The past, present and future of innovation in hospital and secondary care

By Michael Folan, 6 July 2018

 

Michael Folan in open neck shirt standing in front of city centre river

I’m a physiotherapist by background and I come from a family of NHS workers – my mum was a nurse, my wife is a physio and my sister-in-law is an occupational therapist. Family conversations subsequently often revolve around various aspects of the NHS.

As a clinician working in NHS Digital, our work and the impact on the frontline is different to our work in clinical practice but in many ways just as rewarding.

I see my role, and that of the clinicians that I work with, as developing tools, digital and data capabilities, frameworks and networks within which we can facilitate best practice and ultimately support the health and care system deliver care now and in the future.

Looking back to the start of the NHS, there have clearly been a significant number of innovations over the last 70 years. The hospital care delivered in the 1950s is very different to today.

In the field of surgery for example, developments such as transplant surgery has changed the lives of thousands. IVF has made a difference to families up and down the country.

But for me, the top innovation in hospital care over the past 70 years has been diagnostic imaging. CT scanning and MRI scanning have ultimately transformed pathways of care, both for surgery and non-surgical, delivering enhanced diagnostic capability and better clinical outcomes for patients through informed decision making.

Currently the innovation making a big impact in acute and secondary care is decision support capabilities where clinicians are provided with timely knowledge and information about their patients. These are delivering significant improvements in patient safety and clinical outcomes in relation to conditions like sepsis, acute kidney injury and frailty.

Within the Global Digital Exemplars (GDEs which are NHS trusts delivering exceptional care through the use of digital technology) and  some of the other trusts we are seeing far greater digital capabilities such as electronic prescribing, recording clinical observations electronically and the creation of early warning scores.

Looking to the future is difficult, but I think hospital and secondary care will be very different in 30 years’ time.

We’re already seeing a trend towards delivering more care in the community and closer to home and I suggest that will continue.

There is a drive towards increasing specialisation within secondary care for areas like neurology, cardiology, etc, and that trend is likely to increase.

This will have implications on workforce development and technology where we will see more specialist staff seeing patients with increasing complex and chronic conditions.

We will see more specialist centres using new diagnostic capabilities, such as genomics, artificial intelligence and machine learning.

We can all probably recognise some of our work as being key enablers for that transformation. I am looking forward to seeing how new developments in technology is going to continue to drive our work as clinicians and bring about better outcomes for all our patients over the decades to come.