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NHS looks to ‘digital first’ primary care


Mark Say Managing Editor

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Patients are to be given the option of ‘digital first’ primary care as part of the new NHS Long Term Plan, published today by the Department of Health and Social Care (DHSC).

It sets out how the £20.5 billion budget settlement for the NHS from last summer will be spent over the next five years and includes a strong emphasis on the use of digital technology to relieve existing pressures on the healthcare system.

The plan forecasts that primary care and outpatient services will change over the next 10 years to a model of tiered escalation depending on need, in which senior clinicians will be supported by digital tools. This will involve people being increasingly cared for in their own homes, monitored by wearable devices and using more online consultations.

A key element is that over the next five years patients will be given the option of digital first primary care, either from their own practice or one of the new digital GP providers. This will involve extending the use of the NHS App to provide advice, check symptoms and connect people with healthcare professionals, and enabling them to access virtual services.

It will be supported by further investment in the platform, along with the creation of a new framework for digital suppliers to primary care, a review – which will take in the GP payment formula – of digital first practices to ensure they are safe and benefit the NHS, and a review of GP regulation and terms and conditions.

Reducing face-to-face appointments

There will also be a redesign of services so that over the next five years patients will be able to avoid up to a third of face-to-face visits by using digital channels. This is expected to remove the need for up to 30 million outpatient appointments per year.

The NHS App, which is currently being rolled out, will be further developed to enable a simple triage online and create a standard online way for people to access the NHS. It will work other services at national and local level and, where appropriate, be integrated into patient pathways.

Developers will be encouraged to build new functions on the app to support specific communities and conditions, and the NHS login will provide a single way for patients to identify themselves for a range of services.

Other digital plans include:

  • By 2020, every patient with a long term condition will have access to their health record through the Summary Care Record accessed via the NHS App.
  • More support for people with long term conditions through mobile monitoring devices and the interoperability of data.
  • Patients’ personal health records will hold a care plan with information added by themselves or an authorised carer.
  • An expansion of the NHS Digital Academy programme to improve digital leadership.
  • An expectation that informatics leaders will be on the board of every NHS organisation.
  • A new wave of Global Digital Exemplars to enable more trusts to use technology to improve care.
  • The use of depersonalised data from local records, in line with information governance safeguards, to support population health management.

In addition, a number of practical priorities have been identified for NHS digital transformation, including: the use of intuitive tools to capture data as a by-product of care; protecting patients’ privacy; ensuring data security; mandating and rigorously enforcing technology standards: creating straightforward digital access to services; using decision support and AI to help clinicians in applying best practice; and using predictive techniques to support local health systems. The plan also emphasises encouragement for the development of the health IT industry.

Demand for 2024

Underlying all this is a requirement that by 2024 all providers of acute, community and mental healthcare will be expected to advance to a “core level” of digitisation. This will cover clinical and operational processes, and be based on robust infrastructure services for hosting, storage, networks and cyber security.

Other significant elements of the plan include: improving out-of-hospital care by supporting primary medical and community health services; also drawing on these to support older people through more personalised care; and an emphasis on improving maternity safety.

Health and Social Care Secretary Matt Hancock (pictured) said: “The NHS long term plan, backed by a historic commitment of an extra £20.5 billion a year from taxpayers, marks an important moment not just for the health service but for the lives of millions of patients and hardworking NHS staff across the country.

“Whether it’s treating ever more people in their communities, using the latest technology to tackle preventable diseases, or giving every baby the very best start in life, this Government has given the NHS the multi-billion pound investment needed to nurture and safeguard our nation’s health service for generations to come.”

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