Technology in practice

Purpose and context

Developments in technology have reshaped the provision of healthcare. The NHS has successfully sustained advances in the provision of high-quality care, and there have been many transformations in primary care that have improved experiences and outcomes for patients, including:

• full digitisation of patient records, allowing benefits such as patient access to records, analysis supporting health needs assessment, and coordination of healthcare provision;
• computer systems and other technology that support improved patient safety in diagnosis, remote monitoring and prescribing;
• enhanced communication, with patients having access to high-quality information, the ability to book appointments, and the ability to consult using video and chat programmes, all from their computer or smartphone.

The NHS Long Term Plan (NHS, January 2019) set out the ambition for mainstream digitally enhanced care through integrated care records, support for clinicians with digital tools, and enhanced communication with patients.

The Topol Review: Preparing the healthcare workforce to deliver the digital future (Health Education England/NHS, 2019) recommends the future workforce of the NHS will need to have education and training that ensures that technological developments are used most effectively. The delivery of this education and training will also need to make use of digital advances to support all the learning required.

Health Education England’s AI Roadmap identified that 29 per cent of artificial intelligence technologies in the NHS are within primary and community care. General practice was the fourth highest clinical area of deployment and general practitioners the second highest direct users of AI technologies (Unity Insights/HEE, 2022). Ensuring that GP learners are prepared for emerging technologies like AI, and understand the importance of data accuracy and its uses, is important for future patient care.

The COVID-19 pandemic led to the very rapid development of remote consulting, through telephone, video and email-based platforms, and there continues to be a significantly higher demand for online and telephone consulting.

There was also a parallel development of online and remote supervision, teaching and learning. Although the initial focus of the NHS during the pandemic was on patient care, there was still a need for support and learning for doctors in training. This was provided through chat groups and virtual communication tools.

We heard...

The increased use of technology to support all areas of training reform has been widely supported by educators and doctors in training, with a consensus forming around the development of a blended approach to teaching and learning that incorporates modules harnessing the advantages of face-to-face and digital methods.

The following areas of learning were considered most important:

• teaching and learning generic IT skills;
• use of technology in enhancing patient care, e.g. remote monitoring;
• remote consulting;
• data collection and analysis to support population health and data-driven innovation and technology;
• communication skills including video consulting and use of social media;
• support for patients who may struggle to use technology, to promote inclusivity and avoid digital exclusion.

Other proposed topics included integration of education into clinical software, and the uses and ethics of artificial intelligence. There was also a lot of enthusiasm for using innovation in technology to enhance learning and create additional experiences, such as the use of augmented and virtual reality platforms.

Priorities and action

We propose to pursue the following initiatives, working closely with the Technology Enhanced Learning Team:

• Development of a primary care virtual training academy that will bring together all the digital resources in this reform programme, offering an integrated education experience using cutting-edge technology. This academy will be a key mechanism for the delivery of many of the priorities and actions in this report.
• Development of a national virtual learning environment (VLE), with regional and programme sections, to support GP training. This VLE will:
  
  • host resources for running online and blended programmes covering the GP curriculum,
  • including e-learning modules;
  • enable the facilitation of online teaching and learning;
  • link to other e-learning platforms and resources, including exam support
• commissioning and development of technology to support GP training programmes, including:
  
  • Virtual Primary Care – a package of real recordings of GP consultations, with associated learning guides and links;
  • technology and pedagogy to support the live-streaming of clinical experiences to small and large groups of remote learners, for example the Virtual Clinical  Experiences platform;
  • high-fidelity extended reality simulations, focusing on rare but important clinical scenarios;
  • development of a wide range of blended modules across the breadth of the curriculum, including areas that have not traditionally been a focus, such as digital skills, population health, health inequalities and planetary health.

We recognise that providing trainees with an experience of the digital world may require them to be placed in non-traditional settings. This could be done through the establishment of innovative ITP placements within digital primary care teams, or through placements with primary care technological partners (Wang & Horton, 2015).