Jeremy is very sorry that he can’t be here today, but I am really pleased to have the chance to join you.
Events like this are exceptionally interesting and informative for all of us who are involved in healthcare. Technology is right at the forefront of the government’s efforts to improve patient outcomes and better integrate the health and care sectors. As with other medical advances, health technology is a permanently dynamic phenomenon, and so it is vital to keep up to date.
I am reminded of a story about Ronald Reagan that dates back to his days as Governor of California. He was challenged by a college student who told Reagan he was out of touch.
“You grew up in a different world,” the student said. “Today we have television, jet planes, space travel, nuclear energy, computers…”
Reagan, as courteous as always, politely agreed, telling the student, “You’re right. We didn’t have those things when we were young. We invented them.”
I hope that I am preaching to the converted on this, but I do think it is worth making the point that there is no conflict between the intelligent application of technology on the one hand and a human and humane approach to patients on the other.
No technology could ever be so sophisticated that it obviated the need for human contact in medicine. But the best of it actually brings people closer to the professionals caring for them.
For example, the Maudsley Hospital gives mental health patients online access to their hospital and GP records. And Newham University Hospital has reduced missed outpatient appointments for diabetes by 11 per cent through the use of Skype.
This kind of thing is standard practice elsewhere in the world. American military veterans can download their health records and Danish patients can view their hospital records online. And over 85 per cent of prescriptions in Sweden are transferred from doctor to pharmacy online.
Another way that technology can improve the patient experience is by freeing up resources.
PWC has estimated that better technology could liberate some £4.4 billion for the NHS every year – money that can be freed up to provide safer, more effective, more personal care, and more face-to-face contact where that is appropriate.
The Royal National Orthopaedic Hospital has trialled a system where spinal surgery patients recorded on an iPad their progress in hospital after an operation, and then continued doing so online when they got home. It is thought that this created the capacity for 300 new outpatient appointments per consultant surgeon annually.
This is a real imperative for us. For not only does good technology bring real benefits, inadequate technology causes huge problems.
Making records electronic will offset the widespread problem of staff being unable to access the data they need. An elderly woman arrives at A&E and it isn’t immediately clear that she has dementia; a paramedic team picks up a man and don’t know that he has diabetes. This causes problems that are both enormous and avoidable.
And people stay for too long in hospital because it takes too long to get a discharge note, which is distressing for the patient, bad for their health, and ties up much-needed beds.
44 people died in the NHS last year as a result of being given the wrong medicine. Had prescription histories been readily available to hospitals, this number could potentially have been a lot lower.
So sharing data more effectively is vital. It will increase safety levels, save people from having to repeat themselves whenever they see someone new, improve care, and help us in the hunt for new cures and therapies for killer diseases.
As always with any kind of information sharing, there are issues around privacy. Dame Fiona Caldicott undertook a review into these issues, to which we recently responded. Dame Fiona is going to monitor progress and report back in a year’s time.
Several safeguards are being put in place. Health and care staff will receive first-class training in information governance, any data breaches will be dealt with honestly and immediately, and designated leaders on information governance will be appointed.
Technology can be empowering for the patient. We are determined to give people greater control over their information, and the Health and Social Care Information Centre’s Code of Confidentiality will provide far greater clarity on how data can be held and shared safely and appropriately.
The right balance must and can be struck here. When a patient objects to their information being shared, they have the right to be heard. But it is in the interests of people, both as individuals and collectively, for information to be shared more effectively and more widely.
We want the NHS to go paperless by 2018. In the overwhelming majority of cases, professionals should be able to access and share a patient’s history at the touch of a button.
We have increased IT investment for the next two years to £1 billion. And we are already making progress.
The march to a paperless NHS will be made in stages. In May we announced a £260 million “Safer Hospitals Safer Wards” capital technology fund, to help hospitals replace paper-based systems. It will largely be used for electronic prescribing, so doctors will be able to send computer-generated prescriptions directly to pharmacies, using barcodes unique to each patient.
St Helens and Knowsley NHS Trust has already got all their patient records accessible online for doctors and nurses. At New Queen Elizabeth Hospital in Birmingham, an online portal allows patients to view and update their own records.
All hospitals should be in a position to share digital data from next April, and to make paperless referrals a year later. By March 2015, patients will be able to access their GP record online, book appointments and order repeat prescriptions.
There have been big strides in improving transparency.
A lot more clinical data on surgical procedures is being published, which is absolutely essential if we are to have big breakthroughs in treating and preventing various conditions.
The Department of Health is also showing leadership in Whitehall with its excellent digital team.
Past NHS IT projects have been famously disastrous.
A major change this time around is that we are ensuring that the changes are driven locally, by hospitals and GPs. The Health and Social Care Information Centre will give local commissioners much better information. A top-down approach just doesn’t work.
One of the best bits of my job is being able to champion and celebrate best practice.
The Acquilion One CT scanner is a brilliant piece of kit. It is revolutionary and unique in being able to scan a whole organ in a single rotation – which takes 0.35 seconds! Most CT scanners in the UK can only cover 4cm in a rotation, so this is a major advance.
It means that the patient does not have to hold their breath. Irregular heartbeats can be scanned, as can the whole brain. It can pick up tumours in the kidneys, liver, and lungs.
And it reduces radiation by a factor of ten.
It took ten years to develop, involving some brilliant clinical scientists, physicists, bio-medical engineers and others. It makes tremendous sense economically and it will improve the patient experience and patient outcomes immeasurably.
The Department of Health is here to help foster a culture of innovation.
We have nine NHS Innovation Challenges, including three new ones in Chronic Obstructive Pulmonary Disease, Diagnostics and Falls.
There are also three new NHS Breakthrough Challenges in Stroke, Diabetes and Dementia. Up to £1 million of prize money can be awarded for each of the NHS Breakthrough Challenges.
So please – get innovating and inventing!
Technology has transformed our lives. Much that seemed like science fiction only a few decades ago is common-place today. Doubtless there will be further massive advances in the coming years.
Health and care should be ahead of the curve. In some ways they have been behind it.
I was told a lovely story about two men on a flight from LA to New York, each of them called Mr Smith. One of them worked for IBM and the other was the head of American Airlines.
They got chatting, and one Mr Smith told the other that he was really struggling to cope with the explosion in demand for flights. At the time it took three hours to book a ticket.
The Mr Smiths put their heads together and a new computer system was designed that allowed any travel agent anywhere in the world to know which seats were available on any flight, and then issue a ticket within minutes.
Hardly surprisingly, it revolutionised the air travel industry.
Great things have been achieved in health technology, and particularly in certain areas, but we haven’t yet utilised technology to integrate health and care to the same extent that air travel has been revolutionised.
Because let’s not be under any illusion about this. The potential prizes for harnessing technology in the area of human health are vast. It is not hyperbolic to say that we can eradicate some diseases altogether, that we can hugely increase capacity in the system, and that we can help people to lead far longer and much healthier lives.
So I’d like to end by throwing down a challenge to you all: think smart and think big.
And who knows - perhaps this very conference could facilitate a meeting of great minds and lead to something special.
I certainly hope so.
Thank you very much indeed.