We need to focus on value – and optimise our existing technology

New technology can bring immediate efficiencies but after a few years “the picture changes”, writes Matthew Little, chief nurse information officer (CNIO) at Gloucestershire Hospitals NHS Foundation Trust

It’s undeniable: the NHS has made tremendous strides in recent years, harnessing technology to enhance how we deliver care.

From routine procedures to investigative diagnostics and cutting-edge treatments, digital systems now underpin our work across hospital wards, general practice, and community nursing services — even in complex areas like theatres and emergency departments.

This progress didn’t happen in isolation. It’s the result of collaboration between clinicians, nurses, IT specialists, technology partners, administrators, and in some cases, even patients.

We’ve rolled out systems, shared learnings, and built best practice. But now comes the next challenge: how do we make the most of what we already have?

With responsibility comes duty

Working within the NHS means managing public funds — and that comes with a deep responsibility. We owe it to patients and staff to ensure that every investment is maximised.

While this does not mean that we stop innovating and pushing boundaries to make healthcare better, we really need to fully leverage the systems and technologies we have already invested time and money in.

Many technology rollouts, for example with electronic patient records (EPRs), have been staged over a set time, maybe two or three years.

We see immediate benefits — improved efficiency, better documentation, enhanced patient outcomes. However, a few years down the line and the picture changes. Healthcare continues to evolve and so too must the software and the technology that we use to support these.

Optimising what we have

Here’s where the challenge lies. Most digital tools are scoped and costed based on an initial business case. Once implemented, that “business case” is technically fulfilled — but that doesn’t mean the system has reached its full potential this is where we need to start optimising what we have.

Optimisation will always be challenging.

New technology comes with a full benefits business case, which is quickly realised once implemented and immediate efficiencies are achieved. True optimisation may not always bring dramatic new benefits, but it does enhance the existing ones.

That’s why it’s essential to shift our thinking away from just “productivity” or “efficiency” and focus on value.

We often talk about productivity or efficiency gains, but focusing on what gives most value can make the most difference – and is a more appropriate way of demonstrating benefits.

An important benefit that cannot be quantified easily, for example, is the freeing of a member of staff’s ‘headspace’ to focus on the patient in day-to-day care.

Being able to provide improved care is highly motivating and increases staff job satisfaction, which also reduces turnover. You end up with a happier workforce because the systems that they’re using really work.

Small ripples, big changes

If we were to consider future technology, for example, the world of ambient AI, then this viewpoint has real traction.

If ambient AI could be used to capture the care that a physio delivers on a ward, where there is significant documentation involved whether it’s electronic or paper, this could potentially free up the physio to spend time with more patients, possibly treating two or three more a day with the time saved.

This in turn could have an impact on flow within the organisation. Getting more patients up and moving could result in shorter stays in hospital, freeing up bed space in the wards.

Of course, AI is still in its early stages and processes would need to be put into place to check the information captured, plus there is the aspect of a patient’s right to access data collected.

However, the principle remains that small changes in working methods could have bigger impacts across the organisation.

Small frustrations, big opportunities

Sometimes, it’s the little frustrations that make the biggest difference. Take logging into a computer during patient care. At home, we all know how slow it can be. Now imagine doing that repeatedly, under pressure, during a packed clinical shift.

Even when at home it takes time to log in to a computer. In a healthcare environment, where there is pressure to get through a day’s schedule,

Having login processes replaced with ‘tap and go’ cards or facial recognition reduces these irritations. Importantly it also allows the healthcare professional to focus and deliver care, without being distracted as they try and log in to a computer.

Coming back to EPR, the advantage is that it brings in standardisation, which can help to deliver improved care across the hospital.

While EPR has made great improvements in how we work, it’s really important that we keep records up to date with current clinical knowledge, changes in policy and best practice. If our digital system stays static, then we can’t move forward.

This means that we must continue to consider how we can improve upon what we have.

Engaging the workforce

Optimisation is not just about the tech. It’s about people.

When we talk about optimising it’s also about the importance of engaging the workforce. In my experience, successful projects don’t rely on a few enthusiastic individuals. They bring in the whole workforce — nurses, doctors, physios, occupational therapists and more.

It is very easy when you want to start bringing in change with any digital system for a small group of people to get excited about that change and start moving forward on their own.

What is more effective, however, it to bring in the wider workforce – understanding how documentation is used across roles, removing duplication, and creating workflows that truly reflect team-based care.

Ultimately, we are talking about multidisciplinary teams accessing patient data and our documents need to work in the same way. Currently I’m working on an optimisation project focused on nursing admission documentation, risk assessments, and wound care.

We’re working to capture the right information, streamline the process, and ultimately improve care. But this only works because we’re designing with everyone in mind.

An evolution in healthcare

There are some really exciting things going on with technology at this moment. It’s almost like a jump in evolution in healthcare, where the software and the hardware have caught up to a level that presents real opportunities for change.

I mentioned AI earlier. We are seeing people using AI tools to design predictive algorithms on falls prevention or pressure area care, or length of stay to help estimate date of discharge.

This last aspect has always been a challenge in healthcare organisations and we’re now starting to see early work around predictive tools to analyse this.

The result will improve care, reduce harm free up beds, and improve patient flow throughout the organisation, from admissions to ward care.

Ambient AI technology could also bring huge benefits in ward rounds. It could enable clinicians and nurses to interact with patients without having to worry about writing up notes. The future may extend to theatres and emergency settings, where details of medicines and treatments administered can be captured and recorded.

Of course, AI will also rely on constant learning to improve, but if it can capture to around 70% accuracy, then surely that is a significant improvement on notes made by a human working in a high stress environment?

Clearly, we have some way to go, but the future is exciting, nevertheless.

We have made fantastic progress with our technology advancements to date, now is the time to build on the progress we’ve made by optimising and innovating in equal measure.

The future is exciting.  Now is the time to build on the progress we’ve made by optimising and innovating in equal measure.

Matthew Little is CNIO and associate chief nurse (Nursing, Midwifery and AHP Digital lead) at Gloucestershire Hospitals NHS Foundation Trust.