Dr Owain Rhys Hughes, founder and CEO, Cinapsis, looks at the role tech can play in any staffing crisis.
The turbulence of 2020 has accelerated the growth in demand for truly flexible working. This is true across all sectors, but none more so than within the NHS, where social-distancing regulations imposed at the height of the pandemic and the need for some consultants to shelter, proved that intelligent remote working is a viable option for medical professionals, too.
The feasibility of allowing GPs, consultants and other medics to work outside of a traditional clinical setting is something which has been previously downplayed by management. Often, inappropriate technology and concerns over confidentiality would be used to quiet calls for change. However, when March and April saw clinicians delivering sophisticated care from afar - from their homes, from different hospitals or even from self-quarantine - received wisdom was turned on its head and exciting new possibilities emerged.
In response to demand, a new generation of tech tools were implemented so that new patterns of operation and collaboration might be tested. Freed from their desks and consulting rooms, doctors were given the opportunity to experiment with new avenues of care delivery. Systems were overhauled and new technologies fast-tracked, transforming the healthcare system as we know it. The NHS must use this as a blueprint for the way it operates going forward. Both patients and clinicians stand to gain from a more flexible approach.
In primary care, video calling and instant messaging from mobile and desktop apps have allowed GPs to not only offer remote consultations, but seek advice and guidance from secondary care colleagues. Rather than direct patients down a circuitous referrals pathway, photo sharing technology and direct online access to specialists are helping primary care practitioners get patients to the service they need, first time around.
These new efficiencies have proved invaluable for GPs struggling with burgeoning workloads and ever-increasing incidences of burnout. In an August BMA survey, 53% of GP respondents reported currently experiencing a work-related mental health problem including anxiety, stress, depression or emotional distress. This calls into question the likelihood of the government achieving its target of 50 million extra appointments each year. However, by allowing GPs to access expert advice more easily from a network of responsive consultants, their time can be more efficiently managed and their mental health protected.
For hospital consultants too, 2020 has offered an opportunity to take back control, and enjoy a taste of a tech-enabled flexible career. Using secure apps, consultants have been able to ‘see’ patients outside of their usual clinic times, and then easily communicate with colleagues to secure the best outcome for the patient. These same doctors were given the chance to share their expertise in non-traditional ways: either on the phone to a concerned GP in the midst of a patient consultation, via video call to a paramedic wondering whether to bring a COVID patient to A&E, or by instant message to a junior colleague on a ward round.
Giving consultants greater autonomy over their working hours, location and method of knowledge sharing is incredibly important for NHS retention and recruitment figures. If Britain’s largest employer wants to remain attractive to top medical talent, it needs to listen carefully to what the present and incoming generations of doctors want. For example, just as is currently the case across numerous professions, medics want the opportunity to pursue portfolio careers - blending different roles with ongoing education, personal projects and family commitments. With some smart leveraging of the same tech tools which have come of age during the pandemic - and the help of new ones such as the new Integrated Clinical Advice Network - blended career opportunities can be made possible for consultants, and their expertise retained for the benefit of NHS patients.
New collaboration tools are not only important for doctor retention. The digital first approach enables knowledge sharing and communication across the different arms of the NHS, simultaneously shortening waiting lists and treatment backlogs. Ultimately, these outcomes will conserve the financial and physical resources which are in permanently short supply within the NHS.
Now is the moment for the NHS to enthusiastically action the promises it laid out in its 2020 People Plan: to make flexible working a norm and pursue the best technologies to support our new reality. Rather than forcing doctors into one-size-fits-all career frameworks with an emphasis on full-time hospital presence, we need to reimagine how their expertise can be most effectively disseminated across boundaries. It’s time to let tailor-made working replace off-the-peg jobs in our health service, for the benefit of both patients and clinicians alike.
