The NHS’ phenomenal response to COVID-19 has been boosted by the rapid adoption of new ways of working and digital technologies. But a new Ipsos MORI poll of 18-75-year-olds in lockdown, commissioned by IBM, reveals the monumental challenge healthcare systems face.

Among those who needed routine treatment between March 2020 and 3 July, 76% said treatment was either delayed or cancelled by themselves (31%) or their healthcare provider (48%).

Of those needing treatment for new conditions, 65% had treatment delayed or cancelled either by themselves (23%) or their healthcare provider (42%).

In an IBM blog, Mark Davies, chief medical officer (CMO) Europe, recommends that to emerge stronger from the crisis, the NHS would be advised to embark on full scale digital transformation, aligned with a three-stage strategy to help rebuild operational performance and re-establish full healthcare provision. The three stages are: understanding the impact of the virus, redesigning treatment plans and reinstating access, and rethinking healthcare provision for our ‘next normal’.

Understanding the impact of the virus

According to IBM’s study, 31% of respondents said someone in their household required treatment for non-COVID reasons during lockdown. Only 49% of these were able to get all the care required. 

Yet only 15% of respondents in households which received healthcare were dissatisfied with their experience, suggesting public understanding for the adversity the NHS is facing.

However, Davies believes we cannot rely on such goodwill forever, especially if COVID-19 continues to impact capacity.

“The backlog is significant, to address it requires creative models for mobilising resources, leveraging expertise and insights across teams, and using a combination of some short-term and some more sustained solutions,” he explains.

Well-established processes shown to deliver fast responses include user-centred design methodologies and ‘garage’ style sessions that bring strategy, design and technology together.

Rory Deighton, regional lead North West, NHS Confederation agrees: “Looking forwards, the big question is capacity, how we manage risk and how we recover core NHS services safely.

“Firstly, we have to be really careful that we support staff appropriately. But we also need to recognise that newer hospitals are often easier for infection control, not all hospitals are like that, and recognise that the availability of one-hour turnaround testing capacity will influence how quickly we can recover core diagnostic and elective services.”

Redesigning treatment plans

The crisis has created a unique opportunity to introduce new models of healthcare, redesign treatment plans and evolve how people access services, says Davies.

The data suggests the use of video consultations has been limited, with only 12% of households which received healthcare for non-COVID reasons accessing video services, versus telephone (67%) and in-person consultations (44%).

Video consultations would be preferred by 58% of those surveyed for primary care and 54% for secondary care, either alone or combined with in-person consultations. A majority of 56% care favour a blended model for both primary and secondary care. While 34% prefer consultations to remain in-person only for primary care and 38% for secondary care, with these respondents more likely to be of an older demographic.

Some areas of the NHS have adopted artificial intelligence (AI) powered virtual agents to improve access to advice about COVID-19 for both staff and the general public.

One example is Cwm Taf Morgannwg University Health Board which launched an English and Welsh speaking virtual assistant named CERi to answer questions on prevention and management of the virus.

Meanwhile, London specialist cancer hospital, the Royal Marsden NHS Foundation Trust launched the Maisie virtual agent, to ensure key workers have immediate access to COVID-19 HR related information, hospital updates and workplace guidance.

Rethinking healthcare provision for our ‘next normal’

When asked what changes to healthcare respondents would like to see, 47% chose more flexible 24 hour services, while 37% opted for flexible appointment booking and admissions systems. Better collaboration and communication was important for 32% who wanted more joined-up health and care services and 28% who would like more care delivered in the community through GPs and health centres.

Only 22% requested more access to video consultations, 14% remote diagnostics and 17% more access to support services available remotely at home.

Prof Kiran Patel, CMO and Consultant Cardiologist at University Hospitals Coventry and Warwickshire NHS Trust supports these findings: “There are no good reasons why we can’t explore the opportunity to deliver a 24/7 integrated care model, optimised through real-time data insights. If we can develop these capabilities, we will improve population health management and incentivise better health.”

The NHS must become more personal, participative, integrated and ultimately more digital to achieve this enhanced flexibility and reduce barriers between services, insists Davies.

Embracing technology for an agile NHS and improved outcomes

When respondents were asked to rate their online experience of using websites and apps with companies across six sectors on a scale of 0 to 10, healthcare lagged significantly behind with a mean score of 6.98.

Also, 29% of respondents never use apps or websites for healthcare purposes, suggesting there is work to be done to maximise the potential for tech in the sector.

Healthcare providers will need to work closely with technology suppliers to change perceptions of consumer-facing digital tools according to Davies.

Sarah Wilkinson, CEO of NHS Digital comments: “Individuals are creating more data than ever—smart watches are pretty sophisticated machines. As we deploy solutions like virtual wards for COVID-19 we want, initially, to get patients more comfortable with using devices such as pulse oximeters. Before long, tracking your own health with apps and wearables and commodity medical devices will become as common as using a home thermometer has been for some time.”

Davies concludes that the survey’s findings point to the need for a true digital transformation to create an agile, learning system which equips the UK to both recover from the pandemic and improve future outcomes for patients and the NHS.

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