Professor Sultan Mahmud, Director of Healthcare at BT reflects on a recent roundtable at The King’s Fund, hosted by BT, in which business healthcare and technology leaders debated what’s standing in the way of a digital health revolution in the NHS.
The NHS is at a pivotal point in its history. For more than 75 years it has provided free, accessible and world-leading healthcare to people across the country, shaping modern medicine, and becoming one of the UK’s most cherished national institutions in the process.
And yet, the 21st Century has brought enormous change. The evolution of the internet and advent of the smartphone have transformed the way consumers interact with organisations, and each other, and while much of society has embraced this new digital age, the NHS has been slower to adapt.
Talk to anyone – inside or outside the service – and you’ll hear opinions on why. From funding to pandemic backlogs, cultural hurdles to its sheer size (the NHS is the world’s largest single health system, and sixth largest employer); change in such conditions is always going to be challenging. Nevertheless, it’s understandable that people feel frustrated at how slow things are moving, especially when lives are at stake.
BT has been a trusted partner of the NHS since day one and is committed to helping it navigate technology and embrace the potential it brings. I am also passionate about the NHS, having spent more than 20 years in the service, including senior regulator, provider and commissioner roles. It’s this background, and my belief that technology has a major role to play in shaping its future, which led to BT launching a major research programme last year, speaking to patients, to NHS staff, and now, to leading minds from across healthcare, policy and business, to understand what’s standing in the way of progress, and how we can collectively do something about it.
Our roundtable was co-hosted by Anu Anand, BBC journalist and podcaster, and myself, and attended by Dr. Paul Bhogal (Consultant Interventional Neuroradiologist), Dr. Michael Quinn (Consultant in Nephrology and Acute Medicine), Rachel Murphy (entrepreneur, health tech advisor and public speaker), Dr. Franz Pfister (CEO & Co-Founder of deepc), Bryce Travers (Digital Lead at ImageEast) and Dr. Amrita Kumar (Consultant Radiologist). It was a rich and rewarding debate; here’s what we agreed on.
Barriers to tech transformation
With many pilots in place at any one time, the NHS is no stranger to trialling with technology. We’re working with it today to introduce electronic patient records and AI-powered communication platforms, such as Diagnostics AI Marketplace, Patient Concierge, Smart Messaging, and Heath Cloud, but too often attempts to introduce modern technology hit hurdles. What exactly did the experts point to as standing in the way?
- Lack of incentives for innovation – responsibility for finding, proposing, testing and championing new technology all too often falls on clinical staff, who are already incredibly busy providing care for their patients.
- A fragmented NHS structure – add to this the fragmented and disjointed structure of NHS trusts and you have a world where no single group of people are incentivised to drive technological transformation in the NHS.
- Short-termism – pressure to address growing waiting lists and plug staffing shortfalls are preventing senior NHS leaders from exploring the long-term solutions that could address these problems more sustainably. As trusts across the country grapple with increasing demands for care with current resources, the NHS needs to find time to build an actionable vision for technology that can support staff in their day-to-day roles.
- Patient journeys are not ready to be digitised – improving the way each patient journey is managed is essential to ensure appropriate care is offered throughout. Patients often don’t have access to their own health data, and records are rarely compatible to be shared either externally or within different healthcare units within the NHS (i.e. GP surgeries, hospitals, specialist clinics, etc.) A platform that is interoperable and that contains all patient data, harmonised to support transfers in between healthcare providers, is crucial.
- Lack of trust in tech – with the recent explosion in the data economy, stories documenting breaches have created an overall sense of fear and distrust in emerging technologies. The successful adoption of new technologies relies on the NHS’s ability to prove how patients benefit from these innovations and alleviate concerns about their data being compromised, misused, or sold off to nefarious third parties.
Digital health: Five priorities for this year
Our roundtable revealed incredible examples of how technology can transform the way patients receive care across the UK and improve the NHS’ productivity – from using AI to help detect suspected abnormalities in breast and chest X-rays, to developing pioneering solutions for early detection of stroke-like symptoms that cut down patient journeys in half.
However, none of these innovations can be scaled to help more patients without a true digital revolution in our healthcare system. Indeed, technology can provide solutions to many of the challenges the NHS is currently faced with, however a true culture shift is required to jumpstart the acceleration of digital health. Drawing from experiences working with or within the NHS, our conversation coalesced at a five-point plan to enable positive change.
- Build platforms to scale – once a new technology implemented in a trust has proven to enhance patient care, other NHS bodies should be able to access a governance structure that allows them to implement the same framework across multiple trusts. Quick and easy scalability is the key to ensuring successful pilots are implemented regionally, improving outcomes for both patients and the NHS.
- Modernise data infrastructure – harmonisation of data is key to ensuring GPs, primary and secondary care providers are aligned on patient journeys, helping reach the right treatment plans faster. Mandated contracts with trusted technology partners would help trusts implement solutions specific to their needs, while also allowing them to organise and share data in a format that encourages interoperability and communication between other trusts.
- National leadership, local delivery – there is a real case for moving certain roles responsible for designing governance frameworks for technological adoption to the frontline of the digital revolution. Similarly, implementing and leveraging vanguards across trusts will allow those who have been successful in implementing technological innovations in their trust to share their framework and support adoption across other regions.
- Better communication – there is a real opportunity for the NHS to share more about its technology use and how it improves outcomes for staff and patients alike. The NHS does manage incredibly sensitive patient data, so there needs to be safeguards in place to continue building trust that it is kept safe. However, these should not hinder communications or the implementation of technology – why it is necessary, how it works and, most importantly, why it will benefit patients in the long term.
- Shift mindsets to move faster – the pandemic showed us how quickly trusts can respond to crisis and enact change. We must reflect on the key learnings and success stories from the NHS’s Covid-19 response and carry on the proactive, can-do attitude that saw many new policies implemented at pace and efficiently, throughout the country.
Implementing change at scale – especially while pushing for a culture change – can be a slow process. We know how important it is for each step of the NHS’s digital transformation to be carefully considered from all angles, to put patients’ best interests at the heart of each decision. Yet as the world heads from one digital revolution to the next, with new technologies like AI unlocking opportunities never before possible, it’s time for the NHS to leapfrog ahead and lean on trusted partners to help build the digital health future the country deserves.
