The NHS Long-term plan highlights the importance of innovation to improve efficiency in the NHS.
The NHS Long-term plan highlights the importance of innovation to improve efficiency in the NHS. The plan dedicates a whole chapter to digital health alone and the use of digital health is clearly embedded throughout every part of the plan, for all ages and all conditions.
I worked for the NHS as a Speech and Language Therapist for 9 years. I specialised early in my career and worked my way up to being a highly specialist Speech and Language Therapist. I enjoyed helping clients and working with families and a wide variety of professionals. But I wanted a new challenge.
I was aware of digital health from working in the NHS, and I was sure there was a way technology could be used to improve patient care and experience. But as clinicians, we never seemed to be able to harness the technology or really integrate it into our care.
But in December I took the leap from being an NHS employee to working for ORCHA, which has given me new insight and hope.
Now from within ORCHA, I can see it is the obvious and achievable future of health care, with five key considerations:
Whilst the NHS long term plan does, to some, appear to present ideas that seem far reached; if applied with the right approach to timing, collaboration, reach, patient focus and cost benefit, it is not only achievable, it’s happening today in many places.
I read comments on twitter that the NHS long term plan would only be possible if the NHS works in collaboration with other organisations such including, education, charities and the private sector. As a clinician, I was not able to do my job effectively without working with other organisations, so it seems only right that this is reflected in all that the NHS does. The NHS can not achieve wrap-around care to the entire nation on its own and nor should it, that is not what it was designed for. There are organisations better placed to do the work, that are already trying to role out ideas that the NHS has suggested. This is why companies such as ORCHA and many others working in digital health, are ecstatic at the emphasis on digital health in the future of the NHS. We are already ready and raring to go with innovative ideas to make this plan happen.
“It’s easy to be cynical about the achievability of these big technology-driven shifts in outpatient care. But there are now at least four reasons not to be. They are already happening in parts of the NHS, so this is clearly ‘the art of the possible’. There is strong patient ‘pull’ for these new ways of accessing services, freeing-up staff time for those people who can’t or prefer not to. The hardware to support ‘mobile health’ is already in most people’s pockets – in the form of their smart phone – and the connection software is increasingly available for the NHS to credential from third party providers. And the Long Term Plan provides dedicated funding to capitalise on these opportunities…”
The bottom line is, whatever the difficulties and challenges people perceive the plan to present, the majority of the public are ready for the change and the NHS needs it.
Up next… activating the nation
Eleanor Smith MP chaired a parliamentary roundtable discussion on Tuesday 16 October 2018, supported by Roche Diabetes Care.
Eleanor Smith MP chaired a parliamentary roundtable discussion on Tuesday 16 October 2018, supported by Roche Diabetes Care, to discuss and determine how the use of health apps can be encouraged across the NHS for the benefit of patients.
Experts were brought together to discuss:
• The potential benefits of health apps to patients and the NHS
• The key challenges and barriers to utilising health apps in the NHS
• What advice and support should be provided to those wanting to develop or adopt a health app
• The role the life sciences industry should play in the health app NHS landscape
This note provides an overview of the key themes from the discussion, which was held under the Chatham House Rule.
Background
Through proactive leadership from NHS England and NHS Digital, health apps are being increasingly utilised
at national and local levels across the NHS. This welcome leadership and ‘open-door policy’ is most evident in the
creation of the NHS Apps Library and the development of the NHS App. Attendees commended this proactive approach, noting that it is viewed as a global exemplar.
Alongside an update on both initiatives, attendees highlighted various health apps that have been developed by the NHS and by the digital industry, to meet specific healthcare challenges or requirements. These apps can provide different types of digital support, including:
Empowering patients and carers to self-manage and to improve health outcomes
• Improving patient care from prevention to management
• Complementing existing care delivery
• Addressing health inequalities
• Acting as portals to other digital services
• Supporting administrative tasks
• Relieving pressure on the current NHS workforce
It was agreed that, despite the success to date, more can be done to fully realise the potential of apps.
