The Download: Making a difference this winter

“This could make a difference this winter, this January” – an immediate positive impact on performance is not something you often hear promised on tech adoption.

Normally, people take a deep breath and then turn on the new EPR and everything is disrupted for three to six months.

The quote above came from a GP who told a joint HSJ and IBM tech event this morning that he couldn’t find an actual nurse to work in his practice. He said he’d happily pay £20k a year for an AI digital nurse that could help patients control their blood pressure, that would be a bargain. Primary care is nimble enough to buy that quickly and get it working quickly, where it would be making a difference this winter (a winter that is shaping up to be terrible).

The event was entitled “How digital technology can help deliver the NHS 10-year plan” – now obviously there isn’t a 10-year plan yet, but dollars to doughnuts it will have a lot to say about the elective waiting list.

This is where one of the biggest challenges and opportunities for tech in the NHS is going to be in the medium term. Policy people in the room pointed out that 84 per cent of the elective list is outpatients – and the tech wasn’t just going to be about doing remote consultations.

One mentioned that American healthcare giant Kaiser Permanente has its outpatients provide 17 points of clinical data digitally before seeing a clinician – making the doctor’s job much less about gathering and inputting data. Imperial’s director of clinical analytics Erik Mayer said that within five years this sort of burden time was going to be removed by the technology.

This echoes what Karin Smyth, the minister responsible for this beat, said at her first speech in the role: that she’d judge new technology on whether staff told her it made their working lives easier.

So how’s that going?

Well the bad news, from one industry figure, was that lots of boards are still “fearful” or “contemptuous” of AI.

Others noted that the NHS doesn’t have a management cadre that is experienced in digital transformation programmes. To be fair, they often have other things on their minds, rota-ing a safe service, for example. Many integrated care boards – the convenors of systems – don’t have a chief information officer.

But with the Thirlwall Inquiry in the background and a major review of the NHS’s patient safety systems expected soon, no one should be surprised when the latter (from former McKinsey partner Penny Dash) goes big on digitisation’s role in improving safety.

Also, there’s no money. Or what money there is and when it arrives is unclear. There’s definitely not the money for tonnes of double-running while staff get used to using new systems. And there’s no sign that anything more than one-year financial planning is coming to make rational investment decisions easier.

But policymakers are hopeful that while there’s not a lot of new money about (and the NHS is routinely outcompeted on pay for tech talent) there is a new generation of entrepreneurial medics, who practised for a while but are now in tech. It was noted they were “much more comfortable failing” than the previous generation – although it’s fair to say we’re yet to see the first big AI in healthcare scandal. An AI, and a clinical decision it makes, are only going to be as good as the data it is fed. Another risk is that clinicians get too trusting of an AI after using it 100 times and are then slow to realise it has hallucinated something.

And that’s if it’s even asked to do the right thing. One speaker talked about work his organisation was doing with a royal college to try and reduce the time the medics spent in multi-disciplinary team meetings – MDTs can feel like a waste of time, but they’re there for a reason.

But there are upsides outside of productivity. University Hospitals Birmingham FT chief medical officer Kiran Patel said in five years mortality trends were going to be obvious to departments much quicker than they are now.

Imperial’s Mr Mayer gave an example of tens of thousands of patient experience responses arriving at his trust each year – the vast majority of them good – but there currently is only a tiny team to process them. Ambient AI – the less glamorous, scary end of healthcare AI – would mean staff can get patient insights, and positive feedback, much more easily.

Hearing you’re appreciated by the patients, the reason you got into healthcare, is something that might make a difference this winter. And yes, a happier workforce is also more productive.