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NHSX IT chief outlines opportunities of elective recovery tech fund

Priorities for the digital unit of the health service include remote recovery with virtual wards, pre-surgical digital support, and use of robotic process automation to reduce the administrative burden on staff

NHSX chief digital officer (CDO) Tara Donnelly has outlined the opportunities that a new fund for elective recovery technology will bring to surgical pathways and waiting lists in the healthcare system.

The scoping of potential opportunities relates to the £250m Elective Recovery Technology Fund established this year, focused on the development of digital solutions for elective recovery. The funding pot is part of the £700m Targeted Investment Fund established as part of the government’s broader recovery plan for health and social care, announced on 30 September.

Areas of focus for the programme include supporting people at home on alternative care pathways, including digital offers for patients in need of support with their mental health or pain management, avoiding the need for hospital-based care.

Citing the case study of a digitally supported virtual ward in Norwich in a blog post, Donnelly noted that about 80% of integrated care systems now have a set-up whereby patients can leave hospital to recover at home and be supported by clinicians remotely.

“This funding means that they could expand further, open up to a wider range of patients, and increase their coverage, particularly over winter, to enable the elective programme to continue successfully,” she said, referring to the system that supports early discharge and home rehabilitation.

In addition to virtually supported wards, other categories supported by the Elective Care Recovery Fund include digital tools for self-management in areas such as weight loss and smoking cessation.

The plan also includes home-based pre-surgical support, including virtual surgery schools and patient information, plus digital pre-assessments, enabled preoperative rehabilitation and consenting.

According to Donnelly, a major orthopaedic surgical centre in south London saves almost two hours of clinical time per patient by conducting home-based pre-assessments. “The clinical time saving is worth £94,000 for every 5,000 patients, and it reduces carbon emissions because it saves many trips to hospital,” she said.

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As part of the programme, NHSX also plans to use operational data and digital support to promote enhanced recovery for patients who have undergone surgery. This is expected to lead to fewer post-surgical complications, as well as improved patient outcomes, faster recovery and shorter hospital stays.

NHSX is also driving the implementation of patient-facing tools for communication, aimed at digitally enabling personalised follow-ups to optimise resources: “The platform is very highly rated by patients and means that appointments take place on the basis of need, reducing those that were adding no value by one-third, freeing up space to see new patients, reducing waiting times and allowing time with those that do need clinical input,” said Donnelly.

Other tech-enabled areas supported by the Elective Care Recovery Fund include the deployment of robotic process automation to reduce the administrative burden on staff and improve the efficiency of clinical processes.

Improved use of data will also have a role in balancing capacity and demand, using real-time operational systems and population health management tools. These are expected to provide insights on performance and reduce waiting times.

The priorities for the elective recovery fund follow plans announced in September 2021 by health and social care secretary Sajid Javid to reduce the NHS waiting list backlog through use of technology.

During the Covid-19 pandemic, waiting lists have soared, with people waiting longer and longer for elective surgeries and procedures. There are currently 5.5 million people in England waiting for treatment or non-urgent surgery, and the government predicts that this number could reach 13 million by the end of 2021 if not dealt with.

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