare services where necessary to create successful and effective integrated care pathways that better serve patients and staff.

“87% of patients expect and are happy for clinicians to share data between organisations involved in their care”

The NHS and other healthcare providers should be focused on what they do best: caring for people. Whilst this can be improved with technology, this is not the bread and butter of these organisations, but is for tech companies.

Technology companies have experience in dealing with various and sporadic systems, and delivering projects to successful completion. The NHS should utilise this instead of trying to go about digital transformation alone.

Think of it as trying to complete open heart surgery with no medical training; you have no idea how all the arteries, veins and valves interact, or how to put it all back together – you may not even be looking in the right place. The only possible outcomes are negative, but there are trained and experienced cardiovascular surgeons who do know what they are doing, who can take over and mentor the inexperienced in a managed and safe environment.

Conclusion

There have been technological developments within the NHS because of the pandemic, but there is a long way to go for complete digital transformation. The health service should embrace change and choose collaboration and strategic investments to make the most of technology.

Moving to new technology solutions may be seen as a fine line within the NHS. Balancing efficiency and service is critical to ensuring patients feel seen, and are not constantly facing bots and online forms in the name of ‘efficiency.’ People like to speak to people and ensure they are being taken seriously without clicking through multiple rounds of automated messages.

This is not what technology adoption is seeking to do. Automating where possible will increase efficiency and reduce errors, this can be internal and still improve the way patients receive care, without them knowing robots were ever involved.

1. The NHS needs to focus on innovation and manage the fallout of cultural implications
2. Providing a foundation for digital transformation will come from strategic funding and investment
3. Partnerships with technology companies will optimise project outcomes

[1] Ensuring end users are properly equipped with training to utilise these technologies and changes to working practice will aid in effective uptake and operation. Aligning goals and involving stakeholders will further improve this and increase the likelihood of successful project outcomes.

[2] Investing strategically in technologies will improve the long-term outcomes and scalability of a solution. Thinking in the short-term or looking for the cost-effective solution is not always the best way to go (they have a time and place outside of digital transformation). These are the cases where you spend small upfront only to see huge bills down the line. Clearly outlining strategic objectives will help in mitigating the chances of investing in the ‘wrong’ solution and ensure key players are on the same page about how to measure the project’s success.

[3] Technological partnerships can provide high-demand, low-supply skills and expertise at competitive costs when they are needed. Going about digital transformation alone is not the way forward, so finding a partner that understands technology and has already encountered the challenges of a considerable project like this is an investment that will pay off.

Read the full report from PwC here: https://www.pwc.co.uk/healthcare/assets/documents/making-healthcare-digital-tech-powered-health.pdf