Professor Maeve Lowery:

This is a great point. Our delivery of care has changed and needs to change further, for cancer and for everything else. I know about cancer so I can speak to that. It is both a challenge and an opportunity. We have been doing things one way for a long time. For chemotherapy, people get in their car, drive, park, get blood tests done, sit and wait and a nurse hangs the chemotherapy drip. Now we are thinking about how we stop people coming to hospitals. Why do people need to come to St. James's Hospital? Perhaps we should go to them. If patients are sick from the chemotherapy, we ask them to come in to us so we can have a look at them. Why do we not go out to them? Why do we not say we will go to see them and see how they are doing today, perhaps with a nurse and an outreach service that does this? Suddenly there is a shift from where we always said to come on in and everyone sits together and waits. Now we are thinking this is not safe and wondering whether it was ever quite right. It is a big challenge but I also see it as a big opportunity.

Applied research can help us with this. St. James's Hospital is the only cancer centre in the country to have an electronic record and thank goodness we have it. It insulated us a lot from the cyberattack. We have been utilising it for research. We think that in the next five years patients will want to read their electronic health records. It will not just be I who reads it and writes things about patients, who have to go to another office to request to have it printed out and given to them. They should be able to see what I am writing about them and understand it. They should also see their blood tests and CAT scan results and what the dieticians have said about them. It should be presented to them in a way they can absorb and understand so they can come back and interrogate us with some questions. It will probably be an app. It will not necessarily mean logging onto a desktop. This has to evolve for the provision of care and education. Of course it would also facilitate research and data collection.

There is a huge opportunity to change what we are doing. If we work together we can do it quicker. Change does not come that quickly. There is a big opportunity, greater than there has been over past decades, to look to see how we can change the delivery of healthcare. This is the point about what a researcher looks like. A lot of the research is driven by nurses. We need to look at the pathway of nursing PhDs and masters programmes and make sure those nurses who provide care in clinics have an opportunity to use what they have learned over those decades of service and apply the right research to answer the questions and deliver the care they want to give. It is not the answer to all of the problems but it can help accelerate the solving of some of the issues.