The NHS is at a pivotal point in its history. For more than 75 years it has provided free, accessible and world-leading healthcare to people across the country, shaping modern medicine, and becoming one of the UK’s most cherished national institutions in the process.

And yet, the 21^st Century has brought enormous change. The evolution of the internet and advent of the smartphone have transformed the way consumers interact with organisations, and each other, and while much of society has embraced this new digital age, the NHS has been slower to adapt.

Talk to anyone – inside or outside the service – and you’ll hear opinions on why. From funding to pandemic backlogs, cultural hurdles to its sheer size (the NHS is the world’s largest single health system, and sixth largest employer); change in such conditions is always going to be challenging. Nevertheless, it’s understandable that people feel frustrated at how slow things are moving, especially when lives are at stake.

BT has been a trusted partner of the NHS since day one and is committed to helping it navigate technology and embrace the potential it brings. I am also passionate about the NHS, having spent more than 20 years in the service, including senior regulator, provider and commissioner roles. It’s this background, and my belief that technology has a major role to play in shaping its future, which led to BT  launching a major research programme last year, speaking to patients, to NHS staff, and now, to leading minds from across healthcare, policy and business, to understand what’s standing in the way of progress, and how we can collectively do something about it.

Our roundtable was co-hosted by Anu Anand, BBC journalist and podcaster, and myself, and attended by Dr. Paul Bhogal (Consultant Interventional Neuroradiologist), Dr. Michael Quinn (Consultant in Nephrology and Acute Medicine), Rachel Murphy (entrepreneur, health tech advisor and public speaker), Dr. Franz Pfister (CEO & Co-Founder of deepc), Bryce Travers (Digital Lead at ImageEast) and Dr. Amrita Kumar (Consultant Radiologist). It was a rich and rewarding debate; here’s what we agreed on.

Barriers to tech transformation

With many pilots in place at any one time, the NHS is no stranger to trialling with technology. We’re working with it today to introduce electronic patient records and AI-powered communication platforms, such as Diagnostics AI Marketplace, Patient Concierge, Smart Messaging, and Heath Cloud, but too often attempts to introduce modern technology hit hurdles. What exactly did the experts point to as standing in the way?

• Lack of incentives for innovation – responsibility for finding, proposing, testing and championing new technology all too often falls on clinical staff, who are already incredibly busy providing care for their patients.
• A fragmented NHS structure – add to this the fragmented and disjointed structure of NHS trusts and you have a world where no single group of people are incentivised to drive technological transformation in the NHS.
• Short-termism – pressure to address growing waiting lists and plug staffing shortfalls are preventing senior NHS leaders from exploring the long-term solutions that could address these problems more sustainably. As trusts across the country grapple with increasing demands for care with current resources, the NHS needs to find time to build an actionable vision for technology that can support staff in their day-to-day roles.
• Patient journeys are not ready to be digitised – improving the way each patient journey is managed is essential to ensure appropriate care is offered throughout. Patients often don’t have access to their own health data, and records are rarely compatible to be shared either externally or within different healthcare units within the NHS (i.e. GP surgeries, hospitals, specialist clinics, etc.) A platform that is interoperable and that contains all patient data, harmonised to support transfers in between healthcare providers, is crucial. 
• Lack of trust in tech – with the recent explosion in the data economy, stories documenting breaches have created an overall sense of fear and distrust in emerging technologies. The successful adoption of new technologies relies on the NHS's ability to prove how patients benefit from these innovations and alleviate concerns about their data being compromised, misused, or sold off to nefarious third parties.

Digital health: Five priorities for this year

Our roundtable revealed incredible examples of how technology can transform the way patients receive care across the UK and improve the NHS’ productivity – from using AI to help detect suspected abnormalities in breast and chest X-rays, to developing pioneering solutions for early detection of stroke-like symptoms that cut down patient journeys in half.

