What’s your take-up on technology?
by Paul Vousden, managing director, NHS THOTH
The UK has a poor record of adopting new technology when compared with other European countries. Such reluctance often owes less to a lack of money than a lack of adequate education and training.
As a result, the skills needed to deliver many of the promising new medical technologies lie with only a small minority of professionals.
The NHS needs reliable and time-efficient tools to train more clinicians in relevant, advanced medical technologies – because trained people are as important in healthcare as the medical technology itself.
With this in mind, THOTH (Training Hub for Operative Technologies in Healthcare) was set up with funding from the NHS Innovation Centre and the Department of Trade and Industry.
It works with the NHS, academic and educational bodies, and IT and medical device companies, to improve and increase the uptake of technologies in healthcare, addressing inconsistencies in training.
Take laparoscopy, where Britain is known to lag behind other European countries, such as Italy and France. According to the Association of Laparoscopic Surgeons of Great Britain and Ireland, there were nine training courses being delivered by hospitals and institutes. There was, however, no standard curriculum and no agreed framework for setting course content.
One of THOTH’s early projects was to establish a single framework for training curricula for laparoscopic colorectal surgery. The Laparoscopic colorectal cancer training guide has now been developed with input from Professor Sir Ara Darzi, who holds the Paul Hamlyn Chair in surgery at Imperial College, and who was recently appointed Parliamentary Under Secretary in the Department of Health, and THOTH’s lead clinician, Mr Rajesh Aggarwal.
As well as several successful completed projects, THOTH has many others in the pipeline. Covering issues from infection control to training in simulation technology- all have been selected for their urgency, usefulness and relevance to the current challenges in NHS reform.
Indeed, to target its work, THOTH this year identified four key, strategic areas:
From polyclinics to new mental health strategies, projects look at the education and training implications that arise as control moves away from the centre and into local communities.
Addressing the growth in primary care delivery and new ways of caring for patients in the community, THOTH is examining the training needs now arising, with projects including remote care for the elderly and for those patients with serious, chronic disease.
Exploring new ways to encourage patients to be more involved in their care, the focus here is to respond to an increasing need to communicate and engage with patients in a meaningful and participatory way to deliver better health outcomes.
THOTH’s approach recognises that both health professionals and patients need to understand and support the move towards a more modern and technology-advanced NHS.
Part of the challenge is the scale of the NHS and its fragmented structure and
THOTH is looking at ways to standardise training across the health service, particularly where this is linked to medical devices
And of course training and education is not just for NHS professionals. Patients, too, have a role to play to ensure they benefit from good healthcare. They need to understand and support the move towards a more modern and technology-advanced NHS. They should be encouraged to be involved and ask questions about their care. This ensures they are more informed, while also serving as a check and balance for clinicians, making them more aware of patient safety.
Membership of THOTH, which is currently free, is increasing and includes NHS managers, healthcare professionals, academics and employees of government bodies, as well as trade bodies, manufacturers and service companies. There is also a virtual network for healthcare professionals, designed to promote cutting-edge thinking in training to use medical devices.
Advances in medical technology play a pivotal role in the improvement and transformation of the NHS and the health economy of an ageing UK society.
For patients, better diagnostics, less invasive procedures and more effective treatments mean faster recovery and improved quality of life, reduced waiting times and greater access to the NHS.
While introducing new, more efficient medical technologies can involve increased short-term spending, lasting economic gains can be achieved by reduced treatment costs and a more rapid return to normal, productive life for patients. Improved patient outcomes also help the NHS achieve National Service Framework targets and other Department of Health guidelines.
On an individual Trust basis, THOTH has met great support from those clinicians and managers who can see the benefits to patients and the NHS of introducing new technology. But still the adoption rates are surprisingly low, and the NHS still seems to be slow on the uptake and resistant to change, even when the arguments are very strong.
The question that THOTH would like to debate is how can we change this situation and make sure that the NHS is truly a world-beating health service that uses the latest medical technology to improve patient care and reduce costs and time for NHS clinicians and others.
At its recent workshop in Manchester, THOTH showed a short DVD entitled ‘Around the world of medical technology in eight minutes’. The audience gasped approvingly at innovative surgical techniques and the use of robotic devices to perform high precision procedures. Many asked why more of these new ideas were not available in the NHS in England?
The irony is that all of the new technology shown is in fact in use now in England in teaching trusts and could be widely available if only clinicians and managers would be willing to invest time, training and some initial investment in getting these new techniques adopted for the wider benefit of patients across the country.
So how do we do it? The technology is definitely there, the cost is often an affordable and ‘business case approved’ investment, and the benefits would be enormous. We would like to hear from readers of their views on the technology take-up debate.