Implementing the new NHS/public contract in November.

Using data and technology to implement the new.

Another week another topic…

Over the weeks leading up to November I’m concentrating on how the new contract between the NHS and the public will be delivered over the next 10 years. The purpose of a new contract is to deliver new things and, as a consequence, it will have to do this in new ways.

Last week the Prime Minister announced her aim to have a ‘step change’ in how cancer is diagnosed to improve survival rates as part of this contract.

‘Step changes’ are not delivered by doing more of the same. They are delivered by doing something different. More of the same will not produce different. Different will produce different.

So this week I will be exploring how the new – in terms of data and technology – will make help to create different healthcare.

Let’s start with the PM’s promise about cancer.

If, during the next decade, we increase the number of tests by say 40% – there will not be 40% more qualified staff to administer them. By 2028 tests will be carried out and checked almost exclusively by machines. Over the decade machines will have built up a database which will improve their accuracy enormously. Qualified staff will be required for those few people who are diagnosed with cancer, technology will do the rest. And, as technology gathers more data, so its accuracy will improve.

It will be very different.

Implementing a new approach to data and technology in the NHS is extraordinarily difficult. For decades, one reason it has been so hard is that, for most of that period, staff and patients have been very anxious about how technology and data changes their work and experience of care. It will be different – and that has been very scary.

But in 2018 – let alone 2028 – people’s everyday experience of using technology and data to make life easier has provided an opportunity to change that. Very many patients, and most NHS and social care staff, use technology and data to organise their lives every day.

One of the best ways I can think of to demonstrate what I mean by this is to stand outside a hospital in the evening when a shift of nurses has changed. The first thing the wave of uniformed people do as they leave the hospital is to get out their mobile phones and start organising their lives. For some it’s confirming a meeting; others ordering a takeaway; still others looking for the time of the next bus etc. etc. For all of them it’s how life works now.

What’s interesting about this is the complete normality of their use of technology to run their everyday lives in contrast to their work experience. They leave a place of work where this does not happen. Most people are now digitally enabled most NHS and social care places of work are not.

Let me contrast this situation with that of 20 years ago when I was involved in ‘introducing computers’ to the workplace in a range of public services. Many people didn’t really know what they were or how they would help them with their work. There was no background of everyday experience to relate them to – there was a lot of naked fear about the whole exercise. I can remember going back to one location where ‘computers had been introduced’ and finding that the big boxes that had been so carefully placed on desks had been mainly moved aside to be used as convenient coat hangers.

I would hazard a guess that if an organisation gives updated technology to its staff in 2018, the main response would be that it’s not updated enough. Based on their life experience, many staff members yearn for the introduction of better technology at work.

In the past wise organisations appointed an implementation committee representing a diagonal slice through its structure with each member thinking about how best to implement new technology in their area of activity.

Nowadays you could set up a committee of people whose colleagues already use more useful technology to organise their private lives than that they use at work.

There are very deep skills everywhere waiting to be transferred from life to work.

It’s similar for patients. Last year I received my first text from my GP reminding me about the need for flu jabs. I ran around the room with glee – at last! at last! My wife pointed out that she had been receiving such messages from her hairdresser for 15 years…

Many people – outside of public services – will reach into organisations from which they consume services to develop their own relationship, on their own terms, with quite complicated structures.

As is so often the case with the NHS – if a resource hasn’t been created within the organisation it doesn’t exist. But within society staff and patients now notice the insufficient flow of information throughout the NHS. They are impatient for change.

Peoples lived experience of new technology is a massive resource which we don’t use when we think about implementing ICT. We don’t use it because we don’t notice it – people’s CVs don’t say “I organise every electrical element of my home remotely from work”.

It’s not on CVs. It’s life.