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17.11.16

Patient-led tech will not be a ‘magic bullet’ for the NHS, Nuffield Trust advises

Patient-led digital technology could transform the lives of NHS patients and staff but not necessarily for the better, a new report has found.

The report, ‘The digital patient: transforming primary care’, by independent health think tank the Nuffield Trust, found that the use of new consumer-led tools is helping patients to manage their chronic conditions, potentially reducing pressures on the NHS in the long term. However, some of these tools have proven to be inaccurate or off-putting for patients less familiar with technology.

The think tank has therefore advised the NHS to embrace technology cautiously, warning policy-makers and politicians against the assumption that it will produce budget savings in the short term.

Sophie Castle-Clarke, fellow in health policy at the Nuffield Trust and lead author of the report, said: “Technologies that patients can use offer some of the brightest hopes on the NHS horizon. Digital tools that help people stay healthy and manage their conditions at home will be critical to the future of the health service. The good news is that this is increasingly becoming a reality in the NHS. 

“But this technology could be a double-edged sword, and there’s still a lot we don’t know. Without regulation and a careful look at the evidence – not all of which is compelling – these digital tools could compromise the quality of care and disrupt the way care is provided.”

The report focused on the use of seven types of technology for patients in primary care, including interactive symptom checkers, wearable technology, online GP appointment booking and the 165,000 health apps currently available on the market. 

It found that some systems, like online triage, could be simultaneously risk-averse and atomistic in their clinical assessment of patients, causing unnecessary demand on frontline services. The report recognised the potential of these systems but advised that they be further developed and tested, particularly how the patient interacts with them.

The report also observed that supporting patients in their use of the technology might be necessary as patients often lose interest in self-care or are deterred by complex log-in processes, especially the 12.6 million people in the UK lacking in basic digital skills. It therefore warned that the NHS should take great care to guard against the ‘digital exclusion’ of patients.

“The evidence suggests that patients tend to use tools for self-management more effectively when they are supported by professionals, particularly when they have complex care needs,” the report advised.

“Services to support patient engagement and effective self-care, such as better use of health coaches and others, are likely to improve effective uptake in the long term, particularly in those with specific health needs.”

The think tank recommended that the NHS invest in embracing technology, such as expanding the role of staff to show patients how to book an appointment online, or fostering relationships with the private sector in order to keep up with ever-shifting trends. However, it accepted that this would require a “change in health service culture”.

“To encourage patients to use technology more, NHS staff need to work differently,” the Nuffield Trust said in an accompanying statement. “For example, patients are likely to get greater benefit from accessing their online records if they are shown how the information in the record can support self-care.

“Changing ways of working in this way will take time, and require a change in health service culture – the authors warn that the technology will not act as a ‘magic bullet’ for staff.”

The NHS has been notoriously slow to adapt to digital technology, with the service so far offering a low uptake of patient-led services. The Nuffield Trust argued that this has led to a growing gap between the digital experience people have as consumers and as NHS patients.

NHS England hopes that at least 10% of patients will be using an online service by 2016-17, rising to 20% the year after. A total of £45m will also be invested to support the uptake of online consultations.

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