NHS England’s director for operations and information has described the best NHS users of technology as comparing unfavourably with the best internationally.
Speaking at a Thursday event in London Swindells said “the best hospitals in the UK, in terms of using IT, are mediocre by international standards”.
“Our hospitals are a desperate disappointment in terms of technology,” said Swindells.
“Hospitals in Chile, Peru, Mexico, Qatar, Malaysia and Singapore, all of whom have made a better job of digisiting hospitals than the best the UK has to offer,” argued the NHS England director.
Swindells added: “We have to get from the best the NHS has to the best internationally”.
The NHS England director of operations and information, and former Cerner executive, suggested that the supplier community was still suffering “post-traumatic stress” following the experience of the NHS National Programme for IT, continuing to discourage innovation and risk taking.
“What a CIO from NSW in Australia said to me was that there was post-traumatic stress disorder that the IT industry and the NHS are suffering after the national program. The fear of doing anything innovative, the fear of chief executives to get into IT because it could cost them their jobs.”
Swindells also took issue with the benchmark Commonwealth Fund 2017 Mirror, Mirror report, which rated the UK NHS, alongside Australia and the Netherlands as being the best healthcare system in the world, on a basket of measures including equity, access and outcomes.
“I don’t think the NHS is the best healthcare system in the world despite what the Commonwealth Fund says,” said the NHS England director.
“I do think it is the best value healthcare system in the world, and part of our job is to prove if the government chooses to put more money into the health service, what they buy is more healthcare and more health, that it is good value for investment.”
He argued that the NHS requires root and branch transformation, and currently has almost all the patients in the wrong place, and needs a systemic correctional shift.
Referring to the emergency service care strategy, as winter approaches and A&E departments are already at capacity, he said “we are struggling to meet the target we set for ourselves.”
“Half the people who go don’t need what A&E has to offer, they need what a GP has to offer.”
But, he said this wasn’t possible, “Now GPs are full and it’s hard to get an appointment. The Royal College of GP study says 27% of people who go to a GP don’t need to, they could have gone to a pharmacist instead.”
He said the fastest growing group of patients attending A&E is working adults – so they can be seen quicker – even though it’s four hours – it’s a guaranteed four hours. “So, the system is designed to incentivise behaviours that make the system harder to run.”
The challenge, he stressed, was to change the system, using technology as an enabler, “We have to put in place a set of pathways that is a digitally, technically-enabled set of pathways, it isn’t about getting technology into the system, it is about changing the way patients pass through the system.”
The opportunities to take out duplication, take out waste and stop wasting patient time is absolutely there – “and a big part of what we have been doing is trying to align the thought process around technology with the thought process around the transformation of the NHS.”
He said it is about delivering the most healthcare with the money pot available and not focusing on a gap in technology but the gap in service, which can be supported by the deployment of technology.
The NHS England director said that the old NHS IT strategy, now being updated with the GDE programme, wasn’t wrong, “it just felt like an IT strategy and not like an NHS transformation strategy.”
As part of the GDE programme NHS England required vendors to create deployable models. “Part of that is we expect to drive down the cost of deployment of systems and we can see vendors working hard to get their templates/blueprints to roll out.”
He also announced that he expected fast followers to become GDEs. “I also expect Fast Followers to become GDEs, to have fast followers of their own so it becomes a spread model… you can’t hang around here not delivering.”