Critical Healthcare Challenges That The Industry Must Overcome
At the inception of the NHS, 70 years ago, its key founding principle was to provide healthcare to all, free at the point of access. Today, this principle remains. However, the NHS and other Healthcare Institutions are under enormous pressure.
Infrastructure, processes and staff are stretched like never before. The waiting lists for appointments and surgeries are ever-growing and patients have become more comorbid. As it emerges from the challenge of COVID-19, it’s at a crossroads. It’s universally accepted that the NHS must change to survive, change to continue being the institution we champion, and change to continue supporting us in our hour of need.
NHS England has identified key themes and priorities for the NHS moving forward.
(1) Workforce needs reinforcing and motivating
(2) Throughput needs considerably enhancing
(3) The backlog needs tackling and overcoming
And alongside these, as an entity, it needs to become more environmentally sustainable to meet critical targets to curtail the climate crisis. Modern technology can help with many of these issues and there has never been more enthusiasm to embrace this than now.
During COVID-19, the NHS was forced to transition face-to-face services to online and app based modes of delivering healthcare. There were questions about whether this would work, jeopardise the level of care or be accepted by our patients, but it worked. The NHS had dipped its toe into the world of telemedicine and it has opened the proverbial floodgates.
Utilising modern healthcare technology
Medicine, the world over, has started to champion the use of Robotic Assisted Surgery, Remote Patient Monitoring and High Fidelity Virtual Reality Simulation. We are entering an exciting era of advances which will directly improve patient care and train our healthcare providers of the future. What must not be overlooked is the ability to address NHS England’s priorities with technological solutions too.
There is only so much time in the day, only so many patients that can be seen in a clinic and only so many operating theatres, efficiencies need to be found to ensure the right person is seeing the right patient at the right time and for the right thing. A digital agenda for change could see new systems introduced to distribute resources in a more effective way, reducing redundancies in the system. The following are some examples:
Lack of smart booking technology
In 2021-2022 the NHS offered 122m outpatient appointments however 8 million patients did not attend, 8 million appointments were cancelled by patients and 12 million cancelled by the hospitals. The reasons behind this are numerous but smart booking technology with the ability for patients to rebook through portals, app based reminders and electronic health passports could improve the situation.
Enhancing the surgery procedure
Similarly, £720 million worth of operating time was lost in 2021 due to last minute cancellations for elective surgical procedures. The lack of effectively curated waiting lists prevents last minute cancellations being filled by low complexity medically fit substitutes. Future systems to track patients through the process of Pre-operative assessment, Preoperative optimisation, remind them of actions to take and alert booking teams of their readiness for surgery would allow for automated list population. Furthermore, if these were combined with initiatives using machine learning to identify patterns amongst patients in terms of procedure length or duration of inpatient stay then healthcare institutions could increase the efficiency of operating list time and bed management.
Machine learning for risk planning
Data capture on a large scale can not only inform logistical aspects of patient care but also clinical. Machine learning in parallel with improved coding can be utilised to determine risks amongst our patient populations. Ultimately this could highlight patients who need extended monitoring, potentially at home with wearable smart technology, or make consent for surgical procedures truly individualised inline with the Montgomery Judgement in 2015; with patient specific percentages for complications based on similar clinical presentations to inform the shared decision making process.
New systems to facilitate patient referral triage
The cost of living crisis is affecting millions of people throughout the UK. Patients on low incomes are likely to have a lower quality of health but may be prevented from seeking medical review due to fears about affordability. Time away from work, zero hours contracts and hospital parking charges provide a perfect storm for exacerbating healthcare inequality.
New systems are needed to facilitate front end triage for new referrals, one stop Diagnostic and Results Clinics, as well as reliable telemedicine portals for clinic consultations. Private Primary Care providers have found early success with similar initiatives but scalability within the NHS could see far more patients benefit.
Karve: a digital agenda for change
Technology can help us do more with the resources we have now, use them more efficiently and rationalise precious time. It will take time to grow more doctors, nurses and allied health professionals whereas technology can be implemented now. Healthcare in the future is likely to involve prevention and prediction of disease rather than treatment alone. For now, we need to address the backlog, optimise throughput and better understand patients as individuals to identify trends in health. A digital agenda for change can help address these issues and it needs to be ambitious to maximise the benefits.