Why a Systems thinking approach is required for NHS digital transformation ambitions?
We know the main challenges: citizens’ expectations increasing, people living longer and insufficient resources to run today’s services.
To meet these challenges, digital transformation is clearly necessary, but without understanding the holistic view of each service within the NHS System, we will never achieve the transformation required.
Using district nursing as an example, this service plays a key role in helping patients to maintain their independence and manage long-term conditions. They deliver an ideal model of person-centred, preventative and co-ordinated care, which can reduce hospital admissions and help people to stay in their own homes. This important role faces many challenges as demand is increasing at the same time as nurses are leaving the profession. These issues are exacerbated by an ageing population and working practices which are unsupported by modern technology, including manual writing of patient notes and substantial administrative duties. One obvious way to tackle these issues is to provide a mobile solution. However, on its own this is clearly not enough to address the bigger challenges. Digitising some of the manual methods would help improve efficiency and job satisfaction; however, to really make a difference we need three approaches in parallel:
- Improve what is currently there (short to mid-term efficiency benefits)
- Transform what is currently there (mid to long-term benefits)
- Transform the root cause (Long-term benefits)
Improve what is currently there
A true mobility solution will improve the way district nurses work today, by providing mobile access to the relevant applications. This would ensure that everyone benefits from accurate and up-to-date data. This approach would provide short-term benefits e.g. allow district nurses to spend more quality time with patients and improve the nurses’ work / life balance.
Transform what is currently there (mid to long-term benefits)
We can only reduce demand by transforming the way we currently work. The implementation of self-care, family and friends care, and/or increased use of allied health professional’s support are areas that could deliver a significant impact. To provide a quality caring service a district nurse has to take a holistic, person-centred approach to care. For that patient they may be the only person they’ve seen for the last week, so a friendly chat and a cup of tea can also be an important part of the service. IoT solutions could provide virtual interfaces between friends, families, other NHS professionals and patients, increasing the circle of carers. It could also provide dynamic updates ensuring district nurses are supported to make the right choices at the right time. Digitally transforming self-care and family support would reduce the demand on district nurses and the wider NHS.
Transform the root cause (long-term benefits)
Finally, we need to address the root causes. Why do some people rarely have health problems? They may be genetically predisposed to being healthy but for a very large percentage, obesity, drug and alcohol abuse, depression, etc. can often be linked to social determinants. So how do we get people to live better? Clearly many of these issues are wider than the NHS and would need to be addressed by other government bodies, but there are areas the NHS could address: wearables, providing health information from an earlier age, could motivate people to adopt a healthier lifestyle. If this data is shared with the NHS it could provide a more proactive approach by asking people to visit the doctor when the data shows their health is changing. Genomic data could be used to screen people at a very early age for determining whether they are genetically predisposed to illnesses. The benefits would be early detection and treatments that can improve and save lives.
If we focus on making improvements today, alongside transforming current services and transforming the root cause, we would see clear benefits across the entire NHS.