Written evidence submitted by the Royal College of Physicians and Surgeons of Glasgow (DHS0014)

The College received a request for a submission on 12th October with a deadline of 2 November2022. In view of the complexity of the document there is not enough time for our usual practice to obtain written reviews from experts in the field. This is unfortunate. We have therefore submitted general statements which the College believes should be taken into account by the panel.

Care of patients and service users

1. Our aim is that, by 2024, 75% of adults will have registered for the NHS App with 68% (over 30 million people) having done so by March 2023.

We consider this is an ambitious programme and we are wary that the roll-out has not taken note of feedback from users of the systems. The system is far from user-friendly for the novice and is repetitive. It is not necessarily intuitive.

2. By increasing digital connection and providing more personalised care, we can support people to monitor and better manage their long-term health conditions in their own homes, enabling them to live well and independently for longer. 

While this may be an idealistic view, it should be remembered that those who have health inequalities are less likely to use technology. This is applicable to many who have protected characteristics such as elderly and disabled people, those from ethnic minorities especially if their first language is not English or unable to read and those who are homeless or in custodial care. There is an assumption that all the population has the ability to access technology. This is not the case because of geographical location, poor internet or mobile signal or simply lack of understanding and availability of the technology. Thus, those in most need may not be able to access the system. There may be a false sense of security as those who are in least need may be the first to take up the technology.

Recent experience for individuals who need Covid boosters or Influenza immunisation has shown that widespread use of text messages and emails do not always reach the vulnerable individuals who have most to gain.

3. Roll out integrated health and care records to all people, providing a functionally single health and care record that people, their carers and care teams can all safely access, enabled by a combination of nationally held summary data and links to locally held records, including shared care records.

This depends on good access to technology geographically. An assumption is made that there is always access to the internet and Mobile signal which is not the case. In recent times when power has gone down there is no access to either of the systems. No alterative back-up systems are available.

All access should be line with Data Protection Safeguards for all but particularly vulnerable people of all ages

The health of the population

4. Through the Data for Research and Development programme we will invest up to £200 million to transform access to and linkage of NHS health and genomic data sets for data-driven innovation and inclusive clinical trials, whose results will be critical to ensuring public confidence in data access for research and innovation purposes.

It is not known what the current situation is. However, the general public continues to raise concerns about the use of data for commercial purposes without an individual’s permission.  Previous actions by the DHSC have been such that the public have a mistrust in this area. While research in this area is commendable and vital, there is need to gain people’s trust.

5. NHS Digital will develop and implement a mechanism to de-identify data on collection from GP practices by September 2019

This remains an area of considerable public and professional worry. To our knowledge there has been no statement by the Information Commissioner in this area. Most general practices do not have an individual who is aware of how personal information is processed yet it is statutory duty.

Cost and efficiency of care

6. We will streamline contracting methods both to leverage NHS buying power and simplify the process of selling technology to NHS buyers (ongoing).
7.  We will consolidate routes to market and strengthen our commercial levers for adopting standards through a new target operating model for procurement. This will include embedding standards as part of procurement frameworks, supporting NHS procurement teams to prioritise adherence to standards. Consolidation of the number of frameworks will encourage market entry and more choice in some markets, incentivising vendors to follow NHS standards.

This is not within our expertise

Workforce literacy and the digital workforce

8. We will co-create a national digital workforce strategy with the health and care system setting out a framework for bridging the skills gap and making the NHS an attractive place to work.

While commendable, the NHS lacks a coherent workforce strategy overall as well as this specific area. The NHS has considerable issues understanding the needs and wellbeing of its staff generally. There are issues in recruitment and retention of staff.

9. We will enable recruitment retention and growth of the digital, data, technology workforce to meet challenging projected health and care demand by 2030 through graduates, apprentices and experienced hires creating posts for an additional 10,500 full-time staff.

As above

The College has continuing worries over the delivery of digital transformation of the NHS. The NHS needs to learn from its Covid experience and develop strategies which reach all individuals. There is a need for back-up systems when technology fails

Dr Richard Hull RCP Glasgow

Honorary Secretary

Fraser Paterson

PR and Public Affairs Manager

Royal College of Physicians and Surgeons of Glasgow
 

19 October 2022

Nov 2022