We are universally bad at predicting how new innovations will transform healthcare – often expecting introduction at great speed (when in reality they take years to deliver) but also surprised by how quickly some complex interventions become common practice.

Previous regional surveys have demonstrated that, while 91.2% of respondents have had ideas for improvement in their workplace, only 10.7% have had their ideas for change implemented.[1]

For most innovation to be sustainable, it’s not simply about coming up with a new idea, but about creating the conditions that are needed to allow innovations to flourish.

The Topol Review, published in 2019, concluded that the UK has the potential to become a world leader in healthcare technologies, including genomics, digital medicine, artificial intelligence, and robotics. The case studies we’ve looked at to inform this report predominantly focus on the use of technology to deliver care in new and innovative ways. This isn’t really a surprise, as technology takes on an increasing role in many aspects of our lives.

Through the Paediatrics 2040 project, we’ve completed a literature review looking at the impact of health technology on the delivery of paediatric care across the last ten years – and it’s use of digital and communication tools that dominate the landscape. We’ve also worked with experts in their field to create a repository of subjects, from genomics to wearables, to examine as case studies.

We were pleased to see the Topol Review note that technologies will not replace healthcare professionals, but will enhance them, and leave more time to provide care for patients. We hope that this report will provide some useful guidance for how to make this happen in the best possible way when it comes to paediatrics.

Survey of RCPCH members

In February 2020, we ran a survey across our UK membership, and over 300 paediatricians took the time to share their views with us, reflecting on the past and joining us on a journey to the future.

We asked a three questions about the last ten years:

• What has impacted the most on your working life?
• What has created the biggest risk to delivering effective services?
• What has changed paediatrics for the better for you?

Technology featured as a key theme in questions on impact and changes for the better – suggesting that paediatricians view technology as having a positive impact on their working life. When you drill into the themes further, you can see this relates in particular to the increased communication and integrated working that technology has facilitated. Electronic records and a paperless system were also frequently mentioned, as was the ability to work remotely.

Figure 1: Responses to the question “In the last ten years, what one change, initiative, idea or process has impacted the most on your working life?”

Figure 2: Responses to the question “In the last ten years, what one change, initiative, idea or process has changed paediatrics for the better for you?”

Figure 3: Responses to the question “In the last ten years, what one change, initiative, idea or process has changed paediatrics for the better for you?” that have focused on technology

Learning from COVID-19

Since we completed this survey in February 2020, we have seen unprecedented changes in paediatric services as a result of COVID-19. It has transformed ways of working, to the extent that lots of the theoretical futures we were exploring in this workstream, especially with regards to the conditions for innovation, have already been experienced.

It was Winston Churchill who first said, “never let a good crisis go to waste.” What COVID-19 has demonstrated is that when we are forced to change something, we can more often than not find a way to do so.

Some might argue that what we have seen during this period isn’t necessarily true, transformative innovation, but more a form of reconfiguration – forced organisational change in response to the crisis.

When thinking about this, it might be helpful if we look at the definition of innovation:[2] Innovation – (the use of) a new idea or method.

While not everything might be thought of as “new”, COVID-19 has forced many paediatric services to innovate in some form, and to introduce and use things that they haven’t tried before. For many, the pace of change in this period has meant that the theoretical futures we were hoping to see in the next five, ten, even twenty years, now seem possible – and indeed some of them are here already, as whole services have moved into a new, virtual world.

COVID-19 has seemingly created the conditions for many technologies to flourish more widely across paediatrics in the UK. Whilst not wanting to stifle this, it will be important to evaluate the impact of using these, both in terms of delivery of care and patient outcomes, when thinking about how to sustain them. It will also be important to think about putting appropriate guidelines and frameworks in place, specific to paediatric care, to make technology safe and accessible for all.