In a recent webinar, BCS discussed the unique pressures faced by teams delivering IT within a health and social care setting. The revealing session shines a light on fascinating human stories and shows glimpses of the new normal, Martin Cooper reports.

Health and social care are on the front line when it comes to meeting Coronavirus’ many challenges. And a key to many organisations’ ongoing success in this battle is the increasing and evolving use of technology.

In the recent webinar - How is COVID-19 changing NHS IT? - BCS explored, among many other topics, the NHS’ ongoing digital transformation.

We discussed:

  • How the provision of health care is changing.
  • Why and how the technology needed to support care is shifting.
  • What patients and the public expect now and what they may demand in the future.

Our panel of experts included:

  • James Freed FBCS Chief Information Officer for Health Education England
  • Lisa Emery, Chief Information Officer, Royal Marsden NHSFT
  • Stephen Slough, Chief Information Officer Dorset County Hospital NHSFT
  • Brian Runciman MBCS, Head of Content and Insight BCS

James Freed gave one of the conversations most memorable quotes: ‘I would never have expected, every Thursday, to see people applauding the NHS. And that applause is for us [in IT] as it is for frontline workers.’

Tech workers within health and social care settings are providing a truly vital service. If you know a an IT professional who is doing invaluable work right now, nominate them in the BCS #vITalworker campaign

1. Laptops - the digital respirator

The need for respirators to help keep COVID-19 victims alive while they hopefully recover is well storied. Across the country, armies of high-tech firms have set about designing, optimising, making and delivering respirators.

Within an IT setting, what are the resources that teams and leaders feel they are most lacking? The answer is: laptops and, to a marginally lesser degree, monitors, webcams and headsets. In short, the raw stuff we all need to work from home.

‘It’s the physical hardware,’ says Emery detailing what her teams need most of. ‘Getting those things in, at scale, is hard.’

Homeworking, of course, expands a network’s scale and dimension. This increase in network size places strain on existing fixed infrastructure and on the people managing it. Factors such as real-time visibility, analytics, compliance, reporting and performance management all need controlling by humans.

‘It’s the classic,’ Emery explains. ‘It’s the people and the tech. But, the hardware has been a real difficulty and a real sticking point.’ And that, she says, has forced her team to think differently about how it offers solutions.

These observations were echoed by Freed. ‘I see a much more pressing requirement for home working. How do you go from a situation where the default place of work is the office to one where the default is the home? How do you make that change rapidly? Extremely rapidly…?’

Picking up the digital respirator analogy, Freed points to video consultations between patients and healthcare professionals as a place where supply and demand are not aligning. ‘We’ve all seen a massive surge in the use of video consultations’, he says. ‘I’m interested in what this means culturally for organisations.’

‘Respirators is a good analogy,’ Slough says picking up the conversation. ‘But, maybe, it’s a bit more like the digital equivalent of toilet roll. When this all hit, everybody dashed out and bought every laptop and headset they could buy. As a result, there are none left now. Laptops are in high demand… suppliers are offering desktops at reasonable rates but people are saying “no”. They aren’t portable. Portability… that’s the mode we’re in now.’

2. Hardware and the new normal

The shock associated with the dramatic shift to home working is beginning to recede and people’s attitudes are changing. Suddenly, people are seeing the positives.

‘We’ve kitted out some people with two monitors for home working,’ Slough says. ‘And, we’ve got people saying they don’t want to go back into the office. They’re quite happy working at home… and could they please keep the new monitors at home? And, if they need to come back into the office, can they have two more for the office too?’

Continuing, he explains: ‘There has been a significant change. You see it in those organisations that planned for something like this and in those who are having to rapidly staff-up, knowledge-up and equip themselves.’

3. Seeing the rise of new positives

Coronavirus is responsible for a huge spectrum of negatives across all aspects of human and organisational life. Oddly though, within health settings, there are some positive by-products.

