Daniel Hallen, Regional Head of Digital Technology, Digital Urgent & Emergency Care Lead (North West), has one of the most complex jobs in UK healthcare. As the NHS faces huge demand under unprecedented conditions, Hallen has overseen the development of a capsule digital-first strategy covering the North West of England, which the NHS is now rolling out nationally.
Working with an interconnected team linking neighbouring regions in the North West, the system provides a conduit for a major digital transformation programme, tailored to differing local needs.
Each area presents different challenges for the same systems – what’s appropriate in low-density rural Cumbria won't work in high demand city centre hospitals with specialist wards in Manchester or Liverpool.
Hallen says he's proud of the legacy the North West has in terms of digital advances. Recently they launched the 111-First service, which aims to cut down A&E visits by improving patient access to referrals. The service encourages patients with an urgent medical need to contact NHS 111 either online or via telephone before attending A&E. It’s been highly successful - Hallen states that between 70 and 80 per cent of patients who contact 111 first are finding that speaking to a doctor or pharmacist is more appropriate than attending A&E.
The NHS is "a really wide family", Hallen says. "There's public and private working together in a really good, collective way. Our medicines and our machines from suppliers, we source our technology from suppliers with expertise according to what we need. Core to Cloud is one of the suppliers that has worked really closely with us on cybersecurity, and on developing security approaches and capabilities across our hospitals and sites. Together we’ve developed a blueprint over the last two years that we've rolled out across the country."
The average hospital will have hundreds of different IT systems for different clinical specialties, and as well as ensuring they are secure, Hallen states it is important that these systems are able to talk to each other. "When you take into account the complexity of the many systems or devices that a clinician might use, ranging from laptops to MRI scanners and ECG monitors, you've got to make sure those devices are really stable and secure, but also easy to access - you can't lock them away in a room. We worked with both Core to Cloud and Imprivata colleagues to develop applications that help us both secure and detect our systems."
One of the most critical components of the NHS' digital transformation is ensuring patient data is kept secure. "Cyber security will only take us so far" Hallen says. "Our ever growing reliance on digital systems means that we've got to understand who and what you want this information for. Being able to verify that a nurse, a paramedic, a doctor or a healthcare professional are the people that need to have access to that information is really important. A Digital Identity is one of the tools that is a really critical part of that, especially now that we're not in the same physical environment.
“Our national organisations have seen more than a few cybersecurity attacks over the years” he adds, “but with each one we've learned how to protect data in a better way, protect vulnerabilities and ensure it is kept safe and secure, but still accessible."
When asked about the pandemic, Hallen says "it has changed many things about life, technology and the broader world. I pay tribute to every single NHS employee, in clinical, digital care, cleaning, catering, every single person who has worked utterly tirelessly for the last 12 months. We're not at the end of that journey yet, but what is clear is how closely and well people work together.
"If anything, our strategic aims and intentions have expanded to include COVID-19 specific responses to handle the circumstances. But it's really shone a light on the capability of what digital can do in healthcare, and can continue to do in a space where pandemic distancing rules have changed again."
The adoption of telehealth and remote monitoring have hugely increased in the last 12 months, demonstrating the benefits of this technology. “I have a device in my chest that previously would have involved three or four trips every year to the hospital for check-ups” Hallen says. “The results were downloaded from the system, I’d sit and chat with clinicians and there’s the time spent getting there and back. Now this is remotely downloaded every night from a device by the side of my bed that's about the size of the box that you might get a smartphone in. It analyses data automatically and alerts the clinicians if there are unusual issues.
“This saves travel, saves fuel emissions and saves time. In terms of ecological sustainability it comes down to the shared social contract that we all have.”
While the acceleration of digital tools has enabled them to "see exactly what we can do with it to revolutionise healthcare” he adds a note of caution, “We must make sure our healthcare system is accessible to all, not just to those that have the access to this technology. We don't want to start to increasing health inequalities by assuming everything can be digital. Digital must be accessible for all, not just to those with economic means.
"I think the pandemic has, from a strategic point of view, made us kinder to each other. We're all working long hours to deliver the care that we need to our colleagues, friends and patients, and that really does have an impact on the individual. We interact in different ways and we have a different insight into people's lives, and that has changed us as an organisation - but our digital strategy continues to be very ambitious."