Will NHS plans to introduce free apps and devices improve patient care? | Fieldfisher
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Will NHS plans to introduce free apps and devices improve patient care?

16/09/2016
In a major drive to harness technology to reduce patient deaths, the NHS has announced it intends to offer millions of people free devices and apps to help them better manage conditions such as diabetes, heart disease, asthma and sleep disorders, as well as areas such as infertility, pregnancy and mental health.

NHS England chief executive Simon Stevens admitted that , while the health service has a "proud track record of world firsts in medical innovation", getting wide uptake of this type of technology has previously  been "slow and frustrating".  To encourage take-up of this latest scheme, a new Innovation and Technology tariff will mean that Trusts receive automatic reimbursement when an approved innovation is used.

Anything that takes pressure off overworked and overwhelmed health professionals has to be a good thing in principle. The obvious worry, however, is whether current NHS IT systems – not notorious for their efficiency - are equipped to cope with the use of cutting edge technology to successfully monitor and manage millions of serious health conditions.

The devices, which can be strapped to the back of a smartphone or used on a tablet, are intended to help patients detect and monitor their condition.  They will also remind them when to take their medication and encourage certain exercises to improve their illness.

Examples supported by the scheme include: MyCOPD – an app which allows patients with Chronic Obstructive Pulmonary Disorder to manage their condition on their phone or tablet; AliveCor – a mobile heart monitor that instantly captures electrocardiogram (ECG) recordings, allowing the user to detect, monitor and manage heart arrhythmias, and Pneux – a cuffed ventilation tube and inflating device used to electronically monitor patients breathing in intensive care to prevent bacteria leaking into the lungs – something that occurs with standard tubes and can result in ventilator-associated pneumonia, the leading cause of hospital-acquired death in intensive care.

The majority of people suffering such conditions as these are likely to be the elderly, not the digital native 20-somethings who use apps without a thought. Will those who actually need them actually  be able to access and use apps and technical devices intended as part of their daily healthcare routine?  Will they understand the information the app is delivering to them?  Or, is the danger that while these innovations should undoubtedly be hailed as an exciting step towards the future of healthcare, they run the risk of becoming an expensive initiative that doesn't work in practice?

My colleague, Jonathan Zimmern, a medical negligence specialist who witnesses first hand when medical care goes wrong, recently commented on the future of the NHS 111 non-emergency call service. This was a similar innovation introduced to streamline delivery of medical care, recently been rated as "inadequate" following a series of incidents that put NHS patients at risk.

If not implemented properly, there may be similar risks posed by relying on devices and apps to monitor serious conditions. 

It is no secret that the NHS has had a poor success rate when implementing new IT initiatives, much to the frustration of its staff.  In December 2015, the latest board minutes from the Health & Social Care Information Centre found that "the NHS currently has £5bn in IT projects deemed at “high risk of failure”". 

We know doctors, nurses and NHS staff are currently stretched to the limit. They are already trying to cope with cuts to vital front-line services. If the scheme works, helping patients to improve their self-care and avoid episodes of acute illness that require hospital admission could reduce NHS expenditure on chronic conditions. But will NHS staff be furnished with adequate resources to monitor and act upon the data that the proposed devices will generate, or will it simply become a task too many?

As claimant lawyers, we welcome any advances within the NHS that improves the care of patients and reduces mistakes. Let's hope this latest scheme brings such progress.

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