Improving Patient Care & Safety

1. Improving Patient Care & Safety Dr Manpreet Pujara Clinical Director for Patient Safety manpreet@nhs.net

2. My Roles Current • GP • Clinical Director for Patient Safety NHS Digital • Senior Clinical Adviser for Medway CCG • Council Member of Faculty of Clinical Informatics Past • Chair RCGP Health Informatics Group (July 2019) • Co-chair Joint JP IT Committee (JGPITC)

3. A changing society Population aged 60+ will increase by 46% in 20 years those age 85+ will double to 3.6 million by 2039 Long term conditions account for 70% of the annual health spend Dementia will affect1 million by 2025 and 2 million by 2050affects >25% hospital inpatients

4. Digital transformation in the National Health Service (NHS) 2019 2014 2012 New national technology organisation NHS Digital New models of care supported by digital infrastructure Ten year plan for digital everywhere

5. A digital transformation that touches on everything we do in health and care.

6. 70 years of our National Health Service • 1 million • patients cared for by our NHS every day 1.3 million e-prescriptions everyday Over 1 million e-referrals every month

7. Our changing technological landscape 4 in 5 adults own a smartphone 55 to 75 year old ‘silver swipers’ are the fastest-growing adopters of smartphones. 2 in 3 adults in Britain use social media 2 in 3 smartphone owners use apps that employ machine-learning 89% of UK adults used the internet at least weekly in 2018, up from 88% in 2017 and 51% in 2006.

8. The scale of the challenge complexmulti-year transformation thousandsof national and local partners vital to delivery public concernabout data and analytic usage ingrained behaviouramong patients and clinicians speed and scalein pace of delivery Transforming a national system at speed and in all dimensions

9. NHS Digital’s mission is to harness the power of information andtechnologyto make health and care better

10. Better health and patient outcome Better care and patient experience Better value and affordability Five priorities Empowerthe person Supportthe clinician Integrate services Createthe future Managethe system effectively Infrastructure

11. Driving efficiency across the system 65% of prescriptions are now electronic Almost every community pharmacyin the country has secure access to patient records (SCRs) 162,000  vulnerable children protected by the Child Protection Information Sharing (CP-IS) system 45.5 million people have access to NHS Wi-Fi at point of care

12. A new generation of channel choice for patients and clinicians 15 million patients with access to digital primary care NHS 111 Online NHS App NHS.UK Personal Health Record NHS Login • Widening Digital Participation • Apps and Wearables • Digital Maternity • Digital Child Health 12

13. Digital tools for prevention and self care Widening participation NHS.UK Apps and wearables

14. Scale and impact: the NHS Website 100,000 healthcareprovider pages covering every health and care provider in England visited 64 million times a year 1 in 10 visitors decided not to see their GP because they found the information they wanted on our medicines pages 30 millionvisitors every month One billionpage views every year Almost 4 in 5 viewed through a mobile device

15. NHS Pathways: our national Clinical Decision Support System • NHS Pathways supports non-clinical call handlers and clinicians • to help patients by triaging them to the most appropriate care at their time of need. • such as: • out-of-hours service • ambulance dispatch • subject to rigorous training and ongoing review Algorithms developed and maintained by registered clinicians 15 milliontriages per year 9 in 10 result in no emergency department attendance 40,000+ Calls every day

16. The NHS App The NHS App provides a simple and secure way for patients to access a range of healthcare services on their smartphone or tablet. • Once registered, people can: • check their symptoms • find out what to do when they need help urgently • book and manage primary care appointments • order repeat prescriptions • securely view their medical records • choose whether the NHS uses their data for research and planning

17. Threats! • People – 1.3+ million staff • Cyber Security • Information Overflow • Prompt Fatigue • AI. Machine learning and Medical Devices

18. The next phase…. the ten year plan Replace legacy primary care platforms (8,200 sites) Make primary care data available to clinicians in integrated care New digital workflows in care pathways e.g. cancer, diabetes, out patients etc by 2023 New priorities New enablers (all required to enable the above) Move to open standards and platform architectures New industry standards for AI, algorithms and interoperability Support SME/medtech sector “Digital First” culture  18