However, none of these innovations can be scaled to help more patients without a true digital revolution in our healthcare system. Indeed, technology can provide solutions to many of the challenges the NHS is currently faced with, however a true culture shift is required to jumpstart the acceleration of digital health. Drawing from experiences working with or within the NHS, our conversation coalesced at a five-point plan to enable positive change.

1.     Build platforms to scale – once a new technology implemented in a trust has proven to enhance patient care, other NHS bodies should be able to access a governance structure that allows them to implement the same framework across multiple trusts. Quick and easy scalability is the key to ensuring successful pilots are implemented regionally, improving outcomes for both patients and the NHS.

2.     Modernise data infrastructure – harmonisation of data is key to ensuring GPs, primary and secondary care providers are aligned on patient journeys, helping reach the right treatment plans faster. Mandated contracts with trusted technology partners would help trusts implement solutions specific to their needs, while also allowing them to organise and share data in a format that encourages interoperability and communication between other trusts.

3.     National leadership, local delivery – there is a real case for moving certain roles responsible for designing governance frameworks for technological adoption to the frontline of the digital revolution. Similarly, implementing and leveraging vanguards across trusts will allow those who have been successful in implementing technological innovations in their trust to share their framework and support adoption across other regions.

4.     Better communication – there is a real opportunity for the NHS to share more about its technology use and how it improves outcomes for staff and patients alike. The NHS does manage incredibly sensitive patient data, so there needs to be safeguards in place to continue building trust that it is kept safe. However, these should not hinder communications or the implementation of technology – why it is necessary, how it works and, most importantly, why it will benefit patients in the long term.

5.     Shift mindsets to move faster – the pandemic showed us how quickly trusts can respond to crisis and enact change. We must reflect on the key learnings and success stories from the NHS’s Covid-19 response and carry on the proactive, can-do attitude that saw many new policies implemented at pace and efficiently, throughout the country.

Implementing change at scale – especially while pushing for a culture change – can be a slow process. We know how important it is for each step of the NHS’s digital transformation to be carefully considered from all angles, to put patients’ best interests at the heart of each decision. Yet as the world heads from one digital revolution to the next, with new technologies like AI unlocking opportunities never before possible, it’s time for the NHS to leapfrog ahead and lean on trusted partners to help build the digital health future the country deserves.

NHS staff have joined a chorus of voices¹ calling for the rapid rollout of digital technology to tackle growing wait times for diagnosis and treatment, as concerns mount around existing targets to reduce hospital waiting lists in England.

According to new research from BT, three quarters (74%) of NHS staff see future investments in tech as a priority. While NHS employees (60%) also believe more funds should be spent on growing the size of the workforce.

Digital diagnostic tools, such as virtual image streaming, and community-based healthcare services, like virtual wards, are already revolutionising access to health services by allowing patients to be diagnosed and treated from the comfort of their home. However, more than half (59%) of the people working in the NHS believe pilots are taking too long to reach widespread adoption, and that this is ultimately holding back patient care.

The vast majority (93%) of NHS staff see speedier access to diagnosis and treatment as either critically or very important for the future of the healthcare system, and 89% feel the same about curtailing wait times for test results specifically. Hospital waiting lists have reached record levels this year, with 7.7 million people waiting for treatment in August², almost double the pre-pandemic number of 4.43 million; while 1.5 million are waiting for a diagnostic test ³.

The benefits of investment in digital tech are clear, with most NHS workers believing further investment would dramatically improve outcomes for both patients and taxpayers. Four in five (81%) NHS staff believe greater use of digital diagnostic tools would cut NHS wait times, a similar proportion (83%) expect them to improve patient outcomes, and 76% say that they would ultimately cut NHS costs.

This positive sentiment is also felt for virtual ward technology, with 76% believing further investment in this space would cut waiting times, while also improving patient outcomes (77%) and cutting costs too (71%).

