Tara Donnelly used to work at a national level in the NHS, including as Chief Digital Officer for NHS X/NHS England. She now leads a consultancy called Digital Care, which works with NHS organisations and health innovators to embed new technologies and ways of working in the NHS.
Recent advances in generative AI have been described as both a risk and a massive opportunity for the NHS. Which do you think is right?
I think there is more opportunity than risk. We can’t have a ‘head in the sand’ attitude towards AI and think this might not happen. Rather, we should be thinking about how we can use the potential of AI for good.
For example, the use of generative AI, and particularly large language models (LLMs), could enable the development of clinical co-pilots that can help clinicians safely manage much larger groups of patients when remote monitoring. This could be transformational, and it's probably not that far off.
Another interesting way AI could help is in effective self-management – particularly for people with long-term conditions. This type of technology could ensure that feedback given to people is more personalised and thereby more motivational, so that people feel in control of their long-term condition rather than the other way around.
Beyond that, this kind of technology can help us develop new drugs faster, write code for future systems, and transform the back office of the NHS. This will speed up processes, reduce costs, and make everything more sustainable.
And then there are AI transcription tools, or ‘digital scribes’, that free clinical staff from the burden of endlessly documenting what they're doing. These could really help change things like burnout and workload issues for clinical staff.
What do you see as the biggest challenges facing the NHS when it comes to digital transformation?
In their survey of 7,100 representative members of the public, the Health Foundation found that 78% would be happy to monitor their own health at home using technology instead of in a hospital. For those aged 65 and over, this rose to 85%. This older generation believed even more strongly than all the age groups put together that they’d be happy to be treated out of hospital, which I think is fascinating.
So it seems we have a public appetite, fuelled in part by the pandemic, where people started using digital tools in new ways, as well as developing a rightful fear of hospitals. At the same time the cost of technology has dropped, and the quality has increased. It means now is a great time to act.
And while there are challenges in implementing digital technologies, I think these are nothing compared to the size of the challenges they're solving.
Digital transformation is something that patients want. In fact, I don't see this as a digital transformation; I see it as a service transformation. I think we're talking about new models of clinical care where the change is supported by digital tools.
What can the NHS learn from past attempts to make digital transformation happen?
We need to help some leaders understand that not all digital technologies cost millions of pounds and take many years to implement. They’re not all going to be on the same scale as the big electronic patient record projects. The kinds of digital innovations I’m talking about are easier, lower risk, and cheaper.
People who have successfully practised in a certain way for 10 or 20 years are going to be sceptical about new methods and want to see the evidence. But when they see it work for themselves, they become the best converts.
How do you think the tech revolution will change the role and experience of patients?
Four years ago, there would only have been a handful of people receiving hospital level care at home. This morning, around 6,000 people woke up in their own bed across the NHS in England. Not in a hospital bed, but still getting medical supervision. These ‘virtual wards’ provide a new way to scale.
One of the best things about being involved in this work is that every week you get amazing feedback from patients. Most recently, a lady in her 90s called Edna told me, ‘I just recover better with a cup of tea and being at home.’ In many ways this is something that patients are ahead of the NHS on.
The proactive nature of the new tools being developed is also great. It’s not a one-size-fits-all approach; people are different. And these tools can be used to look after the whole person. For example, if you have COPD or heart failure, technology can be used to check all your vital signs and monitor your overall wellness. That’s great when dealing with comorbidities. There's no point in siloing people's health care.
What role do different stakeholders across the health and care system need to play to support the implementation of health care technology and innovation more broadly?
There are several important roles stakeholders can play on this journey. This includes inspiring people to be bolder in their commitment and painting a positive picture of the future.
We need to raise awareness, with NHS staff and the wider population, so that everyone knows we're on this journey. For example, I think the Sepsis Trust has done so well in getting sepsis stories into TV programming, hugely increasing awareness. I’d love to see a major character in a soap receive care in a virtual hospital!
Ideally, the first time someone’s asked about digital homecare shouldn’t be the first time they've ever heard of it.
What will it take for technology to finally fulfil its potential within the NHS?
We need to make bold moves. We should keep going at pace because it is great for the NHS to be leading in a digital arena.
Now that we have started to put the basic architecture in place, let's put our energy into thinking about how we can maximise the potential of technology within health care, just in the same way that we do with technology in our personal lives.
This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.
Photo credit: Emile Holba