April 14, 2021 | General Practice

Nigel Starey talks to use about technology and the future of Primary Care, and the part technology is playing in the transformation of many services offered by Primary Care Professionals.

Nigel Starey is a retired family doctor and academic GP, and is currently an advisor to the Care Quality Commission, UK.  His views on technology and Primary Care focus on a model of managed care between the health and social care sectors to enable a holistic view of care for all individuals.

He has answered some questions for us on the Future of Primary Care and how massive moves in technological enablement of the Primary Care sector during the covid pandemic will shape its future.

1. What uses of technology do you think have had the biggest impact over the last 12 months?

Internet based access and consulting.- The use of Skype, Zoom etc has dramatically changed the consulting day of all Primary care clinicians. Alongside and supporting this has been the use of mobile communications – texting and sending reminders to improve the efficiency of care and support near patient diagnostics – home monitoring of hypertension, diabetes and other chronic diseases using digital equipment.
We should not forget the impact of pulse oximetry on Covid monitoring – access to patient held oximeters to support decision making about further treatment has been an important aspect of improving treatment.

2. Do you think there are any negatives associated with the use of certain technologies within Primary care, especially concerning patient acceptance of the use of such technology?

Access to digital systems is not universal and those disenfranchised such as the elderly and “Inverse care law losers” can suffer reduced access to care and can become disillusioned and negative to the changes involved.

3. How would you like new technologies to be used moving forwards to best effect for Primary care?

My book describes the changing relationships in Primary and Social care involved during digital transformation – I’d like to see us adapting to these evolving new roles and relationships and expanding the use of new technologies which enable more home based care

4. What are the challenges of sharing data and records between Primary care, Secondary care and Community services to ensure integrated care models can be delivered and how will confidentiality of data and IT system design inhibit any rollout of a fully integrated system?

Two challenges to consider. First the Cultural challenge – all providers treasure their own systems and all will need adapt to come together around a common record, and second the challenge of confidentiality, people have to learn to trust the system to maintain an accurate and useful record.

5. What are the particular challenges of adopting a digital based strategy for remote, rural and deprived populations?

These groups include people whose health needs are among the greatest in the population- but have historically received least attention. This means that the challenge is to finally consign the “Inverse care law” to history – my book describes some of the system and design features which will be fundamental to this.

6. How can the use of other forms of digital technology affect the way Primary care operates in the future?

By enabling more care to be provided closer to home and at higher quality – to maximise everyone’s control over their lives.
Other aspects of digitalisation such as shopping, banking, governance and management support, distance learning and virtual team support all mean that Primary care will look very different in the future.

7. Why should the Primary care sector respond to the Covid pandemic by transformational change when it might be seen as quite a short term crisis in the context of the whole of world history?

Because it is the opportunity for the sector to address and adapt to the changing world around it – changing demography with the rise of the frail elderly,– changing professional roles – less Dr knows best and more adult partnership with patients and everyone taking a more active role in their own care – active citizenship with more volunteering and perhaps even having control of our own medical record (as in Australia).

8. How should the Primary care sector catalyse and stimulate integration between the Health and Social care sectors in the absence of any government long term plan for the social care sector?

By working more closely together – with joint staff training and Primary care tasking a lead in developing and providing “Managed care” for people in nursing and residential care homes or for the frail elderly living in their own homes. Regular “Holistic” reviews involving the individual concerned their care staff and family members, medication reviews with pharmacist input and links with other partners such as solicitors around issues such as lasting power of attorney and wills, social services about safeguarding and family members about issues such as the quality of care and meeting the cost of care.

Nigel is the Author of Health and social care in the digital world which is available to buy on the Routledge website.

Nigel has also shared his views on technology and Primary Care with us on video. You can watch them on our After the Storm Page HERE


April 14, 2021 | General Practice