Earlier this month the NHS National Director of Quality and Efficiency said that the system should have no more money until it puts its “house in order.”
Professor Tim Briggs is undertaking the NHS’s most comprehensive clinical efficiency audit, finding costly variations in the day-to-day running of hospitals. He is absolutely right to insist that taxpayers should get value for money for every pound the NHS spends. So much of this can be achieved through better use of technology.
Improving the transfer of information between computer systems and updating IT programmes could significantly reduce the administrative burden on back office and frontline staff. The NHS is the world’s largest purchaser of fax machines. Tasks such as faxing, form-filling, and chasing lost or hard-to-find information stifle efficiency. At present, junior doctors spend between 15 and 70 per cent of their time on administrative work. For midwives, it’s around 50 per cent.
For automation to be fully effective, the public must directly engage with robots and computers. In a UK survey, 47 per cent said they would be willing to use an “intelligent health care” assistant via smartphone, tablet, or personal computer and 37 per cent said they would use Artificial Intelligence to monitor a heart condition. Younger generations are much more open to such interactions. Chatbots are being deployed by the NHS in London and Liverpool to answer medical questions and triage patients effectively. Across the country people are paying to interact with health apps. Over 3.6m people in Britain regularly use wearable technology.
Machines can interpret imaging with greater speed and accuracy than doctors. A high proportion of breast screening yields false positive results when interpreted by humans, leading to one in two healthy women being told they may have cancer.
AI is enabling interpretation of mammograms 30 times faster with 99 per cent accuracy, reducing the need for unnecessary biopsies and the concern of a misdiagnosis. Senior NHS officials are starting to question what the role of radiologists will be in the future.
As well as replacing aspects of jobs or even whole roles, technology can also improve productivity, meaning fewer clinicians are needed to deliver the same standard of care. In general practice, for example, an app allowing patients in Birmingham to communicate with their doctor has reduced accident and emergency admissions.
Internationally, telemedicine has been deployed on a larger scale, allowing care to be delivered at a much lower cost than in the UK.
Technology has enormous scope to reduce the size and cost of the workforce. Recent Reform calculations, using US figures, have estimated that technology could see the number of frontline staff, including doctors and nurses, fall by a quarter (150,000) and lead to cost savings of £4.6bn each year. These savings would single-handedly achieve the efficiency targets the NHS has set itself up until 2020.
The debate on the future of the NHS is too often dominated by calls for extra resources. Instead, the way to keep the service sustainable is to improve productivity. This rests on the workforce and wider public embracing technology. Getting the house in order is not a matter of filling in the cracks with old solutions, rather the house must be modernised to ensure that it is ready for challenges ahead.