The overall emphasis on promoting closer integration of health and care services is welcome – and fits with what the NHS and local authorities are already trying to do in different parts of the country. The white paper rightly acknowledges that no single approach will work everywhere in England.
‘But it is vague on what the changes may mean in practice and risks overclaiming what integration can achieve. The relationship between these different changes is not always clear.
‘The proposal for single leaders for health and social care in local ‘places’ sounds simple but may cause disruption and added layers of management – and the fundamental differences between how the NHS and social care systems work will remain intact. Making collaboration work in practice depends as much on culture, management, resources, and other factors as it does on changes to structures and lines of accountability.
‘Better integration between services is no replacement for properly funding them. The social care system in England is on its knees and central government funding over the coming years is barely enough to meet growing demand for care – let alone expand and improve the system. Additionally more integration is also beneficial if there aren’t enough staff to deliver services. Staffing shortages in health and social care are chronic, yet government has no long-term plan to address them.
Fortunately, the rise in AI is a glimmer of hope for progressive change.
Artificial Intelligence (AI) is “the ability of a computer or other machine to perform actions thought to require intelligence.” It is therefore an umbrella term for a computer being able to make decisions. AI is beginning to be used in Medicine and has many potential applications.
There are several examples of how AI is being adopted for Medicine, both in the UK and internationally:
Medical Diagnosis: AI systems are being designed to accurately diagnose disease from medical imaging scans and microscope slides.
In Radiotherapy: Radiotherapy normally uses generic dose prescriptions that don’t consider the characteristics of individual tumors. However, an AI framework has been developed to use a patient’s CT scans and electronic health records to create a specific individualized dose.
For Virtual Nursing: Virtual nurses are robots designed to monitor health.
Robotic Surgery: Robots have been developed, which are able to carry out routine operations. Recent research has shown that these surgeries can have up to a five-fold reduction in surgical complications. This, partnered with the decrease in staff required and time saved, could be a promising investment for the future.
Information Services: The Department of Health announced a partnership between the NHS and Amazon’s Alexa, so that Alexa now automatically searches NHS websites when asked medical questions. By integrating the NHS website content directly into Alexa’s core knowledge base, it is able to reach a far wider user base as users do not need to enable this skill in advance.
AI could help address the health and wellbeing gap by predicting which individuals or groups of individuals are at risk of illness and allow the NHS to target treatment more effectively towards them.
Therefore, Integration of AI in tandem with proper funding could be a long-term solution in the health and care system.