England's top doctor calls for NHS to harness the power of technology

Professor Stephen Powis reveals it's ‘time to grasp the nettle’ and use technology innovation to reduce outpatient appointments

England’s top medic is calling on the NHS to harness the power of technology and innovation to reduce the thousands of unnecessary outpatient appointments that happen across the country every day.

In his foreword to the latest Royal College of Physicians Report; NHS England medical director, Professor Stephen Powis, said it was ‘time to grasp the nettle’ to help reduce a proportion of the 118 million outpatient appointments the NHS provides every year.

Our healthcare system is facing pressures on account of unnecessary outpatient visits, which is leading to increased pressure on clinicians’ time and more administrative work

He said that, over the last 70 years the NHS has evolved and innovated to meet the changing needs of the patients, but added it is ‘crucial’ the health service now looks at how it interacts with patients to ensure it continues to provide the best-possible care.

And he called on trusts and clinical commissioning groups to embrace skype, apps and online tools so that thousands of patients are spared hospital visits, time off work and school, while also saving the NHS millions.

He said: “The outpatient system is older than the NHS and the time has come to grasp the nettle and use tech and other innovations to improve patients’ experience and care.

“As part of the long-term plan for the NHS, it’s right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution, and make the NHS more efficient.”

The report highlights that outpatient appointments should be patient centred, meaning there should be a clear health benefit when asking people to travel to appointments, taking time off work and school.

Ending unnecessary appointments will free up clinical specialists to spend more time with complex patients where they can make the biggest difference.

Professor Powis added: “For many people care can be delivered more timely and conveniently closer to home by specialists at the GP surgery or by using technology in new and exciting ways.

This report shows a snapshot of exciting new models already working successfully through apps, skype, text messaging and remote monitoring systems that are changing the shape of care. We need to bottle and spread those examples building a new consensus for the future based on the views of clinicians and patients.”

The outpatient system is older than the NHS and the time has come to grasp the nettle and use tech and other innovations to improve patients’ experience and care

Welcoming the news, Simon Wallace, chief clinical information officer at Nuance Communications, told BBH: “The increasing sophistication of technology and rise of innovation is fundamental to the improvement of patients’ experience and care.

“Our healthcare system is facing pressures on account of unnecessary outpatient visits, which is leading to increased pressure on clinicians’ time and more administrative work.

“With each visit comes additional paperwork, reaching unmanageable levels that can lead to burnout for doctors.

“Minimising administrative tasks and unnecessary hospital visits is important to combat the rise of this situation and the implementation of efficiency tools like speech recognition and virtual assistants have the propensity to bring more time savings and reduce pressure on clinicians.

“Indeed, recent research found that voice recognition solutions enabled doctors at the South Tees Hospitals NHS Foundation Trust to produce clinical documentation 40% faster than traditional typing methods, with improved accuracy and quality of reporting and freed them up to focus on patient care and improving the patient experience.”

Other examples of where technology is helping include in Tower Hamlets where a pioneering virtual e-clinic enables GPs to send questions on kidney patients direct to specialist consultants for a quick reply, eliminating the need for an outpatient appointment.

In Berkshire, patients suffering high levels of pain now receive a specialist appointment in around a month after services were overhauled.

Previously, patients suffering pain symptoms had been going to pain, trauma and orthopaedics, neurology and rheumatology outpatients for tests and consultant appointments they did not need.

As part of the long-term plan for the NHS, it’s right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution, and make the NHS more efficient

Now, patients at risk of chronic pain are identified early and seen by the Integrated Pain and Spinal Service (IPASS), meaning fewer hospital admissions or multiple attendances.

And, in the North West, a new neurology hotline for GPs in the has spared patients unnecessary worry and travel time, while £100,000 a year has been reinvested back into the NHS.

The call for increased adoption of technology comes in the same week that research by the Medical Technology Group (MTG) showed that 90% of regional NHS plans fail to pay enough attention to the role of innovative solutions.

It found that only four of the 44 regional NHS plans include any meaningful reference to the use of innovative technology, despite NHS England making it a requirement in its guidelines.

Very few Sustainability Transformation Plans (STPs) made any reference to the need to use innovative medical technology. Those that did included the West Yorkshire and Harrogate, South East London, and Surrey Heartlands plans.

While the focus on the greater use of digital technology to improve services for patients is encouraging, all bar a tiny handful of regional NHS plans have failed to address the need for innovation and technology to improve patient outcomes

South East London stated: “We will work closely with clinical colleagues and partners to bring forward system-wide benefits to improve the value that the NHS gets from our significant investment in high cost drugs and devices.”

The MTG report also raises concerns about the focus placed on the Carter Review in the regional plans.

And it warns that, alongside the lack of clear plans for the use of innovative medical technology, if an ‘overly aggressive focus on unit cost’ is the key decision factor when deciding which technology to use, NHS organisations could miss out on the potential savings on offer.

On a positive note, however, the analysis found that the need to improve the use of digital technology is well covered by the plans.

Barbara Harpham, chairman of MTG, said: “While the focus on the greater use of digital technology to improve services for patients is encouraging, all bar a tiny handful of regional NHS plans have failed to address the need for innovation and technology to improve patient outcomes.

“Attempting to retrofit technology to pathway and systems will not work.

“Regional NHS organisations must seize the unique opportunity to re-evaluate the use of technology and take full advantage of its possibilities.”

Regional NHS organisations must seize the unique opportunity to re-evaluate the use of technology and take full advantage of its possibilities

The MTG report makes seven recommendations to ensure that healthcare systems assess, procure, commission and deliver technology-based treatments effectively. These include breaking down budget silos; ensuring local commissioners follow national guidance; and embedding a strategic approach to procurement.

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