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NHS 10 year plan: Making better use of technology in health and care - briefing

Health Policy team
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We urge all RCPCH members in England to contribute to the new 10 Year Health Plan for the NHS. This is your chance to advocate for children and the child health workforce to be central to the NHS's future plans.

This briefing highlights the need to ensure the analogue to digital shift fully considers children's needs, not just adults'. The five key recommendations are: digitising children's health records, implementing a Single Unique Identifier for children, deploying robust digital infrastructure, investing in online health information, and ensuring that children, particularly marginalised populations, are supported to fully engage with digital innovations.

We encourage members to use the evidence, key messages and recommendations provided here to support your own engagement on the 10 year plan.
Last modified
21 November 2024
Post date
21 November 2024
Table of contents
Contents

Proposed shift 

The ‘analogue to digital’ shift intends to harness technology within health and care to improve services and enhance efficiency. This is expected to improve diagnostic accuracy, boost communication and information sharing, and save around 140,000 hours1 of NHS staff time each year— providing quicker care for patients and potentially saving lives. Proposals2 under the shift involve:

  • Using the NHS App to centralise the single patient record by summarising patient health information, test results, and letters in one place
  • Streamline computer systems and electronic medical records within the NHS, so patients can share their information just once, and it will be accessible across NHS trusts, GP surgeries and ambulance services
  • Use of video consultations
  • AI scanners for quicker and more accurate disease detection
  • Advanced robotics for more effective surgeries

The Labour Party’s 2024 manifesto also committed to digitise the Red Book3 record of children’s health and improve data sharing across services through a single unique identifier for children. We support the intention behind these ambitions, and our recommendations below set out what is needed to make the analogue to digital shift work for children and child health services.

Child health challenge 

We welcome the digital shift within healthcare. As well as improvements to digital technology, we urgently need effective data linkage and information sharing within the health system and between health and key partners in education, children’s social care and wider local authorities. Currently only 24% of Local Authorities and 16%4 of ICBs link health data on children and young people. Improved data linkage and information sharing is essential if services are to fully understand children’s health needs, recognise risk of harm, and provide effective care.

 Adopting digital health innovations in child health services can provide substantial benefits to paediatric care when they are implemented with children in mind. They can also lead to cost savings - a recent study found that (18/22) 82% of digital health innovations are more cost effective than traditional care approaches5 . 

However, children and young people are often an afterthought in the development and delivery of digital innovation in healthcare6 . Added to this, there is comparatively poor-quality data on children and young people’s health and care needs, making it hard to plan services, improve care, and understand outcomes. 

Children’s health services face a range of additional challenges when it comes to fully realising digital innovation, including: 

  1. Data linkage issues, as children are assigned different ‘identifiers’ by various agencies (including by the NHS, schools, and social services) which can make it harder to identify and link data held by different settings about the same child in order to identify risks or improve care7 . Barriers to information sharing and disconnected records across services leads to uncoordinated care and the potential for health or safeguarding issues to be overlooked. 
  2. Slow, poorly connected and difficult to use day-to-day systems make every clinician’s life harder and their work less efficient. Every second spent waiting for digital systems to respond, or operate correctly, is a second of lost efficiency. 
  3. Ambiguity in primary legislation on information sharing8  between children’s health, care and education services reduces confidence among child health professionals about what they can, and should, legitimately share.
  4. Digital medical consultations might not be preferred or suitable for everyone, as highlighted by an AYPH report9 . Face-to-face consultations may be preferred, due to the ease of communication and value of building a trusted relationship between clinicians and young people. Some young people find navigating digital, or telephone systems enhance anxiety levels, especially when they are not designed with a youth-friendly format10 . This can be particularly difficult for those with mental health problems, when online forms or telephone consultations are not designed to capture issues. Some children and young people may have confidentiality concerns, particularly when they do not have access to a private space to use. 
  5. Child poverty is at an all-time high in the UK; some young people don’t have access to a stable internet connection or an appropriate device7 . Without further consideration, the digital shift poses the risk of further isolating underserved children and young people from accessing medical support.

RCPCH recommendations

We must ensure that the shift from analogue to digital is not designed exclusively with adults in mind, and fully considers the needs of children.

We recommend: 

Fully consider children and child health services in national plans to develop a digital health record 

Accelerate the development of a digital red book, so that it goes beyond growth charts and vaccine records to provide all professionals and agencies with a full picture of a child’s health. Ensure the digital red book is fully integrated into wider plans for the digital health record. 

Implement the NHS number as a Single Unique Identifier for children

Having a single unique identifier is crucial to enable data linkage on children’s health, care and safeguarding needs11 . Implementing the NHS number as a SUI will support better identification of risks and enable more joined-up care between the health service and health and care provision that takes place in schools, early years, social care providers, local authority SEN teams, and other key agencies12 . 

Deploy robust digital infrastructure and effective digital services, while ensuring paediatric staff can effectively use them

Roll out easy-to use, well connected, fast digital infrastructure and ensure paediatric staff can effectively appraise their appropriateness of use. Introduce comprehensive training programs of education for existing and new digital infrastructure, tailored to paediatric units. This will raise the digital knowledge and confidence of the Paediatric community. This training should also cover CYP patients rights for digital access.

Invest in improving the quality and accessibility of online health information and resources for families

This can be achieved through improvements to NHS online using paediatric exemplars such as Healthier Together13 . These digital resources should be designed with children and families in mind, with paediatric input and a focus on accessibility and interactivity. Evidence from the Healthier Together programme shows that these resources can increase the likelihood of self-care, improve health literacy, and reduce unnecessary ED attendance for minor complaints, which is particularly high for children.

Prioritise the inclusion of all children and young people, particularly underserved populations, in the shift to digital care

Offer marginalised groups, individuals with long-term conditions, and low-income groups, additional support for digital access. Prevent CYP in digital poverty from further marginalisation when introducing new technology by:

  • Ensuring children and young people offered a digital appointment have access to a private space. 
  • Ensuring CYP have WiFi or suitable mobile data to engage in digital sessions and offering funded data options if needed.
  • Non-digital options should be made available to those without access or where there are confidentiality or safeguarding concerns. This includes ensuring children and young people are offered a face-to-face option for medical consultations, rather than only a digital option.