I have been a GP for 30 years, but I’ve been involved with the NHS even longer, because I grew up in a GP household – my father was a GP and, after my training, I went to help him with his practice in Birmingham.
Over time, we started working with more practices so we could share our growing workload and offer more services to patients; and that drew me into healthcare commissioning.
I became heavily involved with the local clinical commissioning group, which went on to merge with three other CCGs to become the biggest in the country.
Birmingham and Solihull NHS CCG covered 1.3 million people and had a £2.4m budget.
Eventually, I was elected chairman and I oversaw this large organisation for three years – and then COVID-19 arrived!
A new way of working
The early days of the pandemic were scary and difficult, and it was obvious that GPs and their teams were going to need to work from home, but it wasn’t possible to procure enough laptops to enable them to do that.
I thought most GPs would own a computer, so I contacted BT to see if we could set up a secure connection to let them run their practice systems from home.
The early days of the pandemic were scary and difficult, and it was obvious that GPs and their teams were going to need to work from home, but it wasn’t possible to procure enough laptops to enable them to do that
BT put me in touch with one of its security experts and he said that while my idea would work, it would be better to create a virtual solution in the cloud.
So, we worked with BT, Microsoft, and NHS Digital to create something to enable GPs to use their desktop in their surgery, as if they were there.
Versions of this are used every day in primary care still… and I couldn’t work without it!
We also needed to think about how we could provide face-to-face care in new ways that made the best use of the very-limited PPE that was available, so we set up red sites to treat people with COVID-19, and amber and green sites for other conditions.
I was also involved in the creation of a COVID assessment site alongside the Birmingham Nightingale Unit.
In the early days of the pandemic, we looked at the case numbers in Italy and Spain and we carried out modelling that suggested the peak of COVID infections might overwhelm local acute services and leave people without the care they needed.
To prevent that, we created a drive-through triage centre on a car park at the National Exhibition Centre (NEC).
We created software to log people in and out and developed safe methods to assess patients, establishing links with hospital colleagues so they could provide support.
It was the largest drive-through healthcare facility in Europe and, as COVID progressed, it was clear that although the peak of infection numbers matched our initial modelling, many patients with other conditions were not coming forward and the health system had capacity to cope.
If you are thinking about new models of care within finite stretched resources, you must start thinking about the role of digital technology and how you can use it to help patients move through the system safely and as efficiently and effectively as possible
We diversified the use of the unit, offering GP appointments, childhood vaccinations, COVID testing, and hospital outpatient appointments.
In total, over 18,000 patients were cared for at the unit and this extraordinary time allowed us to test drive-through methodologies for delivering healthcare.
Our GP Out of Hours provider is still providing care via a drive through facility to this day.
The fact that patients with other conditions didn’t come forward during the crisis is one of the reasons that the NHS has such a big backlog today.
And, to cope with that pent-up demand, it needs to change and to do things differently.
If you are thinking about new models of care within finite stretched resources, you must start thinking about the role of digital technology and how you can use it to help patients move through the system safely and as efficiently and effectively as possible.
That is why I joined the BT Clinical Advisory Board.
I met Professor Sultan Mahmud when I was chair of the CCG. We stayed in touch, and when he moved to BT as director of healthcare, we discussed the importance of clinical input.
BT is a leading telecoms and technology company and a trusted partner to the NHS, both as a supplier and a provider of networks and technology.
We can all track parcels from China these days, but clinicians can’t track their patients through the system, and patients can’t track what is happening to their care
Often healthcare relies on old methods of communication, but BT has the tools and expertise to support the NHS and other healthcare organisations to digitise their operations.
Could we improve the journey for patients by better informing them?
I often say that we can all track parcels from China these days, but clinicians can’t track their patients through the system, and patients can’t track what is happening to their care.
For 6-7 million people sitting on NHS waiting lists could BT assist the NHS by offering different ways of communicating with them?
BT has extensive abilities in smart messaging and I believe this technology can help create a dialogue with large numbers of patients.
The power of technology
In my mind everyone would win here, patients would be better informed, hospitals would be able to prioritise care and understand the true position of their backlog, and GPs would gain as fewer patients would be booking appointments just to discuss their position in the waiting list.
BT is a communications company, and I believe that modern communications technology could really help here.
I’m also very interested in AI.
I think there is a huge opportunity to create digital front doors to the NHS that use algorithms and decision support tools to direct patients to the right part of the system.
Too much of our efforts are currently spent in healthcare systems that are difficult for patients to navigate and duplicate care.
And intelligent signposting could assist here.
I think there is a huge opportunity to create digital front doors to the NHS that use algorithms and decision support tools to direct patients to the right part of the system
My own area, primary care, could benefit immensely if some patients were intelligently directed to other parts of the healthcare team, leaving GPs to concentrate on what they do best, offering a holistic and nuanced care.
That, in turn, might help to alleviate some of the pressure that we are seeing on other parts of the system.
In the future as AI develops, it could perhaps take on some of the gatekeeping role that is currently performed by primary care.
It’s not 1948, any more…
The NHS is now more than 70 years old. It has evolved over its lifetime, but there is more digital transformation required to create a better-integrated system, with patients passing seamlessly along care pathways and using technology to facilitate those journeys.
Central to this transformation would be using communications tools to inform and assist patients.
As part of my role on the clinical advisory board I want to work with BT and those vanguard health and care organisations that are determined to move us closer to that model and to delivering on the aspirations that we all have for more-efficient, better-quality, and more-personalised patient care.