The head of a world-leading organisation dedicated to accelerating innovation in health services believes that Scotland’s model of care is no longer fit for purpose in the 21st century.
With the system creaking as demands pile up on beleaguered hospitals and surgeries, waiting times grow ever longer and staff numbers dwindle, Prof George Crooks says it is time for a digital revolution which will empower both patients and free up clinical staff to direct their efforts to where it is most needed.
It may sound like science fiction, but Prof Crooks foresees a future where citizens are empowered to make decisions through having detailed knowledge of their own health needs, gathered by constant collection of data which flows into the hands of medical professionals digitally.
The ongoing health needs of individual Scots would be recorded in a data cloud accessible to themselves and those who need it, providing scope for targeted care on a round-the-clock basis.
Even details such as whether there are pets that need taken care of should someone need to go into hospital would be recorded, along with data which could even predict when care might be needed before a problem manifests in such a way that the health need becomes urgent.
And this is not blue-sky thinking – it is the core of Prof Crooks ongoing work as the head of Scotland’s Digital Health & Care Innovation Centre (DHI), which has been awarded new funding by the Scottish Funding Council (SFC) for at least the next 10 years.
DHI, a pioneering initiative hosted by the University of Strathclyde in collaboration with Glasgow School of Art, marked its 10th anniversary last year and is preparing for the next decade with an ambitious set of plans.
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The organisation, which brings partners in the commercial, academic, health and social care, and third sectors together to drive innovation and transformation in Scottish health and social care, has already spearheaded major advances including accelerating Scotland’s response the Covid-19 pandemic; the pioneering £5m Rural Centre of Excellence in Moray; and SCOTCAP outpatient gastroenterology technology.
This innovative treatment saw the need for invasive colonoscopy exams replaced with a ‘pill’ containing cameras which passed through patients’ bowels taking 300,000 pictures as it travelled along.
These images were uploaded to allow experts to scan them for signs of cancer – without the patient ever having stepped inside a hospital.
The success of this programme, and the ethos behind it, is what Prof Crooks would like to see happen NHS Scotland as the digital revolution takes hold.
He said: “Growing waiting lists, ageing populations, difficulties recruiting staff, and a workforce that is still feeling the impact of pandemic and pressures of the health and care system are the realities in Scotland – but they are also global challenges not unique to this country. Demand is outstripping capacity and there has never been a greater urgency to do things differently.
“Scotland’s medical model of care, that has served us very well for the past 150 years, is no longer fit for purpose in the 21st Century. We must move away from our existing approach to one where we listen to, activate, and empower our citizens to make better informed health and wellbeing choices supported by resources in their communities.
“The only way that can happen is through the appropriate use of digital technologies allied to an understanding of the lived experience of people in Scotland, using our expertise to co-design with them, and tailoring services to meet their personal and local circumstances. That’s the crux of the knowledge, skills and experience DHI has acquired over the past 10 years.”
A former Medical Director for NHS 24, Director of the the Scottish Ambulance Service and Director of the Scottish Centre for Telehealth & Telecare, Prof Crooks is very much an NHS Scotland insider.
A General Medical Practitioner for 23 years in Aberdeen, he combined that role with that of Director of Primary Care for the Grampian region.
The professor currently sits on the Board of the European Connected Health Alliance and is a Board member and past president of the European Health Telematics Association, and is also an adjunct Professor of Telehealth at the University of Southern Denmark
It is fair to say he knows what he is talking about.
The new funding has enabled DHI to set out seven priorities in its new 10-year plan, including an ambition to transform health and social care and develop digital and data infrastructures as national assets.
Prof Crooks says the technology already exists to do this, and DHI is working on a way to create a system which is accessible and of use to everyone.
He said: “The one thing that people in Scotland tell us that they really don’t like doing is having to tell their story over and over again. We can’t just throw doctors and nurses at the problem.
“You wouldn't think that was the case when you listen to some of our politicians, who basically say ‘we’ll get more money and we’ll employ more doctors and employ more nurses’.
“That’s not the answer. We know by 2030 there’s going to be a global shortage of health and care professionals, so we need to do things differently.”
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He believes that such technology will enhance the NHS, simply by helping patients get the help they need sooner and with greater accuracy.
This goal sounds easy, but changing thinking in an edifice as large as the NHS is a herculean task, while developing the appropriate technology is fraught with pitfalls.
But work has begun which could change the way health services are accessed in the not too distant future.
Professor Crooks said: “What we are not saying is that we are going to replace doctors and nurses with smartphones or technology.
“We want to design services so that doctors, nurses, social carers and others are more available to the people who really need that type of service, when they need it and where they need it.
“It’s not about getting the human touch out of healthcare. Far from it. It is the opposite of that – and that needs intelligent design.”
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