Rising demand for services, constrained funding and a multitude of workforce challenges require us to think differently about the way we deliver health and care services to meet people’s needs and expectations.

This publication explores how digital tools are a key part of the answer to this set of challenges, and demonstrates how technology has the potential to revolutionise the way health and care is delivered.

In light of the national policy emphasis on enabling supported self-care and the shift towards out of hospital service provision, it is more important than ever before for health and care services to provide tools and information to support people and communities to have greater control over their own health and wellbeing. At the same time, technological opportunities can enable the health and care workforce to work differently, and in ways that are better for patients.

As the case studies in this publication demonstrate, the opportunities to make use of technology in health and care services are wide and varied: from the use of apps, devices and telemedicine, to integrating IT systems across multiple organisations.

In particular, the developments in smart phone technology offer an unprecedented opportunity to provide immediate information and support to people, wherever and whenever they need it. As a result, the market for medical and health care apps is rapidly expanding. A 2015 review found there were over 165,000 health care apps available through the two main operating systems for mobile devices. Devices and ‘wearables’ are also becoming increasingly common, collecting sensory information, such as heart rate, blood pressure and steps taken, on a real-time basis. Similarly, advances in telemedicine and telehealth are facilitating major changes in the delivery of care, including the provision of remote consultations and enhancing communication between clinicians.

A 2017 evidence review of technology-enabled care services identified a wide range of potential benefits across a number of conditions, including:

  • telemonitoring can help lower blood pressure for people living with hypertension, while in the care of COPD patients it can support a reduction in the use of healthcare services 
  • text message interventions can have beneficial effects on HbA1C and glycaemic control in diabetes care, and can increase the reach of, and access to, substance misuse interventions
  • the use of video consultations for short term support and counselling can be effective in treating mental illness.

The Forward view published in October 2014, and supported by The personalised health and care 2020 strategy, outlined ambitious plans to deliver a step-change in how health and care services use technology. This was followed by a report from the National Advisory Group on Health Information Technology in England which argued that the NHS would be unable to reach its goals without digitising effectively, and put forward principles for delivering a fully digitised NHS.

These ambitions recognise that the national health and care bodies play an important role in supporting technological innovation, particularly in ensuring interoperability - the ability of IT systems and software applications used in health and care services to communicate, exchange and interpret data, and work together. As the health and care system increasingly moves towards planning and delivering services at whole systems level, this will be ever more important. The Forward view committed to a national focus on the key systems that provide the ‘electronic glue’ which enables different parts of the health care system to work together to harness new technologies. Meanwhile, other systems are for local NHS organisations to decide upon and procure, provided they meet nationally specified interoperability and data standards.

As technological advances in healthcare gather pace it is important to consider the potential consequences of these changes. Some members of the public have legitimate concerns about data privacy and how their personal information will be stored, used and shared. They also want to be confident that they are receiving trustworthy and reliable information and advice. The NHS Digital apps library has been developed in recognition of the need to signpost people to products that have been built on a solid evidence base.

In isolation, small-scale technology projects will not bring about the fundamental shift envisioned in the Forward view. But combining technologies with new ways of working has the potential to transform the way services are delivered. The main focus of this report is technology-enabled care solutions, but the examples also highlight how health and care services can make use of data to understand and predict the health needs and health care utilisation of whole populations, and improve quality and efficiency.

The vanguards and harnessing technology 

As part of the new care models programme, a number of vanguards are focused on implementing digital solutions at the heart of a new approach to care. This publication looks at how five of the vanguards are harnessing technology. They are:

  • East and North Hertfordshire
  • Better Care Together Morecambe Bay
  • Salford Together
  • Better Together Mid Nottinghamshire
  • East Midlands Radiology Consortium (EMRAD)

These five examples represent a small selection of digital projects from the vanguards and are not representative of the variety of work taking place across the country. However, the emerging evidence from these vanguards suggests that technology can support people to take greater control over their own health and care, and enable the more efficient and effective delivery of services. Their experiences demonstrate that the key to the successful introduction of technology is to start from the perspective of the patients and clinicians who will be using it. The examples in this report shine a spotlight on how collaborative approaches, which bring together people who use services, clinicians, and organisations that commission and deliver services, can lead to the development of creative models of care and solutions to challenges.

We hope these case studies will be a valuable resource for others who are working with partners in their local areas to harness technology to deliver transformational and lasting change.