I’m the same age as the NHS. I feel lucky to have grown up with a system which was and is world class.
I grew up in Dumfries where my father was a minister and one of my earlier memories is standing in line to be immunised. The technology of immunisation applied across the population effectively stopped the funerals with small white coffins of children who had died of diphtheria that my Dad used to find so distressing.
Technology starts as experimental (might be a good idea) then moves to breakthrough (attracting media interest) then implementation. It has its greatest impact when people have a memory of what went on before.
After a while it’s just what happens. Technology and the NHS have developed together over the last 60 years so we have had genuine advances in pharmacological treatments - antibiotics, beta blockers, elimination therapy for ulcers doing away overnight with a range of fairly awful surgical procedures. On the back of these fundamental discoveries come the “me too” therapies with marginal incremental benefit but heavy marketing.
Appliances, prostheses, new hips, endoscopy and all the whiz bangs of the integrated operating theatre have revolutionised surgery. It used to be about scalpels, blood, guts and quite a lot of drama with associated personalities to match.
New systems of governance in recent years following the enquiry into the Bristol heart operations scandal have started to change the way people behave. Collecting better information is leading to clinical decision-making based more on science rather than artistic expression.
At the same time we must ensure that the creative process which breeds innovation and the drivers that motivate all clinicians to do their best are not lost in a bureaucratic swamp that forces nurses to collect reams of useless data which end up in critical incident reports that are an end in themselves.
Pharmacological, engineering and potentially, genetic technologies have had a huge impact.
But the technology that will change the NHS in Scotland over the next decade or six is based on the now ubiquitous computer and the networks that enable them to communicate. We have significant drivers in the form of an ageing population with more chronic disease, and costly clinicians. Clinical decisions are increasingly being made by nurses, allied health professionals and paramedics that would in the past have been limited to doctors.
The digital age means that telehealth will enable a connected community of clinicians and patients to provide better service more effectively and efficiently. The need to travel to a clinic where parking is impossible will reduce and having available data rather than the physical presence of the individual will save time and energy at a time where energy costs are rising.
The technology exists now to do a lot of this in the Scottish NHS. To make it happen we need vision, new contracting mechanisms and organisations that embrace clinically-validated change for better patient care. Better Health Better Care gives us that vision, the rest is a work in progress.
Professor Gordon Peterkin
Past Director - The Scottish Centre for Telehealth
Community Health Index
Patients in Scotland are already ahead of the game for the technology of the future.
All of us registered with a GP have a unique NHS identification number. It is unique in the UK and called the CHI (Community Health Index) number and was originally developed in Tayside nearly 40 years ago.
It doesn’t hold clinical details but it does enable NHS clinicians throughout Scotland to access your records on a computer if you fall ill – wherever you fall ill. That means more effective treatment which is both quicker and safer. Your health information is held by your local NHS Board and is only available to authorised NHS staff.