The potential of digital and technology in health services is already well-recognised. Yet successive governments, at least in the UK, have failed to crack the problem of digital integration across wider care system boundaries.
Our research for 2023 indicates that rationalising and integrating technology, data, and cross-boundary processes will become more common in health and care provision, impacting on other local public services. This will include integrated budgets to solve common problems in health and social care.
The UK National Health Service (NHS), in particular, has been beset with underfunding, technology debt and failed IT projects from national government, setting back progress on technology modernisation by a decade. But IT spend in the health sector is now outpacing other parts of the public sector, reflecting a need to catch up on digital modernisation.
“’Digital’ is the glue that will allow local health bodies and local government to work together, to remove the restriction of a physical hospital building, extending health care out into the community and creating a true patient-centred service respecting the needs and wishes of the users.”Tim Cropley, Chief Information Officer, Hampshire Hospitals NHS foundation trust, England
A changing model of care provision in favour of digital and self-service is likely to emerge in the coming year, enabled by health apps, interoperable electronic health records, and home-based health and social care provision. Traditional hospital and social care intervention will be only when required, reducing the numbers attending GP surgeries, accident and emergency, and outpatients services.
The pandemic demanded closer integration of related local services. Health services have become increasingly important to a range of other local public services, such as education, housing, employment, and transport. A number of councils are now joining together with their local health authorities to tackle ‘whole system’ challenges. In England, this joint working is being promoted at a local, place-based level by the introduction of Integrated Care Systems (ICSs). Around the world, there are numerous examples of such collaborative activity, including those featured in our 2022 Socitm Integrated Socitm report.
In 2023, it is likely that the health sector will begin to set a lead in digital innovation in public services. For example, hospitals are already deploying AI in diagnosis and emergency care prevention, digital ‘social prescribing’, ‘virtual wards’ and patient-initiated follow-up services. All of these model approaches could transfer into local government applications, such as in consultations on planning, benefits and housing services, and leisure or tourism applications.
“Technology is central in empowering patients and giving them more control when it comes to their health and wellbeing. The NHS App has changed the way millions of adults in England access healthcare services in the 3 years since its launch and these new features will go further to improve how patients can manage their health and to reduce the burden on the frontline. We are committed to working with our partners across health and social care to deliver the digitally enabled transformation of the NHS and create a system which provides better outcomes and access for patients.”Simon Bolton, Chief Executive, NHS Digital, England
Feedback for this research predicts a rapid growth in a range of new technologies in the health and care sector. This includes more joined-up digital strategies to reduce the fragmentation of data across integrated systems that has held back progress. There are numerous examples, but to list a few provided for this report:
- Digital Health Care Wales: implementation of the Welsh community information system – with digital processes that underpin ‘Looked-After Children’.
- Health Innovation Manchester: connecting technologies, data, and people across a care system to significantly save beds days.
- Gloucestershire hospitals: developing a dashboard across the integrated care system to ensure faster coordination of patient discharges.
- St Columba Hospice: rationalising processes and data to reduce duplication and overlap, providing complete patient information for end-of-life care.
- Princess Alexandra NHS Foundation Trust: have developed the ‘Alertive app’ providing real-time intra-hospital and interactive communication in a shared app.
- NHS Queen Victoria Hospital community diagnostics: connecting primary care providers in a multidisciplinary team of specialist services, to improve the coordination of care around an individual patient.
- Torbay and South Devon NHS Foundation Trust: developing a single integrated platform for mental health services across the whole the region.
- Sheffield Hallam University: have developed a virtual reality scenario for children with upper limb injuries, to facilitate more effective recovery.
- Kings College London: Connecting both structured and unstructured data relating to electronic health records using an open-source ecosystem of technology.
Camden Council – earlier discharges from hospital
Camden trials care tech device to help residents return home from hospital sooner (news.camden.gov.uk)
One of the major challenges facing the NHS is the difficulty in discharging patients to a safe environment – whether at home or in social care. Camden Council is deploying wearable devices to residents who are medically fit for discharge but require support from social services. Residents given these devices have been able to return home on average three days sooner, with the pilot project alone saving £0.25m.
“These ‘help at home’ devices have allowed people to return to their own homes faster, with the confidence that they have technology-based support at the touch of a button.”
– Councillor Anna Wright, Cabinet Member for Health, Wellbeing and Adult Social Care, Camden Council, England
Bristol City Council – combatting isolation
Bristol City Council is working with partner organisations to promote digital inclusion across the city as part of its ‘One City’ approach. This includes addressing digital barriers, by providing recycled laptops and training for those in digital poverty, and a starter package to give access to the internet. Bristol is targeting those who are not in employment, education or training (NEET), older people without a digital device, and community groups who can help with outreach.
“In Bristol we are using technology enabled care that helps combat isolation for those who live alone, installing safety alerts … means people can remain in their own homes for longer, which evidence shows us is a positive thing.”
– Cllr Helen Holland, Cabinet Member for Adult Social Care and the Integrated Care System, Bristol City Council, England