Commenting on the research, Professor Sultan Mahmud, BT’s Director of Healthcare, said: “At BT we have spent the last few months listening to thousands of people inside and outside the NHS, and the message is clear: ‘embrace digital tech and cut wait times’. Those on the frontline and behind the scenes have told us that investing in digitally-enabled services like diagnostics, care closer to home, and the careful use of AI in areas like diagnostics and NHS back office functions could help improve productivity.

“We have the technology – what we need now is a co-ordinated approach. Government, citizens, NHS leaders and tech providers must work together to focus on the investment in infrastructure and delivery mechanisms that can help the challenged workforce. This is about realising the digital dividend of improved patient experience and reduced administrative burden for our clinicians.”

BT is already collaborating with organisations such as deepc and AXON Diagnostics on new digital services and is also working closely with the NHS through its Vanguard programme and Clinical Advisory Board, to support greater use of responsible AI and digital diagnostic technology across the health service.

Another new innovation is BT’s Patient Concierge tool, in collaboration with messaging specialists, Soprano, which promises to streamline patient communication, reduce time spent by NHS staff arranging appointments for diagnosis and treatment, and cut missed or double-booked appointments through the smart use of AI. BT says the tool being developed, and already being showcased to customers, will offer bespoke patient messaging solutions for the NHS and other healthcare organisations.

BT’s research found that more than half (53%) of NHS staff think AI will have a significant impact on clinical service delivery, most immediately through automated appointment booking and improving the accuracy of diagnosis. Most NHS staff now agree that AI has the potential to cut wait times (63%), improve patient outcomes (65%) and cut the cost of patient care (56%).

Barriers to success

Three quarters (76%) of NHS workers believe that health tech has already improved the standard of healthcare across the UK. So far this has been driven by increased collaboration with colleagues (70%), and improved training (56%), knowledge sharing (52%) and record keeping (48%). However, there is broad consensus that the NHS remains a long way behind other sectors.

Two thirds (72%) of the people using digital tech in the NHS every day think it is being held back by a lack of integration with other legacy technologies, while half (59%) complain about too many pilots that fail to roll out across the NHS. Others (48%) report that seemingly small gripes, such as needing to re-enter passwords at every turn, are causing frustration and ultimately slowing them down.

Training is pivotal

Two thirds (67%) of those working for the NHS say that digital training must be a key focus of investment in the future of the NHS, with 38% saying confidence using emerging technology is key to its success. The same applies to patients; almost three in five (57%) NHS staff acknowledge that the need to cater to all patients in the country, regardless of tech literacy, could be holding innovation back.

Dr Paul Bhogal, Consultant Interventional Neuroradiologist and member of BT’s Clinical Advisory Board, added: “The challenges facing the NHS are considerable, in some cases chronic, and nobody is under the illusion that the solutions will be simple, but clearly technological innovation is a big part of how we are going to succeed.

“We live in exciting times, especially in the world of diagnostics, and organisations like BT are playing an important role in bringing innovative technology to life in NHS trusts. If we want to improve access to healthcare in the UK, while improving patient outcomes, we must find technology that works, and put it in the hands of those that can put it to work.”

The insight into the opinion of NHS staff on technology use follows BT’s research earlier this summer¹, which polled the general public on what they want to see when it comes to digital technology in healthcare. That research found a similar trend, with patients wanting to see technology play a bigger role in the NHS, and two thirds (64%) believing it to be a worthwhile investment.

Notes to editors.

Research conducted by Cadence Marketing, Part of BiP Solutions, on behalf of BT, polling 121 NHS staff between September and October 2023.

¹ Research conducted by Opinium on behalf of BT, polling 2,063 UK adults, weighted to be politically and nationally representative, between the 21st and 23rd June 2023.

² Consultant-led Referral to Treatment Waiting Times Data August 2023-24. https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2023-24/

³ Statistics » Monthly Diagnostic Waiting Times and Activity (england.nhs.uk)