Head of Medical Education and Training at Epsom and St Helier University Hospitals NHS Trust

Martina L Yanga BA (Hons)

Digital transformation in healthcare has the potential to unleash patient patient outcomes through improved quality and efficiency of personalized care within integrated care systems (ICS). Implementing new technologies requires systemic and cultural change, as well as investment in the National Health Service (NHS) digital infrastructure and workforce.

As the largest employer in the UK, the NHS spends 40 percent of its annual budget of £155 billion on employing 1.5 million doctors, nurses, clinical scientists, infrastructure, and support staff. Digital transformation necessitates nurturing and developing the workforce in the emerging digital clinical space.

The Topol Review, commissioned by Health Education England (HEE) and published in 2019, aimed to identify educational gaps in preparing the NHS workforce for a digital future. It brought together experts from healthcare and industry to advise on technological developments and their potential impact on the NHS over the next two decades. The review emphasized the importance of incorporating genomics, data analytics, and AI into undergraduate curricula, along with ethical and patient safety considerations. It highlighted the need to upskill NHS professionals to effectively use new technologies like genomics, AI, digital medicine, and robotics. This review recommended that within five years, education and training programs should equip future employees with the skills necessary to work in a technology-enhanced NHS. This included integrating digital literacy into career pathways, offering opportunities for career development in engineering or computer science, and employing graduates skilled in implementing technological solutions to improve care and productivity.

Research has shown that European medical students, including those in the UK, have expressed the need for more digital health education. The COVID-19 pandemic accelerated the adoption of digital technologies in patient care, including virtual clinics, wards, and remote monitoring. Post-COVID HEE training recovery initiatives focused on simulation training to compensate for lost educational opportunities during the pandemic. AI and VR are now more widely used to facilitate learning.

The integration of AI and VR in medical education and training is revolutionizing how students learn and enhancing their preparedness for future changes in the medical field. AI and VR technologies enable learning during ward rounds and operating theater sessions. For example, AI-powered tools assist in diagnostics and process flows, while VR enables immersive simulations and hands-on training experiences. VR headsets can transmit live case information to groups of students with a facilitator, allowing for remote learning experiences. In surgical training, curricula are being adapted to reflect trends in robotic surgery, ensuring that future professionals are equipped with the necessary digital competencies. Robotics training provides opportunities for immersive learning and three-dimensional observation of operations using mobile devices. Overall, AI and VR integration enhances the quality, efficiency, and safety of healthcare delivery by providing innovative and interactive educational experiences for medical students.

“The integration of AI and VR in medical education and training is revolutionizing how students learn and enhancing their preparedness for future changes in the medical field.”

The Global Digital Exemplar (GDE) program plays a crucial role in fostering a digital health learning ecosystem within the NHS. This initiative supports knowledge exchange and establishes informal networks to promote digital transformation in healthcare. The GDE facilitates the integration of advanced technologies and the development of digital competencies among healthcare professionals. For instance, the University of Manchester has been instrumental in developing digital competency frameworks and educational programs as part of the program. Additionally, the NHS Digital Academy offers a Digital Health Leadership program in collaboration with Imperial College London to develop digital health leaders who can drive transformation within the NHS. Nurses benefit from specialized training programs aimed at creating digitally ready healthcare professionals. With a digital health learning ecosystem, the GDE enhances healthcare delivery's quality, efficiency, and safety through innovative technologies and educational initiatives.

Digital transformation in the NHS faces significant challenges, particularly regarding funding and staff training. While initiatives like the Topol Review have highlighted the importance of preparing the NHS workforce for a digital future, implementing digital literacy programs requires substantial investment. The UK government's allocation of funds for digitization has been insufficient, and NHS organizations burdened by financial deficits may struggle to invest in digital training programs. Moreover, there is a lack of educational infrastructure and capacity within Integrated Care Systems (ICSs) and Integrated Care Boards (ICBs) to deliver training aligned with the NHS Long Term Plan. The generational gap between educators and digital native learners poses a barrier to effective training, requiring educators to address their digital knowledge gaps. To overcome these challenges, it is essential to secure adequate funding for digital literacy programs, enhance educational infrastructure within ICSs and ICBs, and support educators in meeting a healthcare professional's digital learning needs. By addressing these issues, the NHS can better prepare its workforce for the digital transformation of healthcare delivery.

Healthcare libraries play a vital role in digital education by making knowledge more accessible to healthcare professionals and supporting evidence-based decision-making. These libraries use resource discovery tools to help clinicians access repositories and allow organizational learning. In the context of digital transformation, healthcare libraries are transforming into Digital Learning Hubs to promote and scale digitization across ICSs. They collaborate with community education practitioners to provide practical skills training using VR tools and improve digital and health literacy among patients and the public. By reinventing themselves as Digital Learning Hubs, healthcare libraries move away from traditional roles focused on books and journals to spaces that encourage learning, networking, and interaction. This transformation enables healthcare professionals to access educational resources, enhance their digital competencies, and stay updated on the latest developments in healthcare.

Technology-enhanced simulation has become integral to medical training at undergraduate and postgraduate levels, offering learners the opportunity to practice and master clinical skills in a simulated environment. Simulation involves using high-definition mannequins and scenarios to replicate real-life medical situations. By engaging in simulation exercises, medical trainees can enhance their clinical skills, decision-making abilities, and teamwork in a risk-free setting before applying them in actual patient care. Technology-enhanced simulation is significant as it provides a safe and controlled environment for learners to develop competence and confidence, ultimately improving patient safety and healthcare quality. Furthermore, simulation centers act as hubs that bring together healthcare professionals from various disciplines, fostering inter-professional working relationships and collaboration. The adoption of an educative and human factors-based approach helps simulation training contribute to better outcomes in terms of clinical effectiveness, productivity, and patient experience.

The NHS is a national treasure. Nigel Lawson, former Conservative Chancellor of the Exchequer, stated in his autobiography: “The NHS is the closest thing the English (sic) have to a religion, with those who practise in it regarding themselves as a priesthood.” It is widely believed that political parties win or lose elections based on their policies for the NHS. Therefore, it must embrace new technologies to future-proof the noble ethos of quality care for every patient, free of charge at the point of contact.