Labour’s plan to future-proof the NHS with a greater reliance on technology risks leaving elderly and vulnerable patients isolated and unable to access care, experts have warned.
Millions of older people across the country will need support within their communities to become “digitally savvy” under the Government’s shake-up of the health service, the head of Age UK told i.
Ministers have launched a consultation on the future of the NHS, promising to put patients and staff at the heart of its forthcoming 10-year health plan.
The plan, to be published in 2025, will ensure greater use of data and technology to help speed up diagnosis and treatment and make accessing patient records easier across all NHS settings. Sir Keir Starmer said that the transformation would be a “moment in our history”.
“We need to go from analogue to digital; we need to use much better technology – whether that is in the ambulance service, in our hospitals, in our neighbourhoods – making much more use of technology,” the Prime Minister said.
One of the ideas favoured by Health Secretary Wes Streeting is to roll out smartwatches to more members of the public in a bid to tackle debilitating conditions such as heart disease and diabetes. The devices would allow people to monitor their blood pressure and glucose levels and be warned about spikes before their health took a turn for the worse.
Helen Kirrane, head of policy and campaigns at Diabetes UK, said: “For some people with diabetes, technology like continuous glucose monitors are a really essential part of how they manage their condition. Increasing access to this kind of tech, so everyone eligible can access it, is a priority.
“There is also great potential in integrating data from wearable tech into NHS systems, as it can be used to help improve the quality of appointments and create a fuller picture of someone’s health. This should be done in a way that is consistent and respects the privacy of people’s data.”
However, one NHS tech expert questioned how the rollout would work in practice, pointing out there are around 4 million diabetics in England alone.
“How on earth is the NHS supposed to keep track of smart watches when it can’t keep track of blood pressure monitors? I think we’ll see a load being sold on eBay and other resale websites. The whole system needs to change for any of this to work.”
Caroline Abrahams, charity director at Age UK, said new technology must be easy to use to take into account the millions of older people in the country who are not “digitally savvy”.
She told i: “It is widely agreed by experts that technology has huge potential to improve healthcare and it’s important that we extract the best from it to benefit everyone, including our growing older population. Many older people are either not digitally savvy or not online at all, so that must be taken fully into account.
“This need not mean they are left out, provided the technology that is adopted within healthcare is easy to access and use, and support is always at hand. Much more investment is also required in community programmes that help older people get online. We can’t have it both ways: if greater use of technology is to be central to the future of healthcare, we have to enable people of all ages to develop the skills and confidence to exploit it.
“In addition, we must also accept that some people, at some times in their lives, will not be able to use even the best-designed health technology, so alternative approaches should always be available.”
In her Budget next week, Chancellor Rachel Reeves is expected to set out a range of tough tax and spending decisions as she seeks to plug a £22bn “black hole” in the country’s finances – largely in order to help restore the NHS.
The NHS in England is expected to receive an above-inflation increase of up to four per cent for the next financial year.
Under the Barnett Formula – which calculates devolved budgets based on increases or decreases in comparable spending per person in England – the health service in the rest of the UK can also expect a boost to their finances.
This is expected to result in billions more being announced for the NHS, but there are concerns that much of the money could be swallowed up by pay rather than genuinely transforming services.
If this happens, the Government’s promise to upgrade technology and boost prevention could fall flat.
Toby Watt, an economist at the Health Foundation, told i that the NHS capital budget being raided to fund day-to-day spending was “something we’ve seen before”.
“If you’re running a hospital, if budgets are tight and you have a service to deliver, that’s where you focus it,” he said. “This was particularly clear during the austerity years of the 2010s.
“When the budgets aren’t big enough, the first thing to go is the capital budget.”
Mr Watt added: “In reality, the only way to deal with it is to make sure there is enough money in the resource budget and, over and above, invest in capital and prevention. It’s very difficult to see how you can choose between one or the other and maintain a resilient and effective health service.”
If Reeves was able to give the NHS a four per cent real-terms annual increase then this might be enough “to keep pace with growth in underlying demand and free up some money for some capital expansion”, Mr Watt said, but he pointed out that even before transforming NHS facilities the service had a £14bn maintenance backlog to deal with.
Launching the consultation on Monday, Mr Streeting said NHS care could be a “death sentence” for some patients and that the health service was going through the “worst crisis in its history”.
He urged NHS staff and patients to take part in the “national conversation” by sharing their views online via change.nhs.uk until the start of next year. “We feel really strongly that the best ideas aren’t going to come from politicians in Whitehall,” Mr Streeting said.
