Bilal Salman is a GP and Consultant in Urgent and Integrated Community Care.
Health Education England have recently published a report on the use of digital technologies and how these can support the NHS and its workforce to perform more efficiently, meeting the increasing demands on the service.1
The report is intended to build on the Topol Review of 2019, ‘Preparing the healthcare workforce to deliver the digital future’,2 which outlined recommendations to make the NHS a world leader in the adoption and use of digital technology for improved patient care.
UK general practice is often said to handle over 90% of all NHS interactions with patients.3 Digital innovation and technology within general practice can be traced back to the 1970s. General practice also led the move from paper to digital record-keeping and under the new general practice agreement, all patients in England are expected to have access to digital services. A digital service can be anything using information technology to enhance delivery of care. Examples include the AccuRX programme for communicating with patients (performing video calls and sending text messages). Other services include the NHS App, self-registration at appointments and repeat medication orders. Digital medicine is a priority for modern general practice and is a core theme for NHS England strategy. Digital primary care is also essential to achieving the NHS Long Term Plan.
“Digital medicine is a priority for modern general practice and is a core theme for NHS England strategy.”
However, having access to digital technology is only part of the solution. Another key outcome from the Topol Review was a focus on a digital ready workforce. For large-scale digital transformation to succeed it requires good leadership. These leaders will need to direct and drive a cultural shift in both the workforce and the public, to move towards the NHS outlined in the Topol Review.
The COVID-19 pandemic has driven forward the use of digital technology in general practice and there are now several established alternatives to the traditional face-to-face consultation. I am a working GP and I believe that digital transformation could be a key factor in redefining the way modern general practice is delivered and perceived by the public. It was this that inspired me to become a Topol Digital Health Fellow (cohort 2).4
The Topol Digital Fellowship is designed to provide health professionals with protected time, support, and training to undertake and lead digital health transformations and innovations in their organisations. During my fellowship, alongside training in aspects such as agile methods and product design facilitated through workshops and interactive sessions, I was able to network with like-minded colleagues from the full breadth of health care without the traditional boundaries of primary and secondary care. ‘Agile’ methodology stems from the software design sector and is an approach to managing a project in which a ‘big task’ is broken down into ‘smaller’ manageable tasks or phases. The approach involves multiple cycles through planning, executing, and evaluating. An environment of engagement with stakeholders and collaborative and open sharing of information and ideas is also key to the method. The key is to have a iterative approach in which a process or continued discussion, review and adaption during the life course of a project.
Learning from current digital experts about their success and challenges filled me with a sense of empowerment to be part of the health and social care digital revolution. An example of a success was gathering evidence of improved outcomes and enhanced care. Albeit a very small scale. The initial work of my fellowship gathered evidence that the workforce required further training and support to implement remote working. This then triggered a discussion with local training providers and development of a strategy for training in remote consultation. A side success was the promotion of the fellowship and supporting 3 further GP trainees to apply to the next round of the Topol Fellowship. It is a challenge to get an already stretched workforce to make further adaptions. Often getting people to engage with new technology is met with ‘distrust’ and multiple stories of how technology has failed or important information has been lost or data breaches have occurred. Overall however the biggest challenge I faced was with changing behaviour and supporting people to learn new skills with the faith it would improve workload rather than increase it.
I thoroughly enjoyed my year as a Topol Fellow and now benefit from the alumni scheme, and although I was the first GP trainee to be appointed I am pleased to say I was not the last!
I would encourage any member of the primary care workforce with an interest in digital technology and transformation to consider applying for one of these fellowships.
Bilal Salman is a Topol Digital Fellow (cohort 2) and Topol Fellow Alumni.
1. Health Education England. Harnessing digital technologies for workforce development, education and training: an overview. 2022.
https://www.hee.nhs.uk/our-work/innovation-digital-transformation/harnessing-digital-technologies-workforce-development-education-training-overview (accessed 27 Jan 2023).
2. Health Education England. The Topol Review: preparing the healthcare workforce to deliver the digital future. 2019. https://topol.hee.nhs.uk/the-topol-review (accessed 27 Jan 2023).
3. Gilbert J. Transforming primary care in London. 2013. https://www.england.nhs.uk/london/wp-content/uploads/sites/8/2013/11/Call-Action-ACCESSIBLE.pdf (accessed 27 Jan 2023).
4. Health Education England. Topol Digital Fellowships. https://topol.hee.nhs.uk/digital-fellowships (accessed 27 Jan 2023).