Key themes from the discussion
There was consensus among attendees on the potential of health apps to support improvements in service delivery and patient
care. The group identified four interconnected themes and made a number of recommendations to improve uptake of health
apps. These themes and recommendations are as follows:
1/ Facilitating greater data sharing
For the full potential of health apps to be realised within the NHS it is vital that there is effective data flow and
interoperability between apps and traditional services, for example by linking data from apps with an individual’s patient
record. Interoperability through suitable platforms and engagement criteria should be incorporated within plans for joinedup
national electronic patient records. Attendees referenced the ‘Blue Button’ concept – developed by the US Government
to signify that a site has functionality to download health records – as a potential opportunity for learning for the NHS.
Recommendation A system of efficient and effective data sharing needs to be established for appropriate health apps
to be compatible for integration within electronic patient records.
Whilst debate continues around the ‘ownership’ of patient data, the importance of ‘intellectual property’ that is produced
by health apps should not be undermined. Attendees discussed the need to develop a centralised model of patient consent
to ensure effective data flow and interoperability. Before such a model could be introduced, attendees recommended that
an extensive public engagement campaign be undertaken around the benefits of data sharing to the individual and wider
health system.
Recommendation
A consultation should be launched by NHS England on establishing a centralised model of patient consent, alongside a public engagement programme on the benefits of data sharing for individuals and the wider NHS.
2/ Expanding public engagement and education on the use of technology
The public should be made aware of the ‘trusted’ health apps that have been accredited by the NHS through sufficient
evidence submissions and how they could use these to achieve their health goals. The group suggested that public
engagement and education should utilise the most effective methods, both digital and traditional, for spreading messages
amongst all parts of the population to promote these evidence-based options over less regulated solutions. Attendees were
conscious of health inequalities and highlighted that any solutions and/or engagement should be focused on reducing
these inequalities across the country.
Recommendation
An extensive public engagement and education programme should be undertaken, using digital platforms where appropriate, to showcase effective / evidence-based health apps and encourage
wider usage.
3/ Incorporating health apps into relevant clinical pathways
To encourage the uptake of accredited health apps, the group suggested an aim of including them in relevant clinical
pathways where appropriate as complementary or alternative options to traditional care. For this to happen, attendees noted
the importance of healthcare professionals understanding and trusting the various levels of evidence required for apps to be
accredited. Attendees commended the work of NHS England and NHS Digital to categorise the associated evidence required
for the app to be assessed. Healthcare professional ‘buy-in’ to health apps and new digital solutions was recognised as a key
component for successful uptake, alongside tailoring to a specific region or condition as needed.
Recommendation
Health apps should be incorporated into relevant clinical pathways, with engagement to secure
‘buy-in’ from healthcare professionals.
It was noted that the current system primarily supports and rewards the initial innovators of apps, and not those adapting
or adopting health apps to meet local patient need. To encourage and spread best practice, the group recommended
improving signposting to examples, as well as increased support both for the initial innovators and for future
adaptors/adopters.
Recommendation
Support needs to be from conception to roll-out for innovators developing health apps, as well as to those looking to adopt or adapt existing apps for local or regional contexts.
The group discussed the approach to appraisal of health apps and the value of establishing reimbursement pathways at a
national and local level to provide structure to support uptake and foster further innovation. The potential success of
personal budgets was raised by attendees. It was suggested that a similar scheme could be rolled-out for the use of health
apps, by allocating additional budgets for people with long-term conditions to choose and purchase their own health apps.
Recommendation
Reimbursement pathways, with clear evidence benchmarks, should be created at both local
and national levels to encourage the continued uptake of, and innovation in, health apps.
4/ Utilising health apps to support the NHS workforce
Health apps have the potential to reduce pressures on the NHS workforce, through providing time-saving efficiencies in
the delivery of care. In order for this to be exploited, healthcare professionals need to be sign-posted to approved and relevant
health apps for their specialism and trained on their use. As the NHS looks to the future, the potential of health apps should
be viewed as a key opportunity for improving the delivery of care and reducing pressures on the stretched NHS workforce,
with health apps being either prescribed or accessible ‘off the shelf ’ solutions that individuals can download themselves.
Recommendation
Sign-posting to newly approved health apps and training on their use should be included within
programmes for newly qualified and established HCPs.
Attendees with experience in developing health apps highlighted the importance of sustainability through ensuring the
products and solutions are regularly updated through partnerships with end-users to get their feedback. As part of the
NHS Apps Library it will be important that mechanisms are established that enable both developers and users of apps
to share feedback and best practice.
Recommendation
Health app developers and end-users should be supported to share feedback and best practice
on the practical development and evolution of health apps.