“They’re going to come from staff working right across the country and, crucially, patients, because our experiences as patients are also really important to understanding what the future of the NHS needs to be and what it could be with the right ideas.”
A “maximum BMI for nurses”, “firing Wes Streeting out of a cannon” and an “NHS TV channel” were just some of the hundreds of suggestions put forward by Monday afternoon.
Jeremy Neuberger, who shared his view online, suggested fining people for missing appointments. “We get fined in this country for speeding, parking incorrectly, not paying for public transport and a host of other things,” he said.
“Not showing up to NHS appointments stretches the system and directly affects other people’s health. It’s worse than speeding, poor parking, or not returning library books. A fining system should definitely be in place. It’s great to offer a free service, but its abuse shouldn’t be tolerated.”
Care Minister Stephen Kinnock insisted the Government had “no plans” to introduce fines for missed NHS appointments, despite claims Mr Streeting was tabling the idea. He said that trials including texts to remind patients and allow them to cancel over message had reduced no-shows by 35 per cent.
Making doctors work in the NHS for at least five years or pay for any training they have received, turning the temperature down 1 degree in wards, and “play videos of Theresa May dancing in all A&E departments” were among other suggestions.
Asked about the public submissions on the NHS Change online platform, the Prime Minister’s official spokesman said: “I’m definitely not going to provide some sort of daily running commentary on the consultation responses.”
The spokesman said of the platform in general: “This is the point of having a national conversation about the NHS, inviting the whole country to share their views and experiences, hearing from people who rely on the NHS every day, but also hearing from the NHS staff who work so hard, day in, day out.”
New laws are set to be introduced to make patient records available across all NHS hospitals, GP surgeries and ambulance services in England.
Plans for a “single patient record” have been unveiled, which will summarise all of a patient’s health information, test results and letters in the NHS app, the Department of Health and Social Care said. But concerns have been raised about privacy and data protection.
Asked about security guarantees, Mr Kinnock said: “We’re bringing forward primary legislation, which will give you that cast-iron guarantee that all of the security protocols will be in place. If you constantly just say, ‘We can’t do this because of data protection concerns’, you’re just going to have the status quo going on and on and on.”
The Government’s plans are “no different to online banking apps” and “definitely more NatWest than it is Star Trek”, he said.
“In the end, if we don’t modernise the NHS, make it more efficient and productive, you can have the best data protection rules in the world, but you’re not going to have a health and care system that actually works.”
Mr Kinnock also made it clear the digital system is another option and does not mean people won’t be able to use telephones or the systems they are currently using but that everyone will benefit from a single patient record.
He said: “You’ve got to have the opportunity for people to engage on the telephone and to use the systems that they are currently using. What we need to do is maximise take up in terms of creating a single patient record, for example. So we’ve got the NHS app, but it’s nowhere near its full functionality.
“So the interface between GPS and hospital, between patients, GPs and hospitals is actually working. So people don’t have to repeat themselves every time they go to an appointment.
“I don’t think anybody who may well be very attached to the current more analogue system would want to have a system where you’ve got to go and repeat yourself every time you go and talk to your GP.
“So these are common sense changes that are actually going to bring our health and care system into the 21st century and make it fit for the future.”
A spokesperson for patient privacy campaign group medConfidential said: “Patients should know how data about them is accessed and used, and their choices to opt out of such uses should be respected not removed. Government may end up sacrificing NHS patients on the altar of economic growth.”
Downing Street said that individuals’ information would be protected by “robust” safeguards from exploitation by private companies.
Asked about concerns over patient data, the Prime Minister’s official spokesman said: “The Data Bill will ensure strong security protocols. It will introduce strong security protocols to protect data, and all NHS organisations have got strong governance arrangements in place.
“What this Data Bill will also do is transform patient experience and that is obviously putting patients at the heart of our reforms to the NHS.”
Pressed about suggestions that commercial interests would want to exploit this data, No 10 said: “It absolutely is the case that, as well as transforming patient experience and reducing the burden on staff, there is an opportunity to drive up productivity, harness the opportunities available for research and game-changing innovations by using the insight available from large health datasets.
“But to be clear, no life science firms or researchers outside the NHS would ever have access to an individual’s patient record, any data shared for research would not only be anonymised and comply with security protocols, but would also have to pass robust ethics principles and governance panels to ensure patient safety and privacy.”