‘One of the biggest keys to this has been some funding,’ says Slough. ‘We’ve now got the money to make [things] happen. There’s been fast decision-making and the removal of some red tape. There has been a huge positive impact on digital services…’

The pace of technical and organisational change has also been profound. ‘I’m now much closer to clinicians,’ Emery explains. ‘What I’m seeing is decision-making being driven by clinicians asking for those digital tools. And, they want the pace of transformation to move much faster. Clinical bodies are embracing change and there’s a lot of positive energy.’

‘They say necessity is the mother of invention. In this case, necessity is the mother of adoption,’ says Freed. ‘Somebody was telling me that, in the video consultation space, we’ve had ten years of progress in two weeks.’

That, Freed explains, is completely phenomenal but, in a way, it’s a product of people having no choice. ‘You quickly determine that imagined - and the very real - problems are easy to overcome or are just something you can accept.’

4. Breaking down walls

Freed also feels that the NHS’ sense of shared purpose is key to this step-change in adoption time. The whole organisation, he explains, has a real hunger to learn and a strong ethos of cross-organisational working.

‘Certainly, in the national bodies… the walls have almost disappeared. We’re working together in the emergency cells and it doesn’t matter what organisation you work for,’ he enthuses. ‘What matters is the resources you can bring to bear and the expertise you can add.’

5. A legacy of lasting relationships

Many of the changes and shifts the panel of experts described have – understandably - been technical, organisational and procedural. Freed, however, is keen to emphasise the cultural.

Such has been the purpose-driven change, people who might not otherwise meet have been thrown together. And this, he says, will have a lasting legacy: people from across health and social care are forming relationships that will likely last much longer than the crisis that brought them together.

‘This is the real silver lining to this rather big storm cloud,’ he says.

6. The power of networking

These are uncharted territories, for us all - not just IT professionals within a health and social care setting. There is no rule book and there isn’t, in many circumstances, any past experience to fall back on.

In these pulse-quickening moments, Emery says having a trusted professional network has been invaluable. And, she says, don’t be afraid to use yours.

It could just be a phone call: ‘We’re doing this… we’re doing it really fast… it’s a bit scary. Are you doing it too? Can you give me a bit of advice, even if it is just a bit of a boost?’

Having that support, she says, has been fantastic.

7. Necessity is the mother of convention

In better times colleagues and co-workers can sometimes find adapting to technical changes difficult. The old ways were comfortable, familiar - and they worked.

In older, calmer times, IT might have been vilified as the agency of chaos and the architect of stress.

Now, perceptions are changing. IT has become central to the provision of so many different services and systems. ‘People are willing to be a lot more patient with us, as a profession,’ says Emery.

8. The public’s perception of IT

The pace of change inside the NHS will likely begin to change how the public thinks about health, social care and technology.

Specifically, Slough pointed to online consultations as use cases worth exploring. ‘The more we’re pushing online consultation, the more people will expect them,’ he says. ‘You can do a lot with your bank online. People, in [health] circles have been wondering why we can’t engage with the NHS in that way.’

There is, though, something of an illusion at play here that isn’t helpful. Banks are generally singular organisations whereas the NHS is an umbrella logo that sits over hundreds - if not thousands - of organisations and bodies across health and social care.

‘Historically,’ Slough explains, ‘these organisations haven’t really spoken to each other because they’ve been in competition. This didn’t lend itself to everybody working well together… now, it is incumbent upon us to hide that complexity from the public. And we need to offer the kind of service the public demands: more online, available twenty-four-seven and services delivered where you don’t need to travel to see a clinician. Or you could get advice from a bot online.’

9. Not everybody is ready for digital

Transformation is happening more quickly within IT and, in many ways, the public appears to accept and even demand new ways of accessing health services. But, there is a risk associated with pursuing fast paced and almost total digital health care.

Not everybody in a population wants digital healthcare and not everybody is able to access services through digital means. Some people lack the digital literacy to interact, some the technology and for others accessibility is a barrier. As such, it is important to ensure analogue services remain funded, functional and in place.

About FEDIP

FEDIP is the Federation for Informatics Professionals in Health and Social Care, a collaboration between the leading professional bodies in health and care informatics supporting the development of the informatics profession.

If you’re in a health informatics role with patient care your top priority, apply for FEDIP registration today and gain wider recognition of your skills and experience.