The NHS 10-Year Health Plan sets out a bold vision for a digitally enabled, patient-centred health service. Central to this transformation is the dismantling of entrenched data and technology siloes that currently hinder collaboration, efficiency and integration across the system.
Those of us working in health data or technology teams will be all too aware of these siloes, the barriers they pose and the multifaceted challenges in breaking them down, often the result of historical decisions which led to fragmented IT systems, procurements and organisational boundaries.
There has been much discussion, both before and within the 10-Year Health Plan, about the co-ordinated national action needed across policy, procurement and infrastructure to remove siloes and enable joined-up care. From mandating interoperability standards to introducing federated approaches to data models and platforms. But what decades of learning from digital transformation programmes has taught us is that the success or failure of data and technology solutions is determined by the people using them.
Leadership and culture
Breaking down siloes is not just a technical challenge – it requires cultural transformation driven by ambitious, visionary leaders. A vital success factor is upskilling the workforce in digital literacy and this upskilling must include leaders. It can't be left just to the ‘digital lead' to understand the potential application and risks of technology such as AI, robotics and quantum – all NHS leaders must improve their digital knowledge and understanding to take responsible, informed decisions.
In addition to prioritising digital learning and certification for themselves and their teams, leaders also need to change their mindset to become responsible risk-takers, engaging in ‘safe experimentation' by balancing an openness to do things differently with agile, adaptive approaches to governance. Executives and senior teams also need to lead by example, not just talking about the power of AI or joined-up data but showing they are using it in day-to-day work and decision making, to inspire trust and confidence among colleagues.
Patient empowerment
The 10-Year Health Plan advocates giving patients greater control over their health data through personal health records and digital applications, such as the NHS App, to foster transparency, engagement and continuity of care. While we should always be mindful of the potential for digital exclusion, in our work at NHS South, Central and West, we have seen a clear, and sometimes unexpected, appetite from service users to replace traditional systems with a digital approach.
Our patient transport advice centre was managing non-emergency patient transport services across the South West via a traditional phone-based system. We piloted a digital contact centre with call-back functionality, caller recognition and automated screening questions. The pilot demonstrated that not only could call waiting times be significantly reduced but most users preferred call-back options. We also saw a marked improvement in staff satisfaction with 100% stating the new digital solution – which gave agents instant live information – enabled them to handle and triage calls more effectively. Additional insights into case numbers and complexity were also available to further improve the service.
Cross-sector collaboration
Population health management approaches have long advocated for joined-up data across organisations and care pathways. While digital alignment and integration within ICSs is the goal, no single technology platform can sustain the complex needs of the NHS. Instead, an ecosystem approach is needed which focuses on connecting data sources and platforms within an integrated infrastructure. Bringing social care data into this ecosystem is critical.
Cross-sector gaps in information sharing carry considerable risk to patient safety. The tragic real-life consequences of this risk inspired our development of the My Onward Care app. An elderly woman with dementia and undiagnosed cancer was prematurely discharged from hospital, without her family being informed, and later found in distress before subsequently passing away. Poor co-ordination between healthcare, social care and family led to untreated pain and suffering. My Onward Care is designed around patients to share information between their healthcare providers, families and care homes. It integrates with the electronic patient record so that during patient discharge the family is automatically notified along with transport and medication services.
By embracing a collaborative architecture and culture, the NHS can unlock the full value of its digital assets. We already have access to a wealth of data, what we need to get better at is ‘putting data to work' to build a digitally mature health system focused on proactive, personalised, equitable health management.
