As the NHS starts to recover from the Covid-19 crisis, Tom Whicher, an NHS Innovation Fellow and founder of DrDoctor, looks into how new technologies can help with the looming backlog of non-Covid conditions.
Despite early fears it would be overwhelmed by the surge of Covid-19 cases, our NHS has held up thanks mainly to the heroic efforts of its staff. The death toll is too high, but we are now through the worst of the coronavirus thanks to the increased capacity coming online across the NHS. That the Nightingale hospitals are underused should count as a success story in an otherwise sorrowful tale.
New technologies, too, have done their part to help the service cope. Tools like efficient electronic patient communication platforms, video consultations, and remote assessments have pushed care away from the physical frontlines to a degree that wasn’t possible even a short few years ago. We are beginning to understand how to receive and deliver effective care remotely.
But there is much further to go.
Some of the spare capacity across our NHS has sadly come as a result of patients with non-Covid conditions avoiding care. This explains, in part, the alarming spike in non-Covid deaths reported by the ONS. After all, heart attacks still need to be treated, even when hospitals are clogged with patients suffering from other conditions. We must – and can do – better, because the pressures on the NHS won’t ease even after the effects of coronavirus are past us.
The solution to delivering care under these trying circumstances is to make it easier for patients to seek care using tools like video consultation, but to also find alternative ways of assessing risk remotely and delivering an intervention without the patient coming into hospital and being exposed to illness. Bedding in this remote approach to care requires a change in attitude as much as it does technology, something the coronavirus is helping to accelerate, even if we are still years away from it becoming the norm.
Addressing the backlog
In the meantime, technology has a more immediate role to play in defusing another surge which threatens to overwhelm the NHS: the enormous backlog in patient bookings.
As the coronavirus spread, hundreds of thousands, if not millions, of care appointments were cancelled on short notice without being rebooked. These patients will eventually have to be slotted back in to continue their care, some of which is rather urgent. We must break this backlog to avoid more unnecessary deaths.
Here, the NHS will be facing two related issues: pace and capacity.
At present, too much patient administration within the NHS still happens by paper. This creates an administrative lag and financial burden that limits the capacity of the system to deliver care. Our data shows that poor and/or one-way administration leads to missed appointments and fewer people in care. Electronic booking systems that use two-way messaging between patient and clinic are much better options for engaging patients and breaking the backlog in resuming care.
Nor can patients afford administrative errors as the system winds back up. The NHS will now need to get millions of patients to the right clinics at the right times. And if an appointment suddenly comes free because of a cancellation it needs to be filled as quickly as possible. This will require an administrative system that is quick, nimble, and flexible and the current system is rarely all of these things.
Time for tech to deliver
That’s why some forward-thinking trusts have already brought in new patient platforms and communication tools to help manage these and other challenges online. The time has now come for businesses like ours to deliver.
In addition to two-way messaging to book-in huge numbers of appointments, clinics should, where possible, use electronic pre-clinic assessments to help patients update doctors on their symptoms and health on an ongoing basis. This will save time and allow doctors to focus on next steps. And those on the vulnerable list who must remain in lockdown should be prioritised for video consultations to avoid unnecessary journeys into hospital.
Proceeding with caution and earning trust
Without a vaccine we must continue to proceed cautiously; using these and other tools will help to break the backlog sensibly. Our goal – perhaps counterintuitively – should be to keep as many people away from hospital so the most vulnerable get care and aren’t put at risk unnecessarily, while also continuing care remotely for those who need it. New technologies are the key to helping us do this.
In this sense, the response and recovery from coronavirus is a preview of the broader change that will have to come across the NHS as it comes to grips with an aging population – or, for that matter, future pandemics. Costs must come down, capacity must increase, and new ways of delivery must mature and become trusted.
And so we must now earn that trust. If we are able to successfully break the backlog of appointments we will minimise any disruption in the great NHS reboot and ensure millions of Britons get the care they need.