2022-02-26
Health Secretary Sajid Javid's speech at the Health Service Journal's Digital Transformation Summit
The Heath and Social Care Secreatry delivered his speech on 24th March (sic) 2022, so maybe we would be wise to pay attention (perhaps they have already digitally transformed the Health Service's calendar?)
I have commented on most of the main points below, but do read the whole speech and assess for yourselves how those on the front line of health care may be affected.
"It pushed digital transformation to levels that we never thought possible and gave this country’s digital infrastructure the biggest stress test in history.
A report from Mckinsey that I remember said that in the first few months of the pandemic digital adoption to access health services accelerated by up to 7 years"
"Due to the investment that we made before the pandemic and the huge strides forward that we took during the pandemic, we are now in an immensely strong position. In terms of digital transformation this is just the start.
Just as a crisis can spark incredible change, it can also provide an incredible platform upon which to build"
He's beginning to sound as though he never noticed the cold socially-distanced queues of old people outside the doctor's surgeries and the (SPI-B stoked) fear that caused people to stay away from Health Services loved ones and everybody else for dread of the plague.
"In my previous roles in finance I saw how successive financial crises led to the creation of the G-20 – and there’s lots that we can learn from COVID too.
The shared experience of COVID, I think it’s fair to say, has been game-changing"
"As we emerge from this pandemic, both clinicians and patients will have new expectations about health and care, and there is so much that we can learn from the experience of other nations across the world"
He's right there. If only he would look beyond his official advisers occasionally.
"We must not just look to build back better, but to build back smarter, drawing on the brilliant advances that we have made.
I think it’s fair to say we have already made a blistering start"
I think he just blew it. New slogan - "Beyond Build Back Better"?
"Today, with so many of this country’s digital leaders here in one place, I wanted to share with all of you my 4 priorities to use the power of digital to drive a new era of recovery and reform.
These are:
firstly, making sure the NHS is set up properly for success;
secondly, levelling up across the NHS and social care;
thirdly, pursuing personalisation;
and fourthly, making big breakthrough bets on emerging technologies and data"
No mention of patients yet ...
"Digital transformation is not something that you can delegate. It must be led from the front"
"It was no coincidence that when I set out the advert for Simon Stevens’ successor I wanted to put digital transformation at the top of the advert, because transformation is not just important for the NHS, but existential.
I know that Amanda Pritchard, and the new Chair of NHS England, Richard Meddings, get this"
"So as you know the Wade-Gery report recommended that we make structural changes to put digital transformation at the heart of the NHS, and I agreed with that wholeheartedly.
We are now in the process of merging NHSX and NHS Digital into NHSE – bringing together all of the NHS’s digital bodies under one roof for the very first time"
... thus moving it ever further away from the front line
"The fact that we have taken this step is a vindication of everything you’ve done to make the case for digital transformation across health and care"
So the health service's office politics have been vindicated? Oh, good.
"I spent last week getting out of Westminster to hospitals and care homes all across the country.
Everywhere I went I saw incredible examples of how digital technologies are already transforming health and care for the better"
"But I also heard stories of where there is much more to do, and where outdated silos and systems were causing frustration"
"We have undeniably seen brilliant progress. But this progress hasn’t always been consistent across the board, for example we estimate there is one in 5 NHS trusts that still do not have Electronic Patient Records"
Maybe some NHS Trusts are still concerned about the implications for patient privacy?
"Electronic patient records are the essential prerequisite for a modern, digital NHS. Without them, we cannot achieve the full potential for reform.
So I want to accelerate the rollout of these vital records with a new approach, so that we hit 90% coverage by December 2023 – by the end of next year.
By then I also want the remaining 10% to be in the process of implementing them"
Still no mention of patients.
"I also want to see a particular focus on social care – where around 40% of providers are still grappling entirely with paper-based records. I want all social care providers to adopt a digital record for social care.
We will work with the sector to deliver this in the most effective way we can, and offer support to those who need it. We have announced at least £150 million to help drive digitisation in social care, and a target of 80% of social care providers to have digital social care records by March 2024"
They are the bosses - don't let anyone escape.
"Because the case for these records is beyond doubt, and I expect every health and social care setting to see this as part of their basic responsibilities in looking after those in need"
Beyond doubt - because he says so? Yup - they are the bosses and don't forget it.
"The shocking events of the past few weeks have reminded us of cyber attacks and how established a form of conflict they’ve now become, and we can only make these digital reforms if we keep the system safe from those who want to cause us harm.
A chain is only as strong as its weakest link, and we are shoring up cyber resilience in all parts of health and care, backed by over £300 million of investment since 2017"
I wonder who got those contracts? BTW - local records make cyber attacks harder ...
