The NHS marked its 60th anniversary on 5 July. Even sixty years ago, hospitals and GP practices needed communications, and it was the General Post Office that provided them with mail and telephones.
Since then, the GPO’s successors have provided the NHS with ever more advanced communications and ICT infrastructure, while its researchers have developed ground-breaking communication and living aids for patients.
Today, BT sits at the heart of the NHS’ biggest ever IT programme, which is creating the ICT services that will shape the NHS of the future and enable it to deliver on its original promise to provide care for all “from the cradle to the grave.”
The Appointed Day
Most of these services could hardly have been imagined on Monday, 5 July 1948; the “Appointed Day” on which a new system of social security was created alongside a new National Health Service.
From the start, the GPO provided the NHS with telephone services, while its scientists helped to develop and then produce the first hearing aid to be truly available to all.
The Medresco hearing aid (named after the Medical Research Council, which held an inquiry into hearing aid design and cost as the government made plans for the new health service) worked on the same principles as a telephone, with amplified sound feeding straight into the ear.
Commercial hearing aids were beyond the financial reach of most families, so it is hardly surprising that a survey of 1,000 patients in 1951 found that “more than half were enthusiastic and 83 per cent approved” of the new service.
Despite this, the GPO’s Research Establishment continued to innovate, producing smaller aids, aids for children and aids that could be used with telephones for more than quarter of a century.
Austerity and the swinging 60s
The 1950s were years of austerity, and investment in the telephone network was severely curtailed. However, the GPO still managed to bring telephones to the bedsides of hospital patients – on the trolleys that were a feature of NHS wards for many years.
In the 1960s, its researchers turned their attention to patients paralysed by polio and spinal cord injuries. They developed “patient operated selector mechanisms” – or possums – which allowed patients with very little movement to operate communications devices by sucking and blowing on a tube.
The first telecommunications revolution
Then in the 1970s, both the NHS and what now became British Telecom were re-organised and given more independence from Whitehall. At the same time, telecommunications underwent a revolution. One innovation was radio-paging, which BT steadily rolled out to major British cities.
Hospitals, GPs and emergency services all benefited. One GP in Birmingham described how carrying a pager allowed him to “shop, visit friends or go for a walk while on call” – while remaining just a “bleep” away from patients in an emergency.
In 1985, BT gave free radio-pagers to the NHS so that 250 patients waiting for organ transplants could be contacted immediately a heart, lung or other organ had become available.
Meanwhile, technological advances such as the introduction of fibre-optic cables allowed telephone networks to carry more traffic and new data services to be developed. One of these was Prestel, which was used to make health information more widely available than it had been before.
However Prestel had some limitations and the widespread take-up of new data services had to wait until the Internet and mobile revolution of the 1990s. When it arrived, BT was in the forefront of taking its benefits to the NHS.
The internet revolution
BT developed the first NHS-wide communications networks to enable hospitals, GPs and other organisations to easily send messages to each other, and to deliver faster test results, referrals and other benefits for patients as a result.
It also set up the first, secure, NHS-wide email service, and, as the NHS celebrated its 50th anniversary, one of the first NHS websites: nhs50. Ministers described the site as “a significant step in the drive to modernise the health service and take advantage of IT.”
Another significant innovation for patients was the creation, in 1999, of the nurse-led telephone helpline, NHS Direct, for which BT provided telecommunications and support for its website, NHS Direct Online.
By the turn of the century, it was clear to the government, the NHS and the public that a modern health service could not operate without state of the art information and communications technology.
BT is now at the heart of the NHS’ biggest ever IT programme, the National Programme for IT in the NHS, which was set up in 2002 to further improve connectivity and to lay the foundations for faster, more convenient services for patients.
It has already delivered a new broadband network to the NHS, known as N3, and helped to lay the foundations for the NHS Care Records Service.
Summary care records are already allowing authorised clinicians in pilot areas to look up vital details about a patient’s medical history before treating them. Meanwhile, BT is installing new IT systems and services to NHS organisations across London.
Challenges for the future
And it is continuing to look ahead to the challenges that the health service will face in the future. The first babies to be born into the NHS 60 years ago will retire this year and start to grow old over the next two decades.
BT scientists at Adastral Park, the successor to the GPO’s Research Establishment, have been working on telehealth and telecare services that will increasingly help these aging “baby boomers” to monitor their own wellbeing, and live independently and safely in homes kitted out with intelligent medical sensors and alarms.
Since the NHS was set up, the service and the technology used to support and deliver it have changed dramatically; but BT has been at the forefront of innovation and at the heart of plans to turn innovation into mainstream NHS practice.
Some ideas have gone nowhere, some have meant painful change, and some advances that were ground-breaking in their time may seem mundane today. But over six decades, both the NHS and BT have been able to harness technology to do things that were barely imagined in 1948. They should be able to do even more in the future.
A version of this feature was commissioned by BT to mark its involvement with the NHS over 60 years. More information is available at: www.btplc.com/Health/MediaandIndustry/NHS60