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Improving communications

Through the better use of wireless communication technology the NHS can improve its relationship with its patients and reduce its spending. National Health Executive spoke to Professor Nicholas Bosanquetto find out how

The question on many people’s lips is how to deliver better services at lower cost. One answer is through the use of more efficient use of ICT and wireless communications.

“I think the key issue is using low cost technology- what you might call the ‘Dixon’s approach’ -to improve communications between health teams and patients,” says Professor Nicholas Bosanquet, professor of health policy attached to the Dept of Bioengineering at Imperial College London .

“To do this we need to make some fairly significant progress in the next twelve months, however I am not sure whether that will happen.”

Professor Bosanquet attributes these doubts to the confusion over the status of Connecting for Health.

“I would strongly criticise Connecting for Health not just for the content but for the way in which it is being wound down, because it has left the whole situation in limbo.”

Despite the apparent confusion over the government’s approach towards NHS communications, Professor Bosanquet believes there are many great examples of local health services innovating through the use of wireless communications to better interact with their patients such as a sexual health clinic in south west London where young people can go in for a test and then have their results texted to them.

However in the use of more complex wireless technology such as tablet PCs and ruggedized laptops, he feels that there are parts of the NHS which are still lagging behind.

Professor Bosanquet was on the board of the South West London Community Trust ten years ago and whilst it has advanced quite a long way in the use of wireless technology, he feels that there is still a lot of progress to be made.

“I feel that this lack of progress has been caused by the blighting effect of central planning.”

Instead of centrally imposed programme, such as the one which the government is operating, Professor Bosanquet advocates the use of local solutions where the people involved in actually delivering services have the last word on how their systems are formed and what technology suits the needs of patients in their area.

“There is an opportunity for the NHS to have local improvement processes where trusts can make plans for themselves. These local solutions are usually more compatible with data security as well, whilst also ensuring the interoperability of data.”

Once the technology is in place, trusts needs to be far more focussed in how they use it, according to Professor Bosanquet.

“A recent study in Birmingham identified that 20,000 people were using 80 per cent of the services. This has led health teams to target those people far more effectively to enable them to treat those people more effectively and therefore reduce the number of services which those people use.”

One idea put forward by Professor Bosanquet is for all patients to be given a mobile phone with which to call a dedicated team member. Once we redefine health service as a communication programme there are some awesome opportunities.

“This means that the person can call a team member if they are experiencing any problems rather than them simply coming to A&E, which is what they do at the moment, and become caught in a sort of ‘revolving door of admissions’, which is extremely costly.”

Given the demographic of the patients who use the NHS the most, Professor Bosanquet admits that there will have to be some quite intense cultural changes made so that older people learn to accept the use of technology, rather than physically going to hospital.

“The vast majority of the biggest NHS users are the wrong side of the digital divide. This means the health service needs to work with outside organisations to encourage those people to get on the right side of the digital divide, at least to the extent of texting and emailing.”

One way for this to be achieved, according to Professor Bosanquet, is through ‘peer group contact’, to encourage older people to become more technologically aware and then move onto using wireless technologies. However, it may take a while for the message to spread because many older people are actually resistant.

“I even know of a very distinguished retired civil servant who still refuses to use a computer at all. This being said, the older generation, in general, are becoming more technology literate through the use of devices such as mobile telephones but this varies from device to device. For example, the penetration of mobile telephone technology is much higher in the older generation than laptops are.”

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