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Automation is helping the NHS clear its patient backlog, but not as quickly as expected

The healthcare service's big bet on robotic process automation is making 'impactful' but slow progress

The NHS' automation efforts, used to clear the COVID-19-related patient backlog, are being hampered in part by sub-optimal 'depth of understanding’, one NHS Trust head of emerging technology has said.

Each Trust is saving the hours of between one and ten full-time equivalent (FTE) staff, on average, each year with robotic process automation (RPA), according to Tremaine Richard-Noel, head of emerging technology at Northampton General Hospital NHS Trust. However, more staff training is needed to build robust RPA solutions in each organisation.

The NHS’ RPA tools are deployed across every single one of its sub-organisations in some capacity and are currently seen as “one of the biggest solutions” it has to tackle the six-million-patient backlog.

"If you consider the fact that the NHS has got 1.7 million staff, at the minute - this might sound odd - there's quite a lot of impact but, on the grand scheme of things, there's a lot more to do," said Richard-Noel to IT Pro at UiPath’s Forward 5 conference.

There are numerous challenges facing the UK’s healthcare service and deploying RPA across each NHS organisation, of which each is entirely different, is “not very easy”, he added.

The primary difficulty in deploying the tools is educating the IT experts in each Trust, since there is no centralised list of systems and RPA has to be deployed in each organisation individually.

“It's not like you deploy it once, you have to deploy in every place and there isn't a centralised list of systems in the NHS, so there are challenges in educating quickly,” he said.

There is no shortage of experts within the NHS who are willing to train to use and deploy RPA in each organisation - “they’re really keen,” said Richard-Noel. Around 50 individuals are trained each month through workshops and other upskilling programmes.

The upskilling programmes currently in place aim to improve the existing FTE figures and increase each Trust’s expertise to a point where they can build their own software robots and maintain the automations - although completing nationwide baseline training is a “huge undertaking”.

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Cyber security considerations are also slowing the rate of robot development within the NHS, albeit not with the same significance as the lack of training across each Trust.

Some of the software robots being developed by the NHS are built for basic, non-sensitive data entry, and these can be deployed relatively quickly.

Other robot builds require the safe management of patient data and some projects rely on overseas developers, raising the need for NHS organisations to gain a greater understanding of these new risks.

The only risk when managing the safe transfer of patient data, for example, with software robots is if a bot was built badly from the outset, said Richard-Noel. However, the high degree of governance within an organisation like the NHS prevents unsecured bots from ever being deployed, he added.

How is RPA being used across the NHS already?

The healthcare industry is one of the areas in which use cases for RPA are often touted. For example, previous research has shown that clinicians in the US are spending around 43% of their jobs doing data entry and not face-to-face with patients.

Richard-Noel said there is an endless list of ways RPA is being used in the NHS but one of the most notable is with automated appointment scheduling.

He called the specific initiative ‘automation-initiated follow-up’ which is used by some NHS Trusts to deploy RPA software in a way that reads blood tests, for example, and automatically book a follow-up appointment if the result reveals a cause for concern.

Before the use of RPA, NHS IT systems would book a follow-up appointment by default, even if the results were unproblematic. It’s one way in which the NHS is using RPA to gradually mitigate the patient backlog.

Some NHS Trusts are also using RPA to process the significant number of referrals for people being transferred from primary to secondary care - around 20 million a year, Richard-Noel said.

The processing of these referrals can be done autonomously using RPA, he said, moving away from the days of needing them to be printed off.

The NHS’ use of RPA has accelerated in the past five years thanks to it being part of a national directive from the healthcare service to each of its subsidiaries, but “there is evidence of it being used for about ten years” in total, said Richard-Noel.

The NHS has also been funding dedicated centres of excellence (CoE) for specific technologies.

“A centre of excellence develops common solutions, promotes best practice, and acquires new skills that are then spread throughout the enterprise to increase the likelihood of adopting new ways of working to realise value and allow teams to become self-sufficient,” read the NHS’ cloud CoE website.

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