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NHS and local government must overcome barriers to digital care

TechUK recommends more collaboration, knowledge-sharing and holistic changes, according to its report

The NHS and local authorities must tackle barriers such as imbalanced incentives, accessibility and awareness to move forward with personal digital care, according to TechUK.

In its report, entitled Personal Digital Care, the association calls on the public sector to re-establish the case for “assistive technologies as part of an integrated health and care support package”.

“Consumers and patients also need to be empowered – through information – to make decisions about personal digital care,” the report said.

In November 2014, NHS England published its Personalised Health and Care 2020 framework, which made patient-facing digital services a requirement by 2020. As part of the framework, the National information Board (NIB) created a set of workstreams to deliver on this goal, one of which is to make the best use of data and technology.

In its report, TechUK calls on the NIB to undertake a “comprehensive review of evidence and best practice for personal digital care, which should be conducted in collaboration with industry partners such as TechUK, to feed into the trusted repository of collective intelligence that becomes the ‘go to’ point for information and advice”.

It should also consider creating a national “knowledge repository” on personal digital care, which could be fed into by industry partners and providers, the report said.

Health secretary Jeremy Hunt recently announced he has appointed a US professor to undertake a review of the NHS’s digital future, as reported by Computer Weekly. 

Natalie Bateman, head of health and social care at TechUK, said that personalised digital care had the potential to transform health and care.

“However, there are significant barriers to overcome if we are to unlock the potential value for patients and clients, carers, health and care providers, and the UK economy, including the need for a cultural mind-shift among health and care professionals, and greater integration of information,” she said.

“There needs to be a holistic step change in processes and practices in the system, driven by better collaboration and integration between the public and private sector, to achieve Jeremy Hunt's ambition for patient power.”

Rethink of incentives

The TechUK report also calls for a rethink of incentives available to organisations looking to adopt new technologies for patients.

“More often than not the benefits for implementing personal digital care are accrued in a different organisation or care setting to the one that commissioned it. This actively creates disincentives to invest in the technology,” the report said.

Although the Better Care Fund, which was originally launched by the government in 2013, aims to provide financial support for councils and NHS organisations to jointly plan and deliver local services, “its effectiveness and impact has been called into question by both the National Audit Office and House of Commons Public Accounts Committee”, the report said.

It added that NHS England should explore current financial incentives to drive uptake of integrated care and called for a new approach to commissioning based on outcomes to “ensure the decisions taken on services are based on rewarding outcomes that are important to the people using them”.

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Thanks for your article, Lis, it's pretty insightful. The concept of shared decision making in healthcare is not new, but has yet to find the right path to be deployed and become truly empowering. Scandinavia is already successfully deploying such solutions; in particular, Norway is fully reforming their digital care with a deep focus on building effective patient decision aid tools and engines to allow for better treatment decisions. Your colleague David Nikel wrote about this in his article It basically supports what you've covered in your post!

The very first PITCOM exhibition (in 1981) was on computer based aids for the disabled (in the Upper Waiting room of the House of Commons). It was opened by Sir George Young, then a junior health minister. He read his script and then said its was not good enough. Something needed to be done. He was moved a week later. The core problem was identified as a funding regime that prevented the economies of scale that could/should lead to dramatic decreases in cost. One symptom was the inability of the wealthy elderly to privately buy equipment that was in theory available via the NHS and thus avoid lengthy (and expensive) assessment processes which might or might not lead to them to receive it (albeit usually an earlier version) for free.
30 years later such problems have still not been well addressed. In consequence the UK is well behind other developed markets in deploying telecare aids to independent living. The current proposals are bit like a lick of paint on the lifeboats of the Titanic.