"Through the smarter use of NHS data and the adoption of emerging technologies we can move services from generalised to personalised and give everyone access to the information and the tools that they need to manage their health"
Like good dietary advice, life-style advice, stress relief and support for a patient's individual circumstances?
"The extraordinary adoption of the NHS app during the pandemic presents a real opportunity.
Two years ago, the prospect that the NHS app would have been the most downloaded free iPhone app in England would have seemed unthinkable.
But this app is now an essential part of life for so many, and 24 million people, that’s over half of adults in England, are now carrying it around in their pocket"
Oh dear - still blinded by the technology. I wonder who got that contract?
"But we need to keep this momentum going – and so by March 2024 I want this to be 75% of all adults in England.
Now to get there we need to show people that the app is for life, not just for COVID, and that it will be a future front door for interacting with the NHS.
This means improving access to existing services and introducing new services too.
When I think about what the app will look like in the future, I see a platform where you can directly communicate with your health provider, where you can see all your test results and documents in one place, and where you can get personalised advice to manage your own health"
NHS App, or Surveillance-Control State? And God forbid you might see a human being for your health needs.
"We are piloting this approach in mental health and cardiovascular prevention, 2 areas where there is a growing need within the NHS"
Yes, those with mental health issues are clearly ideal for removing from doctors surgeries, they are so tiresome, difficult for a human to help; much better to offer them a machine that they won't know how to work nor have the inclination to try.
As for cardiovascular prevention, I could help him - there is growing evidence that the recent jab roll-out may have contributed significantly to this problem. Sajid could look at this perhaps once he has completed the digitizaton of society to his satisfaction.
"Over 270,000 people have long-term conditions supported by the NHS through digital technologies, and this approach must not be seen as some kind of short-term response to a crisis, but a model for how care can be given.
We have seen the brilliant use of virtual wards throughout this pandemic and I’m pleased that the recent NHS England planning guidance gave them a very important role too.
Norfolk and Norwich NHS Foundation Trust set up their virtual ward a year ago this month. It’s already freed up over 6,000 bed days for inpatients – and the initiative has patient satisfaction levels of 99%.
We’ve had such positive feedback from patients who can recuperate in their own home with their loved ones, safe in the knowledge that their condition is being monitored round the clock by their clinician.
I want us to intensify the pace of the rollout of virtual wards so we can make sure that these services are available across the whole country, and we’ve made up to £450 million available over the next 2 years to support this"
Oh, and they can cut the number of hospital beds yet again - do we really need any at all?
"Finally, my fourth priority: we must make the most of emerging technologies and data.
One of the most revealing experiences that I have had during my time in this role is when I visited a hospital, Milton Keynes hospital, and I saw how they had become the first hospital in Europe to use surgical robots for major operations.
These robots, used under the supervision of human surgeons, have led to a lower risk of infection for patients, faster recovery times and less time in hospital.
It was an incredible glimpse of the future and I want to do everything I can to encourage the development of the most state-of-the-art technologies here in the UK.
One of the great lessons of the pandemic was the opportunities that are on offer when government, the life sciences, academia and industry… when we all come together"
I sense another splurge of government contracts to be put out at breakneck speed to those in the "fast lane" - and maybe they will save on surgeons into the bargain?
(Note: I'm skipping over the bit about their successful discovery of Covid treatment - my comments might not be acceptable to polite society)
"We are also looking at how we can make it easier for patients to access their own data and GP records, including mandating access as they have done in the United States"
Not the GPs themselves, just their records ... whether we like it or not.
"But the benefits of NHS data can be so much broader"
Correct.
"But we know that there is more to do to build trust in the use of data and reassure the public that it will be used securely.
So, for instance, making it smoother and safer for researchers to access and use data through requiring the use of trusted research environments"
'trusted' - like because you say they can trust them?
"I also want to address the stark diversity gap in these clinical trials, and make sure that representation reflects the true make-up of the UK"
" ...when you look at the make-up of clinical trials many groups are under-represented, which presents the unacceptable risk of treatments being developed that aren’t effective for all communities"
Good point.
"Now I want to end by saying that I don’t see digital transformation as a flash in the pan, a quick fix at a time of crisis. It is fundamental to the mission to clear the COVID backlog, and to the long-term health and happiness of this country.
It matters more now than it did when this pandemic began.
This is not a time to slow down and look in the rear view mirror. It’s a time to accelerate"
Hmmm. No lessons to be learned Sajid? You could be over-simplifying here ...
"So I’m delighted to announce that in the spring we will be publishing for the first time a comprehensive Digital Health Plan, the next chapter of this story of digital transformation.
It shows how we will be driving this digital change across all these areas I’ve talked about today, and many more, building on the varied lessons from this pandemic"
I can't wait.
