NHS England urged to produce tech roadmap to cope with pandemic backlog

Technology can help the health and care system clear the care backlog stemming from the Covid-19 pandemic, but NHS England needs to produce a roadmap to enable that to happen and address major issues relating to IT, a report has found.

The report published by the House of Commons Health and Social Care Committee into the NHS backlog noted that of the 5.8 million patients waiting to start treatment in September 2021, 300,000 have been waiting more than a year and 12,000 more than two years – and that the real list, including patients who haven’t come forward yet, could be as high as 13 million people.

With those issues yet to be addressed, the Committee urged the Department for Health and Social Care to work with NHS England to create a national health and care recovery plan with a clear vision of what success in tackling the issue will look like for patients.

Technology has a significant role to play in that process, but basic infrastructure is lacking and IT architecture poses a lot of challenges, making it harder to spread innovation, the report has found.

“We want to improve practice, but there is the IT. If I lose my job, it is most likely because I am going to throw my computer out of the window,” said Dr Andrew Goddard of the Royal College of Physicians, giving evidence to the Committee.

“Primary care and secondary care can easily communicate,” he added. “That is where innovation really needs to happen. An effective IT system throughout the NHS and social care would work wonders.”

While welcoming the Spending Review commitments of £2.1bn in technology and data as “a step in the right direction”, the report noted other shortcomings related to tech across the health and care system, such as its reliance on paper. NHSE chief executive Amanda Pritchard told the Committee that a third of NHS trusts are still largely paper-based. “This is not acceptable,” the report pointed out.

The report also mentioned the Wade-Gery review on digital delivery in the NHS, and agreed with its finding that “now is the moment to put data, digital and technology at the heart of how we transform health services for the benefit of citizens, patients and NHS staff”. However, it noted Wade-Gery had recommended the creation of a roadmap for the delivery of her recommendations. The Committee urged NHS to come up with that plan as soon as possible, so it can be scrutinised before it is implemented.

The latest debate on how to use technology to tackle the NHS backlog follows the announcement of government plans to rely heavily on technology to reduce long NHS waiting lists and put the health service on a “sustainable footing”. Announced in September 2021, the plan includes making use of technology such as artificial intelligence (AI) and virtual wards to tackle the backlog.

According to the plan, some £160m will be pumped into 12 different areas where new ways of working are being trialled, such as GPs using AI to prioritise patients who need to be seen quickly and identify the right level of care for each individual.

The House of Commons Health and Social Care Committee report also mentioned the struggles of patients experiencing long Covid in terms of accessing care, due to the lack of integrated systems, adding that this is an opportunity to develop “truly integrated care”.

“The response to long Covid shows both the kind of integrated, patient-centred care the NHS can provide when systems work effectively, and the frustration and detriment experienced by patients who have to ‘fight’ to access to the right care when systems do not work effectively,” the report noted.

Moreover, it added that it is not appropriate to set targets for remote care in general practices. Instead, the report argues that practices should respond to the needs of local communities and define the best approach for their different types of patients.

“Remote care is not for everyone, and it is essential to avoid unintended clinical consequences that may occur,” it sa, acknowledging that NHS England is already evaluating the role of digital tools in primary care. The report urged NHSE to publish it as soon as possible and include guidance in ares such as how to approach remote care with patients considering they might not always be able to attend in person, and enable them to have input into the decision on consultation formats.