DHSC: Plan for Digital Health and Social Care
On 29th June, A plan for digital health and social care was released by the Department of Health and Social Care. The goal of the plan is to create a digital revolution that drives digital tech in the direction of fast and accessible patient-centric care ‘fit for the 21st century’.
We’ve been here before, of course: in 2013 it was declared that the NHS would be ‘paperless’ by 2020, a target subsequently delayed to 2023, so there may be some scepticism about the latest NHS deadlines. However, there can be no denying the sincerity of the Secretary of State’s desire to accelerate digital transformation, and whatever its awful costs the pandemic has driven a major leap forward in the digitisation of health service. So alongside the recently published and final version of the Data saves lives health and care data strategy, this plan represents the most significant policy statements on the digitisation of the NHS and social care for many years.
The plan is aimed at helping to deliver the Secretary of State’s four ‘complementary’ goals of reform:
- Prevent people’s health and social care needs from escalating
- Personalise health and social care and reduce health disparities
- Improve the experience and impact of people providing services
- Transform performance
It sets out how access to information, and ultimately services, through the NHS App will be improved for people and their care teams, including through the aggregation of information on consultations, appointments, and GP notifications. It also outlines how the accelerated uptake of technology will save time for healthcare professionals and patients, facilitate increased remote monitoring, and ultimately reduce the backlogs driven by COVID-19. In turn this would improve patient outcomes – “with problems picked up earlier, shorter stays in hospital, and fewer admissions in the first place”. An initial £2 billion from the spending review has been earmarked for this digitisation, in the hope that this plan will then permit the release of billions back to the NHS. This investment is noticeably larger than any single previous funding for digital transformation in the NHS and so it will be interesting to see how it is utilised to implement the plan, and how it is distributed across NHS systems.
The Secretary of State, Sajid Javid, stated in the keynote speech launching the plan that he sees the NHS App at the centre of the NHS’s digitisation and, indeed, critical to the future sustainability of the NHS and the whole health system. He promised that there will “be new functionality and more value for patients every single month”. This is a welcome evolution of the NHS App, which has clearly shown its potential as an information source and vehicle for data collection throughout the pandemic. Its extensive coverage is also likely to drive the success of the apps which it is sanctioned to carry. Javid also stressed the importance of accessible information across health settings and that care must be personalised to improve patient outcomes. This will be supported by a focus on digital skills, strong leadership, and culture to make the system durable. While regulatory oversight is covered in the plan, mention of system leadership reform is noticeably lacking, which will be vital in implementing any digital transformation plan and the necessary change in system culture.
There is one major lacuna: the absence of national reimbursement for the most clinically effective and best value digital health products. NICE and the MHRA are making good progress in developing health technology appraisal pathways that are suitable for digital products, but without the opportunity for statutory reimbursement – which is available for medicines but not digital devices and diagnostics – the UK will be at a major structural disadvantage compared to peer group health systems like Germany that offer reimbursement for digital therapeutics. Addressing this gap will, inevitably, cost money and the Treasury will feel that the £2 billion its providing is more than enough to support the digitisation of the NHS. But unless this last step is taken then the full potential of the digital health revolution to improve both the health and wealth of UK citizens will not be realised.
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