Why Wes Streeting’s shift from ‘analogue to digital’ isn’t the answer

With the Labour Party Conference taking place just a week after the publication of Lord Darzi’s review, it’s no surprise that there was a heavy focus on the report’s recommendations, writes Natalie Chishick on behalf of Access Health, Support and Care.

In acknowledging the critical (but not fatal) condition of the NHS, health secretary Wes Streeting and his team focused on sending a clear message that they will be addressing three big shifts: the move from analogue to digital, hospital to community, and sickness to prevention.

And how is this going to be achieved? Through investment and reform.

Commenting on the mistakes of the previous governments that have taken an either/or approach, Streeting talked about lobbying for investment that enables the delivery of a neighbourhood health service and focusing on reform that delivers whole-person care.

In doing so, he will consider wider social determinants of health such as housing, social security and education.

With technology being so central to the government’s plans, it was somewhat surprising not to see a greater focus on digital and data during the grassroots discussions.

In his keynote speech, Streeting committed to a “digital health service powered by cutting edge technology”, however when it was discussed at the fringe events and receptions, it often coalesced around expanding the NHS App and the hype vs opportunities for AI.

Risk or opportunity?

On the one hand, the lack of pragmatic discussions about a “tilt to technology” could signal a set of risks to reform.

Without having detailed conversations about the existing barriers to scaling the adoption of digital and data, we won’t be able to collectively move forward and address the issues in the Darzi report. Subsequently, we might see the new government inadvertently reinventing the wheel as they deliver on Streeting’s commitment to a “digital NHS”.

On the other hand, there was a genuine commitment to a national conversation on what needs to be included in the NHS Long Term Plan, which will be launched “imminently”, and an acknowledgment of the value of technology across health and social care, which suggests there are tangible opportunities to inform and influence how the shift from analogue to digital is achieved.

Notably, Stephen Kinnock, minister for care, acknowledged there needs to be a fourth “big shift” from piecemeal to systemic improvements across the health service. And while he wasn’t talking specifically about tech, this is certainly the right approach for the future, because we all know that the NHS isn’t starting from scratch.

It isn’t as much a shift from analogue to digital, but a move from disparate digitisation to whole-scale transformative implementation.

There are so many great examples across the country of Streeting’s vision of a digital NHS, from North East London Foundation Trust’s approach to virtual wards which uses tech to bring together remote patient monitoring, bed management and discharge services, to the rollout of digital social prescribing across Birmingham and Solihull Integrated Care System (ICS).

However, too often, these are isolated examples that reflect locally driven needs because of the very nature of service demand and commissioning models.

What needs to be prioritised is the right investment and reform to empower the NHS to scale digital and data in a way that it doesn’t continue to mimic the silos already in existence within care settings.

Mitigating digital silos

ICSs have a crucial role to play in driving this forward. Yet discussions about system-level delivery were also limited at the conference. The focus typically centred around national policy commitments and local – trust level – implementation.

It means we’re at a critical juncture, whereby the ambitions of the new government are laudable and early signals suggest opportunities for collaboration that will influence their ‘mission-led strategy’ over the next 10 years.

However, without having a genuine understanding of the complexity of health tech and data integration, there is a risk of not achieving these much-needed big shifts in healthcare.

Thinking about immediate and practical next steps, Joe McDonald is right in calling for a rapid review of IT, which needs to consult with providers, suppliers and patients.

This would surface the common challenges faced by service providers and their industry partners. For example, the competing commissioning incentives across care settings (that cause friction between the part of the system that invests in technology and the part that benefits) and the duplication of siloed decisions that inhibit patient flow and prevent economies of scale.

And by taking these steps, we create the evidence for the national conversation on the 10-year plan and give the NHS the best chance of becoming a digital neighbourhood health service that provides preventative care closer to home.

Natalie Chishick is currently working as a consultant for Access, Health and Care. She’s also founder of Chishick Communications, a specialist health and tech communications agency.