'Digital services can never replace flesh and blood carers'
David Winskill, Crouch End campaigner
- Credit: PA
Twenty years ago, the NHS launched its National Programme for IT.
The objectives were pretty modest: digitise patient records, allow online appointments and referrals and computerise prescriptions.
Despite the involvement of some of the biggest (most well paid) names in IT, nine years and almost £13bn later, the project was quietly abandoned.
Since then, a cottage industry has grown up, giving hundreds of IT consultants a good living explaining what went wrong. At the heart of this massive waste of time and money was the fundamental failure to engage or listen to stakeholders (the people who would have to use the systems) in its design and implementation.
Two weeks ago, the ex-secretary of state for health, Sajid Javid, launched his plan for Digital Health and Social Care, a plan not without ambition…
The long-term sustainability of health and social care is dependent on having the right digital foundations in place, and so digital transformation must be the linchpin upon which all of these reforms are based.
He identified four goals for reform – to prevent people’s health and care [H&C] needs escalating; personalise H&C and reduce health disparities (no longer called inequalities); improve the experience and impact of people providing services and, transform performance.
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Few would disagree that IT offers many benefits for service users and I don’t think any health professional would disagree with too much of his vision. through the many pages of the launch document runs the golden thread of Javid’s determination to create a digital doorway to services.
But, and there are plenty of buts, several things are missing.
Digital services can never replace flesh and blood carers and clinicians: where is the money and the plan to train and employ the numbers that an aging population will need?
Yes, Covid showed that many of us were prepared to make jump to online consultations and e-referrals and so a key part of his vision is a beefed-up NHS App. But not all of us could or wanted to.
Generously, he says: “For those who cannot or prefer not to access digital services, traditional services will remain.“
A vaguer assurance would be hard to imagine.
Trade unions, Royal Colleges and patient groups must be involved from day-one in this project to establish minimum (not grudging) standards of face-to-face access and delivery.
For this all to work, let’s not forget the central lesson from last time round: involve, not impose.
David Winskill is a campaigner from Crouch End.