Quietly, often behind the scenes, often at a hospital or practice level, the last eighteen plus months has required one of the world’s largest organisations - the NHS - to undergo one of the largest staff reorganisations ever seen. Clinicians and administration staff have had to up tools and practice different specialisms to their normal day job, in some cases specialisms they haven’t practiced for years, at times in locations miles from where they usually work. Plastic surgeons in North Manchester have become respiratory advisors in Stockport, rota managers have become volunteer coordinators - and within this all, clinicians and staff from vulnerable population segments have had to work in COVID-free, shielded working sites. As a challenge it has been an organisational rubix cube, played out at a local level, all over the country.
As we head into this winter, we are by no means out of the woods. Bed shortages with the added pressure of a particularly aggressive flu season remain a significant danger - not to mention the mental health and physical scarring that pandemic ‘war-time’ requirements on staff have required. However, we can now start to see both where newly implemented technology to tackle some of these challenges has been effective; and where, learning from the needs of crisis staffing, the NHS workforce will require technology support as it continues to shift and adapt.
So what are the shifts transforming the NHS workforce? And where can technology provide assistance? Here are just a few:
Automating administration and compliance
Still far too much of health professionals’ time is spent on paperwork and administration, and not on their primary skill - caring for patients. A recent report from the Royal College of Nursing showed that 54% of nurses believe they spend too much time on non-nursing tasks, contrast to a 2017 survey from healthtech startup, drfocused, which found that up to 30% of a doctors’ time could be spent in administrative tasks.
During the pandemic, clinical staff’s time has never been at a higher premium, and during this period we have seen a rapid increase in an already fast growing-trend towards the use of technology to automate paperwork and optimize time use. Simple examples of these tools have included smart dictation and natural-language processing tools to automate note-taking, to digital communication tools to cut out email and pass notes quickly. Startup Credentially automates the process of onboarding and credentialing medical staff, helping healthcare providers to hire and deploy staff safely at a much faster pace during the rush of the pandemic. In the tangential dental space, tech company Flynotes uses automation and easy-to-navigate interfaces to inform patients on operations & surgeries and gain necessary consent before a patient has even stepped in a clinic - saving hours of staff and clinician time.
Although huge advancements have been made, there is still a massive potential to save medical professionals’ time and energy. Health providers still have little access or ability to gather granular data on health workers’ time. If large time drains are being spent on needless tasks or imperfect systems, most of the time senior management of hospitals will find it hard to know. Note taking, dictation and other tools that aid with compliance in the vast majority of cases aren’t able to integrate with patient records or hospital operating systems, meaning data is often trapped in siloes or may require additional time to copy & paste over. As digital productivity tools become more common place in the NHS, we will also see them move up and out of purely a B2C model - ‘C’ being for clinician in this context - and start to connect the time-saves of individuals to broader productivity benefits for healthcare systems and the leaders and organisations behind them.
Training development and mapping workforce skills
During the pandemic, many hospital senior managers were faced with a new problem. They needed staff with training in treating respiratory conditions, they knew that probability made it very likely that there were clinicians in their organisation that had had training in this area outside of their main specialism (i.e. there might be surgeons who had taken elective courses on respiratory care) - but beyond sending round a general email, they had no means of identifying who these individuals were, what level their training was and whether they could be moved to high priority COVID-19 sites.
Challenges like this - mapping health workforces training or capability - were regular during the pandemic, and highlighted an area where the NHS and public sector as a whole has been slower to adapt than the private sector. Workforce training tools such as Zapiens help large corporations map the skills and training of their corporate to analyse underused capability and to recommend training and career development opportunities to individual workers. If a new pandemic were to emerge that had specific cardiovascular implications, how useful would it be for the CEO and COO of a healthcare Trust to know at the click of a button exactly how many doctors had cardiology training and could be deployed tomorrow?
More broadly, after many years of investing and benefit in increased specialisation of medical expertise, the pandemic and challenges like the ones highlighted above have highlighted that health professionals with multiple or flexible skillsets carry a large premium in moments of crisis. It is possible in years to come we will see a greater emphasis on training to ensure a broader set of skills across clinicians, as well as the use of smart training tools, such as DemDx, or smart diagnostic aides, like Mendelian, to support this trajectory.
Elective Care recovery outside the hospital
Elective care refers to forms of care or health provision that are pre-planned, such as specialist surgery or physiotherapy - and over the last decade elective care has seen a huge increase across the NHS, with outpatient visits rising from 54 million to 94 million from 2009 to 2019. Since the pandemic, many elective care procedures have been postponed, and the result has been unprecedented backlogs and waiting times. The Health Foundation estimates that elective care waiting lists now number 5.6 million individuals, with particularly high disruption for patients living in socioeconomically deprived areas.
As the NHS England’s Elective Care Transformation Programme puts it, the problem of eradicating waiting times in elective care is as simple as getting “the right person, in the right place, first and every time, and get the best possible outcomes” - a problem faced by a huge variety of logistics and consumer businesses globe over. However, in the context of multi-leveled healthcare systems where primary care often has different operating systems and patient record sharing procedures to one another and to secondary and specialist tertiary care providers, the problem quickly becomes a technological maze of communication to get the right information to the right result in a way that doesn’t require duplication and additional paperwork, whilst also keeping the patient well informed.
A small group of technology providers have begun to provide solutions to the elective care problem. PUBLIC portfolio company Cinapsis, for example, has developed a smart referral platform that allows clinicians to quickly and easily communicate with specialists and refer patients whilst integrating with most patient systems and keeping data in one place to allow for additional analysis. Far more, however, is possible, in particular in modelling demand and supply and supporting healthcare bodies to plan provision across regions smarter than ever before.
Clinicians as portfolio professionals
As much as the combination of the pandemic and technology are changing healthcare systems, they are also changing the working lives of individual clinicians. Virtual appointments have become vastly more common, and the ongoing trend towards ‘locum doctors’ - clinicians who work on a temporary or short term basis, often across multiple hospitals - has only increased. For many healthcare professionals, there is now far greater choice as to how and when to care for patients than ever before.
Some startups are leaning into this new form of flexible working style. Companies such as Patchwork and Locum’s Nest provide health providers with locum staff recruitment platforms that also allow clinicians themselves to sign up to and manage all of their work shifts across multiple hospitals in one place. But why stop there? Why can’t a trained clinician work shifts three days a week in different hospitals, deliver care through an online platform like Babylon or Livi for a few hours in the evening, and maybe even then spend a day a week providing specialist advisory services to a consultancy or an academic institution, all whilst then having a three day weekend to spend with friends and family?
Technology can now allow for this form of portfolio career, and the NHS is increasingly seeing allowing greater flexibility as a way to hold onto brilliant staff, rather than lose them. Maybe now there is space for a raft of supportive solutions for a flexible working style, from support in preparing tax and finances, to greater career guidance and training within the medical profession.
Startups with solutions covering areas such as elective care recovery, population health, citizen access and workforce can apply to the AWS Healthcare Accelerator we’re running for AWS Startups. You can find out more and apply here.