Roundtable: What role can digital leaders play in advancing the NHS’s environmental sustainability?

Despite its growing importance, it is the experience of some that in many instances, digital leaders do not always recognise sustainability as a key part of their day-to-day work.

This raised the question of to what extent sustainability is a key issue for CCIO’s, CIOs and digital leaders.

“It’s very much intwined in everything we are doing. We are on a digital journey within the NHS, but the driving force of it is improving our patient and clinical services. But behind that is always the sustainability and environmental factors,” said Kelly Calvert, Digital Programme Clinical Change Lead and Chief Nursing Information Officer, North Tees and Hartlepool NHS Foundation Trust.

Using examples such as virtual wards, online appointments and telephone consultations, Kelly highlighted the improvement of NHS services and the patient experience as a driving force, but also recognised how sustainability is a by-product of these changes.

Ruth Moore, Data Analyst at NHS England, shared a similar thought, highlighting that while patient care is the main driver of these programmes, “what’s important is that we look for synergies between these various service design considerations, whether that’s to improve a specific part of patient care, or whether it’s related to cybersecurity or user centred design or sustainability.”

Similarly, one recurring point looked at the importance of the patient journey. As members of the healthcare sector, patients are at the heart of everything the panellists do.

And they agreed that making considerations for digital sustainability in health was important not only for environmental reasons, or for trying to reach net zero goals, but also in so far as it helped to improve the service provided to patients.

Mark Thomas, Chief Digital and Information Officer, NHS Bedfordshire, Luton and Milton Keynes Integrated Care System, said that “The primary thing is enabling someone to start well, live well, age well and die well.”

“Some of the sustainability comes from delivering that differently. [It’s] about taking the services closer to the person as possible that adds benefit for them.”

Using follow ups closer to home and Scotland’s Highlands and Islands service as examples, Mark highlighted how these can be used to “deliver remote services sustainably, and safely.”

Delving into more specific examples of the way tech can be used to improve the patient journey and early interventions, Mark highlighted Virgin Media’s remote stroke monitoring service and the effective thrombolysis of residents.

Our own Martin McFadyen, Head of Public Sector at Virgin Media O₂ Business, corroborated this point, speaking on our work with the East of England Ambulance Service. One gentleman, who had suffered a heart attack, was able to get the appropriate care specifically as a result of the connected ambulance, devices and applications that the paramedics had access to.

“We were able to take the gentleman not to standard A&E, but through the intervention and getting the ECGs to the ambulance into the correct cardiologist, they were able to take him to a cardiology unit to get him treated at the earliest opportunity,” Martin recounted.

And while you can highlight the environmental benefits that this kind of digital intervention has on miles travelled, the heart of this story is around the patient and how technological advancements played a role in improving his healthcare journey.

While the panel recognised the position of sustainability as a by-product of improved digital services for patients, there was also an understanding of the barriers which the health sector may face which prevents them from reaching their digital sustainability goals.

The answers ranged, from lack of money and time to resources. But the biggest barrier which the panel highlighted? Legacy tech.

Kelly Calvert initially highlighted this point. In addition to costs and complying with NHS regulations, “one of the barriers I tend to find is, sometimes the technology is not always able to deliver what I want to, clinically.” As a result, asking suppliers to expand on an area or provide extra development can be time consuming.

Martin McFadyen agreed, “I think I see, across all the public sector, the single biggest barrier is actually the legacy IT estate.”

But solving this issue is not that easy. “It requires money to replace that legacy. It requires time to be able to plan for that replacement programming project. It requires resources and training to then move on to the new platforms or the new environment.” And this is against a backdrop of people who don’t want to see those changes happen.

This introduces another question into the fold: is environmental benefit given enough credibility in the business case?

Assessing that question and the answers highlights the role that sustainability and the environment play in digital transformation.

Ruth Moore also made this connection, stating that “It’s always going to be weighing different things up. With old legacy IT, there’s a lot of embodied carbon, carbon emissions and energy usage that’s associated with the manufacturer and the end-of-life stage of different pieces of hardware.”

It’s important, Ruth argues, to find the balance. When one considers the energy already used, compared to factors such as cost and cybersecurity, it’s a case of seeing “when is the best time to bring a new device in?”