Margaret Parton explains how NHS teams are often supportive of implementing technology while the wider system is not
The NHS faces unprecedented challenges as the population ages and budgets come under pressure for competing priorities. The ability to deliver improved patient outcomes cost effectively will require radical changes in approaches.
I’ve headed up the NHS Technology Adoption Centre (NTAC) for the past three years. In that time, I have seen a firm realisation at Department of Health level that the NHS must become more innovative in order to deliver improved patient outcomes in the face of these challenges - the embodiment of Innovation in the QIPP agenda confirms this new mindset.
Innovation is finally on everyone’s lips and there is much activity acknowledging this. There has been a 180 degree turnaround from a technology and innovation averse NHS - as described in numerous reports - to one embracing technology and innovation.
But should this really be surprising? As chief executive of NTAC, I have met numerous NHS clinicians and managers across the country and found that there is much enthusiasm towards innovation and technology.
NHS teams want to work differently and deliver change through technology, perhaps best illustrated by over 60 NHS trusts applying to host technology projects with the NTAC over the last two years.
Several chief executives and senior clinicians have shown themselves to be very technology positive, eager to rapidly implement innovative technologies as part of our technology projects to transform care pathways.
Likewise many of the technologies we have been working with trusts to implement have been developed by innovators in the NHS. The NHS is full of teams that are secretly technophiles - which will make realising QIPP easier.
But system barriers continue to exist…
The current structure of commissioners, providers and suppliers has failed to deliver an innovative approach to delivering the healthcare agenda, based as it is on the traditional and often adversarial relationships between the three groups. Numerous obstacles exist at a system level preventing the NHS from adopting technology effectively. Over the last few years I have noticed three hurdles in particular and would like to recommend the following solutions:
Technology needs to be considered at the start of the commissioning process
Although world class commissioning has encouraged partnership approaches to service development, commissioners and providers are often not identifying technologies required in care pathways early enough. Bringing the commissioners and providers together at an early stage to specifically consider this point will enable technology requirements to be identified more effectively.
Combating silo budgeting
Silo budgeting in the NHS appears to be a real issue, often preventing technologies being implemented in care pathways. Commissioners and providers need to find active ways in which to broker appropriate funding arrangements between themselves and deliver new models of care. Health economies need to consider how technology can impact across a pathway and provide benefits to all stakeholders, rather than consider its impact on a particular episode of care. Finding a friendly arbitrator from the third party could be helpful in this process.
Lack of supplier engagement
When commissioner and providers implement innovative technology into a care pathway, the suppliers are often notified at a late stage. Engaging suppliers at an early stage so that the availability of appropriate technology can be identified much earlier in the process and included as part of the overall specification would be beneficial. Currently technology is often seen as an ‘add on’ to the process and perceived as a disrupter rather than a facilitator. Early engagement with suppliers would enable a much more rapid uptake of well evidenced technology.
The creation of ten regional Commercial Support Units (CSUs) to support the provider/commissioner/supplier interface is underway. This will enable the system to gain better value from procurement and respond more effectively to the challenges of operating in today’s NHS. The NHS Technology Adoption Centre will be working closely with the ten CSUs to support a new cadre of technology implementation managers at the units. These managers will be able to provide up-to-date advice regarding the procurement and implementation of innovative technologies. Their advice will be backed up with all of NTAC’s learning from implementing specific technologies highlighted in NTAC’s online ‘How to why to’ guides.
The key message gained from my three years experience at NTAC is this: many NHS teams are successful, but secret, innovators; in contrast, the NHS, as a system, is not innovative enough. The NHS needs to find feasible ways to empower these innovators so that they can develop new processes for implementing technology.
Margaret Parton is the outgoing chief executive of the NHS Technology Adoption Centre