Digital patient engagement tops NHS IT chiefs' priorities for 2021

The Covid-19 crisis has brought a positive shift to NHS organisations’ views about digital, but most technology leaders feel like they don’t have sufficient funding to deliver these modernisation projects, a study has found.

According to the fifth edition of the NHS IT leadership survey by Digital Health Intelligence, which has spoken to 198 senior health and care IT professionals across the UK, the fast adoption of digital tools during the pandemic has resulted in a more positive attitude to digital among board members.

This attitude was cited by 83% of respondents, while 79% felt staff members are more open to digital, with 69% confident that behaviour will be sustained.

The report noted barriers before Covid-19 that held NHS organisations back in terms of digital, such as competing priorities (cited by 69%) and fear of change (63%) and argued that the urgency of the pandemic has dissolved these previous perceptions.

“Healthcare organisations have widely been freed of traditional cautiousness on digital. There has been a sense of a desperate need to simply get on and make things work,” the study noted.

The area where health organisations have progressed the most, according to the report, is in remote working for staff, cited by 44% of respondents as the most significant digital achievement during the first semester of Covid-19.

Most organisations were ready to make that shift, with more than half (54%) saying that existing IT infrastructure enabled a rapid and effective transition, while just 6% felt existing infrastructure had somewhat hindered the change, and only 3% spoke of it being significantly hindered.

Additionally, supporting the delivery of remote patient services was a second major area of achievement cited by the IT chiefs polled. Some 85% of respondents said their organisation can now provide online video consultations, up from just 25% in 2019.

Clinical engagement online remains as a top priority for technology leaders in the sector, cited by 79% of those surveyed, displacing the focus on interoperability cited by most leaders in previous editions of the study.

The implementation of electronic patient records (EPR) is another key priority, mentioned by 44% of respondents as one of their biggest current projects, and by 31% as the next major project. “This suggests that while various barriers to digital progress have crumbled in face of coronavirus crisis, true transformation remains a long-term project,” the study noted.

NHS IT chiefs are also upbeat about the NHS digitisation in 2021 – 89% declared they thought the overall outlook either ‘very positive’ or ‘positive’, a major increase from last year’s 63%.

However, access to funding to carry out digital projects is a challenge and few respondents believe their current budget is sufficient, with only 14% feeling that they have sufficient budgets to deliver digital projects. Only 19% of respondents are expecting a significant budgetary raise next year, while 31% anticipate a small increase.

According to the research, budgetary responsibility for IT still lies with the CIO or IT director (49% of respondents said they are accountable for spending decisions), but this has steadily declined over recent years. In 2017, 71% of respondents said they had budgetary responsibility for IT.

Issues such as unhelpful prioritisation of capital spending and a lack of consistency were cited among the responses from the IT chiefs surveyed. Moreover, the disparity of NHS IT budgets was also among the findings of the research. Out of the respondents who knew full details of the budget, 12% said it ranged between £1,000 and £250,000, while 7% spoke of a budget of more than £30m. Most participants (19%) cited figures around £4-5m and £7-10m.

According to NHS Providers deputy chief executive, Saffron Cordery, NHS Trusts must be supported with appropriate access to funding – both capital and revenue – to invest in new digital capabilities.

“We welcomed last month’s Spending Review which saw an extra £3bn for NHS budgets. This is a good start, but this funding is prioritised for tackling backlogs in planned care and alleviating pressures in mental health services. If we are to sustain momentum on the digital agenda, Trusts must be supported to back their digital ambitions.”

Additionally, the study noted that Trusts that are not sufficiently digitised could face reverting to old ways of working.

“Microsoft has provided free access to its software following national agreements, but what happens when this agreement expires? Those Trusts that are relying on this could find that staff can no longer work remotely,” said Mandy Griffin, chief information officer at Calderdale and Huddersfield NHS Foundation Trust. “We need to make sure that we don’t leave those Trusts that are less digitally able behind – for it is the patients who will suffer.”