The tech that frees up clinicians, and what they do with that extra time

With the NHS facing rising demand and persistent workforce shortages, there are widespread hopes that technology and artificial intelligence (AI) can help alleviate the pressure by freeing up staff to spend more time on patient care. Most recently, this was evident in the Spring Budget’s eye-catching announcement of £3.4bn for technology to boost NHS productivity.

Are these hopes plausible? Over the past year, the Health Foundation has been exploring this question. With debates about health tech often dominated by policymakers, commentators and industry voices, we decided to ask clinical staff what they think, working with eight professional bodies to survey over 500 clinicians and interview experts on the use of AI and technology in health care.

Which technologies did staff say are saving them most time? 

While cutting-edge clinical technologies often steal the headlines, our survey found technologies to support administrative work (most prominently, electronic health records (EHRs) and inter-professional communication (such as videoconferencing and digital messaging tools) were perceived to be making the biggest difference right now. 

Along with clinical documentation tools and software for analysing images and test results, EHRs were also picked as one of the technologies with the greatest potential to save time within the next 5 years. This clearly indicates scope for further optimisation. As coverage of EHRs approaches 100% of trusts, there’s growing need for a renewed strategy to ensure the NHS is reaping the benefits from them. Improvements to functionality, interoperability and user experience could all make a difference.

The example of EHRs highlights a broader point: time savings come not from just having a technology but from how effectively it is implemented and used. The clinical staff we surveyed told us the biggest hurdles they face in using technologies include a lack of IT support, a lack of funding to support implementation, and poor connectivity. These kinds of barriers must be addressed. Often, relatively modest amounts of implementation support can make a significant difference in realising the benefits of new technologies. So it’s important that government funds ‘the change’, not just ‘the tech’.

There’s another fundamental challenge. Even if technology does free up time, productivity benefits will only emerge if that freed-up time is used effectively – something often assumed but by no means guaranteed. (It is rarely researched either: a recent evidence scan commissioned by the Health Foundation found that fewer than 1% of papers looking at the impact of technology on staff time in health care actually considered how freed-up time was subsequently used.)

How might staff use freed-up time? 

The assumption underlying much policymaking is that time freed up by technology will automatically translate into equivalent amounts of additional time for patient care, driving greater ‘throughput’. Our results caution against this: when we asked clinical staff how they would likely use time freed up by technology, our survey respondents allocated 27% of it to patient care or direct clinical activity. It should also be recognised that allocating more time to patient care could mean longer consultations rather than just increased throughput; expert clinicians we spoke to as part of our research highlighted the potential for using additional time to improve the quality of patient encounters, including a greater emphasis on personalisation and prevention.

This 27% figure, drawn from a hypothetical survey scenario, shouldn’t be taken as a general rule or upper limit on the extent to which time released by technology can be used for patient care. In practice, that will depend on how change is planned and managed in partnership with staff. But it does highlight the need for realistic assumptions in modelling the benefits of time-saving technologies.

In addition to reducing overtime and doing admin, other uses of freed-up time indicated by our survey respondents included wider professional activities such as training and quality improvement – findings also reinforced by our expert interviews. Crucially, these kinds of professional activities are not only highly valuable in their own right and critical for delivering high-quality patient care, but they can also contribute indirectly to improving productivity – for example, through boosting skills, streamlining services and improving staff wellbeing and retention. 

To navigate this agenda, it will therefore be important for policymakers and planners to adopt a broad view of how time freed up by technology can improve productivity. And given that realising the potential gains from technology will require buy-in from across the NHS workforce, there is a crucial opportunity here for leaders and employers to make a compelling ‘offer’ to staff: that in addition to increasing care volumes, a proportion of freed-up time could be used for activities such as training, research or supporting staff wellbeing. Activities like these not only benefit productivity but can also make an important contribution to job quality and satisfaction. 

This kind of approach would help the health service harness the potential that technologies offer while helping to build the consensus and coalition for change with staff that is so urgently needed if the NHS is to improve productivity and truly transform how care is provided. 

This blog was originally published in Health Service Journal (HSJ) on 21 May 2024.