Step into the future…


I got off on the wrong foot; the report is a download in an awkward double page spread, a tiny, spindly, grey font that is hell to read on a phone, not much better on a tablet and skips off the edge of the page on a Mac.

Annoying… and, it’s not properly electronic, you have to scroll from the contents page through the 100-odd pages to find what you want.

I know, I know… get over it.

It’s the Topol Report on preparing us to deliver a digital future. Topol is regarded as something of a rock-star in scientific circles. In the real-world it’s hard to know what he is?

A latter day Don Quixote, perhaps?

There’s nothing in the report that you don’t already know, know about or couldn’t have Googled.

It’s a mixture of science faction, future-now-ism and away-with-the fairies.

There are 163 matches to the word ‘should’, the likes of;

‘… wherever possible the adoption of new technologies should enable staff to gain more time to care, promoting deeper interaction with patients.’

… err, yes, thanks, we know that… and;

‘NHS organisations should invest in their existing workforce to develop specialist skills, including the assessment and commissioning of genomics and digital technologies…’

… shouldn’t we try and recruit some nurses, first?

There is an etherial quality to this report, spiritual, dainty. The advisory panel is 70 strong.

As far as I can see, includes no one running hospital. Perhaps that’s the problem?

The sort of people who drink Evian and eat sushi. There are no tea and toast people.

There are a few case studies. A mix of well-trodden paths, very new stuff, yet to be proven and one they can’t seem to get off the ground. Oh and one ‘high-tec’ solution; a combination of the telephone and take a pain killer

Topol should have gone to Milton Keynes or Morecambe Bay to see the future in action. I guess that was too far from London?

What else? Well, if anyone can explain what this means, send me a fax…

‘The successful implementation of technology-enabled care requires the system to deliver targeted support across health and social care sectors and to deploy it to where and when the patient may need it. Monitoring access, usage and outcomes and mapping it to key characteristics, which are markers for inequalities, are essential.’

Topol makes half-hearted predictions;

‘… in the foreseeable future, information from an individual’s DNA sequence will become part of their medical record and used to inform their healthcare in many different ways throughout their life course.’

He omits a definition of foreseeable. I didn’t see the world banking crisis or Brexit coming. Prediction is a dangerous game.

People… easy;

‘The NHS needs to attract, recruit and retain talented science, mathematics and computing graduates to fulfil leadership roles in computational genomics, data science and public health informatics (collectively, ‘bioinformatics’)…’

… and you might want to give some thought how we are supposed to plan a workforce around this little nugget;

‘…different individuals may learn at different rates…. hence, while some people could enter the workforce earlier, others may wish to spend time developing the skills needed to lead specific technological innovation.’

Topol’s final thought;

‘The greatest challenge is the culture shift in learning and innovation, with a willingness to embrace technology for system-wide improvement.’

No, it’s not. Culture is a dead duck. The climate of change is what is important.

We use technologies in our daily lives. Order our groceries, plan our holidays, insure our homes, distance learn, measure our activity and talk to relatives on the other side of the world. We use artificial intelligence,… it’s called a sat-nav.

All the time the Topols of the world make careers out of creating a mystery of the obvious we will believe it’s difficult. It’s not.

And, any technology that isn’t as easy to use as FaceBook… we don’t want.

We don’t need Topol’s ‘should’, we want ‘how’. We want ‘who’ and ‘when’.

What we need is to change the curricula to drag professions out of the 60’s, rein-in regulators poised to pounce, break up the contracting and reimbursement regimes, designed to entrench the past and reward the status-quo.

Most NHS staff come to work, leave the real world behind and step into the past.

This report will do nothing to help them step into the future.

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Reproduced at by kind permission of Roy Lilley.