Can digital help our elective recovery?

Tara Donnelly, Chief Digital Officer at NHSX reflects on the opportunities for digital solutions to accelerate elective recovery and support new care pathways for patients.

The COVID-19 pandemic has had a huge impact on how hospitals can deliver care and means that now over five million people are on waiting lists for hospital treatment, with waiting times much longer than anyone would wish.

Gratefully seeing the reduction in severe COVID-19 cases, hospitals across the country are beginning to return to pre-pandemic levels of surgery with teams across ICSs developing ways to ensure that patients are treated as quickly as possible.

As a former hospital director of operations, I know what goes into this. The lion’s share will be delivered by clinical staff across surgical specialties working in a multidisciplinary team with their operational management colleagues to plan, schedule, create capacity and deliver more operations and treatments than have been possible over the past year.

So, the question is, can digital technology play a role here? At NHSX we firmly believe that it can, and there are some great examples of this already happening across the country, which have the potential to be scaled more broadly.

To support NHS teams with innovative digital solutions the following three areas as outlined at our recent digital elective recovery workshop would be a great starting point.

Expansion of digitally supported virtual wards

Digitally supported virtual wards were established during the COVID-19 pandemic, particularly to care for people leaving hospital early and sharing their blood oxygen levels with clinical teams, through an app on a home device. A number of these services have since expanded to other conditions, mainly medical but some surgical patients as well.

There are currently 22 technology supported virtual wards out of acute hospitals or in collaboration with community teams within NHSX’s programme estimated to be saving around 100 hospital beds a day. We believe that all trusts and ICSs should consider expanding services further to provide more digital home care to groups of patients who would benefit.

Barry James from Leicester has digital home care to support his heart failure, supported by community nurse specialists running a virtual ward. Barry says “it reassures me, my wife and my family. I feel more able to manage my heart failure as I have learnt what’s normal for me as I have recorded my data.”

Leicestershire Partnership NHS Trust's community led virtual ward service includes patients with heart failure and COPD. Other examples include Norfolk and Norwich University Hospitals NHS Foundation Trust's virtual ward which is saving six beds a day. This includes patients following a stroke, in cancer care, hepatobiliary surgery, vascular surgery and interventional radiology with digital support at home.

Focus on five specialties: dermatology, ENT, MSK, cardiac and perioperative care

These are high volume specialties where there are also high impact digital solutions that can help support a very different pathway for patients and in a number of cases improve the provision of advice and guidance between clinical teams in primary and hospital care. A range of examples are given within the digital playbooks and within the slide pack and webinar on the Innovation Collaborative website.

For instance, in digital dermatology we are working with 24 ICSs who are advancing secure clinical image sharing apps for smartphones to take and transfer images to the NHS e-referral service (known as e-RS). Gaining wider access to dermatoscopes in GP, community and acute settings, resulting in many more patients receiving rapid reassurance rather than sitting on a lengthy NHS waiting list, as well as prompt escalation should symptoms be worrying. We do recommend that all other health systems review this model and explore the other specialties where solutions are making a real difference.

Digital playbooks

We have also brought together a series of case studies in the form of digital playbooks. These playbooks showcase how different digital products support digitising NHS pathways based on examples from across the country during the pandemic and have been co-produced with clinical leads and policy teams.

The digital playbooks for dermatology, cardiology, ophthalmology, MSK are available on the our website. We have also filmed a series of events and webinars in support of the playbooks, held with the royal colleges and societies and national clinical directors.

These three areas were outlined at our recent digital elective recovery workshop. A recording and the slides from the workshop can be downloaded from the Innovation Collaborative Digital Health workspace on the FutureNHS website.

There are lots of resources available to help you advance this work. Our primary community for adopters, where videos, digital playbooks, podcasts, documents and slide packs can be readily accessed and downloaded, is through the Innovation Collaborative Digital Health workspace on the FutureNHS platform.

The platform has been designed for NHS and social care staff who are looking to implement and advance digital home care solutions within their organisation. There is also a section open to digital health innovators.

We would be delighted to work with you to ensure that innovative digital solutions are playing their part in your elective recovery. Should you be keen to introduce digital into your elective recovery you are most welcome to get in touch, email dnhsx@nhsx.nhs.uk.

Join the Innovation Collaborative and find out more

Existing members can access the Innovation Collaborative Digital Health workspace on the FutureNHS platform where you can download the video and workshop presentation.

Alternatively email innovationcollaborative-manager@future.nhs.uk to request to join. You can also join in the conversation by tweeting using the hashtag #NHSXInnovCollab.

Additional resources

Digital playbooks

Supporting care with remote monitoring

Advice and guidance toolkit for the NHS e-Referral service

British Association of Dermatologists

NHSE Dermatology OPTP

GIRFT high volume low complexity (HVLC) programme