The most-recent UK government policy paper on the future of healthcare set out a vision for how the NHS can embrace the digital revolution to ‘transform health and social care in this country’. In this article, Sascha Giese, head ‘geek’ at SolarWinds, shares his view as to why investment in technology and skills is needed to help the NHS become more efficient, as well as improving the quality of care
If the emphasis on innovation is anything to go by – and the word is used nearly 50 times in a recent government paper on the potential for technology to revolutionise healthcare – then we’re likely to see considerable change in the years ahead.
As one of the world’s-largest employers, with around 1.5 million staff; the task facing the NHS when the Government of the day looks at changes affecting the entire organisation is huge.
This helps explain why its technology infrastructure and services have evolved to create a situation where, as the Government points out, ‘we still need to sort the basics’.
But the direction of travel is now based on an open acknowledgment that technology – and the highly-qualified people who run it – is much more than a facilitator and will have a major impact on the future effectiveness of the organisation.
It’s perhaps understandable that successive governments have seen their spending priorities elsewhere, but this problem becomes more acute over time to the point where we find ourselves today
Investment in technologies and skills to help NHS IT management and monitoring become more efficient, as well as improving the quality of care, will be central to successfully delivering this kind of vision.
Living with legacy
The NHS is now over 70 years old and throughout its modern history has invested in technology to keep pace with demand and squeeze maximum value from its available budget.
It’s inevitable, however, for the NHS to feel the impact of ageing IT.
Even when tech continues to do the job it was built for without obvious problems, this ‘legacy’ can bring with it an unwanted collection of deeply-embedded problems.
When older hardware and software is in common, mission-critical use within organisations as large and complex as the NHS, the technical and financial issues associated with replacing it are intimidating.
Whether it’s problems of incompatibility, performance, or reliability; legacy tech can frustrate the kind of innovation on which the NHS is basing its future.
The problems are real. To illustrate, let’s take one of the most-important legacy tech issues: security.
No one would claim simply modernising legacy technology will make security a non-issue. Organisations widely acknowledged as tech innovators also suffer the most egregious security breaches. But legacy technology can leave gaping holes in the security of IT systems.
For instance, we have less than a year before Windows 7 – an operating system widely used across the NHS – goes ‘end of life’, at which point Microsoft will stop providing security updates and support for the product.
Users will then have the choice of paying for extended support, upgrading to the current version of Windows, or sticking with what they’ve got and hoping nothing terrible happens.
According to information provided recently by the Department of Health and Social Care, there are still ‘approximately 1.05 million NHS computers using Windows 7 from a total 1.37 million’.
Aside from the difficulties of upgrading more than a million computers to Windows 10 before support ends; it shows the sheer size of the task facing the NHS for any wholesale technology change.
By removing day-to-day barriers, arming tech pros with the right technology and management tools, and prioritising skills and career development in the IT budget, public-sector tech pros can be better equipped for the future and to help with IT modernisation initiatives as they arrive
And the process can take years – indeed, five years after Windows XP went ‘end of life’, the NHS still has some 2,300 computers using it.
Similarly, applications written to work on legacy platforms become significantly-less compatible with other key elements of IT infrastructure as they age.
This can impede the work of individuals, teams, or entire departments, and it places the public sector in a particularly-tough corner because they run such an extensive estate of specialised and tailored legacy apps.
Rewriting those applications from scratch to ensure compatibility with modern platforms can be extremely expensive.
It’s perhaps understandable that successive governments have seen their spending priorities elsewhere, but this problem becomes more acute over time to the point where we find ourselves today.
They also become more expensive to support.
It’s inevitable for the knowledge and skills needed to maintain niche, ageing legacy technologies to become more difficult to source the longer it is used.
On their own, these issues are bad enough, but, together, they can compound each other to stand in the way of important public service delivery.
Legacy technology can frustrate the kind of innovation on which the NHS is basing its future
Skills to support innovation
The Future of Healthcare policy paper sets out four priority areas where action is required, one of which is to ‘develop the right skills and capabilities so staff are supported and leaders are able to drive the best outcomes’.
This is timely recognition of the need expressed by public-sector tech pros themselves, as revealed in the SolarWinds Trends Report 2019: Skills for Tech Pros of Tomorrow paper.
The study showed more than 80% of public-sector tech pros think more training, time, and budget is needed to develop skills to manage IT environments in the next three to five years.
The NHS, and public-sector organisations in general, need to focus even more on developing the professionals charged with running and pioneering technologies for their organisations
For instance, when it comes to the idea of implementing or managing specific technologies; the research revealed emerging tech is a pain point, with the top three technologies public-sector tech pros feel ill equipped to manage with their current skillsets being artificial intelligence (53%), blockchain (52%), and quantum computing (49%).
Given the likely importance of emerging tech to the future of the NHS, bridging this gap will only become more important.
This tells us the NHS, and public-sector organisations in general, need to focus even more on developing the professionals charged with running and pioneering technologies for their organisations.
By removing day-to-day barriers, arming tech pros with the right technology and management tools, and prioritising skills and career development in the IT budget, public-sector tech pros can be better equipped for the future and to help with IT modernisation initiatives as they arrive.
