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Old IT and staff reluctance stop Scottish NHS from adopting new tech

Outdated technology, lack of scale-up and unwillingness to change working practices are among the reasons why the Scottish NHS is struggling to take up new technologies, according to the Scottish parliament’s health and sport committee

The Scottish parliament’s health and sport committee has called on the Scottish government to get to grips with the barriers stopping the country’s NHS from taking up digital healthcare tools and systems.

A report by the committee found that one of the major barriers to the NHS adopting new tech is a lack of willingness by staff to change their ways of working.

The committee said it had found “a reluctance to adopt new ways of working in the NHS, with staff worried about reprisals should they fail or worse, in some instances, for simply challenging the established order”, and called on the government’s new digital strategy to encourage and empower risk-taking.

“This is the only way real change in the way technology and innovation is viewed, rolled out and accepted will occur,” the report said

It said that even when an organisation had bought a product, deployment was still an issue.

The Scottish Lifesciences Association said in its evidence to the committee: “In one case, NHS procurement bought 30,000 devices that were better for patient outcomes and cheaper than existing products, but then they were put in a warehouse in Lanarkshire and there was silence.”

Another key issue highlighted in the report was the lack of scale-up of IT projects. Despite the Scottish NHS serving a relatively small population, innovation projects were often health board-specific with little incentive to share new technology ideas across organisations, the committee said.

Giving evidence to the committee, NHS National Services Scotland (NHS NSS) said there was not enough focus on widespread adoption and that the country would benefit from a default “opt-out” position for health boards, rather than a default “opt-in” when innovations are identified.

The committee said it was “disappointed to hear of the difficulties” with adoption, and said added: “Under a ‘once for Scotland’ approach, we recommend a default ‘opt-out’ position when successful innovations are identified.”

Although Scotland has pockets of great innovation, such as three hospitals across two Scottish health boards that are piloting a digital pathology service, and the launch of the Scottish NHS’s data-sharing system, the Scottish Primary Care Information Resource (Spire), the country suffers from outdated, inoperable IT systems, the committee said.

Systems not interoperable

This, too, creates a huge barrier when it comes to adopting new technologies, because core systems are often not interoperable and are incompatible with each other, which makes it difficult for staff to share and access information.

“It is no longer acceptable in this age that our health service is still using multiple incompatible systems and various platforms,” the report said. “In all our work, we have heard repeated concerns around data sharing and interoperability.

“This is an area that the Scottish government must tackle urgently to ensure appropriate medical care can be given in the right place at the right time. Work must be done to update systems so they can interact, while work must also be carried out to ensure data protection requirements and opportunities to share data are better understood.”

Scottish MSP Lewis Macdonald said that when the committee agreed to carry out the inquiry into the Scottish NHS’s use of technology, it expected to “investigate different ways where ground-breaking and innovative technologies could make dramatic changes to the way the health and social care sector operates”.

“Instead, we’ve heard how a number of barriers are preventing change from happening,” he said. 

In 2016, the Scottish government published a delivery plan for health and social care, which included patient access to records.

But the committee found a “lack of strategic approach” and national leadership, as well as concerns over investment in digital and tech. It said the government’s digital health and social care strategy, currently under development, would be an ideal opportunity for the government to “lead the way and radically develop the way technology is used in the NHS and social care”.

“It also presents an opportunity to ensure innovation in health and social care flourishes and that Scotland is a leader and is not left behind,” the report added. “It is essential the Scottish government is bold and offers strong leadership on how and when this will be achieved.”

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