Given his well-publicised love of all things tech and digital, it comes as no surprise that Matt Hancock’s main priority as Health Secretary will be to overhaul technology in the NHS. Steeped in his family’s software company before entering politics, and driver of a much-praised digital government and economic strategies he seems, on paper, the ideal candidate for ushering in the ‘tech revolution’.
But Hancock will be equally aware of the challenge ahead, and that the dreaded fax machine has outlived many a Health Secretary. So, will his ambitious plans lead to a tech revolution in the NHS, or will the fax machine outlive him?
Last week Hancock unveiled “The future of healthcare: our vision for digital, data and technology in health and care” introducing minimum technical standards to ensure interoperability and upgradability in the NHS. Any system that fails to meet these new standards will be ‘phased out’, and any providers who do not adhere to the new principles will see their contracts terminated. No deadline for this phasing out has yet been given.
The DHSC also reaffirmed its commitment to delivering upon the AI and Data Grand Challenge set out in the Industrial Strategy to ‘use data, AI and innovation to transform the prevention, early diagnosis and treatment of diseases’. Just last month, health minister Lord O’Shaughnessy announced a ten point ‘code of conduct’ for AI intelligence and other data-driven technologies that encourages companies to protect patient data and seeks to ensure that only the best technologies are used by the NHS.
Under the changes, the use of ‘off-the-shelf’ technologies is encouraged, and CCGs and trusts will be free to buy whatever technology they need – so long as it is compliant with the principles. The DHSC said that “this should encourage competition on user experience and better tools for everyone”.
So far, so positive for healthtech and AI companies – especially for those who can meet the new standards. For new and emerging companies, that is unlikely to be a problem – it is older, more dated and less interoperable companies that are likely to suffer under the changes.
This is, of course, not the first time that a Health Minister has sought to upgrade NHS IT and tech. The doomed NHS National Programme for IT cost the tax payer nearly £10 billion before it was scrapped in 2013, one of a string of failed tech reforms.
Hancock is well aware of these failures and of the pressure to make his reforms succeed where the others did not. A key difference between the new changes and the previous attempts is the cost – so far, funding has been limited. Investment in the plans is unlikely to come out of the £20 billion announced earlier this year, and it is improbable that there will be any tech funding announced in next week’s Autumn Budget. In August, Hancock unveiled just £450 million of funding for new technology across the NHS. Alan Woodward, visiting Professor of Cyber Security at Surrey University pointed out that the funding would likely not go far in reality, saying: “Think about it per head, and what it could actually do”. The NHS spent £157 million on simply upgrading its systems to Windows 10.
This time around, reforms are less of a top-down, funded programme and more about making the market more accessible for new providers. Companies will need to show their worth and make a case for how their technology can make a substantial difference to the individual trusts. With the NHS endlessly battling its debts, a company that can highlight how its software can help to save money in the long-term will be an attractive prospect.
NHS trusts can also provide immense non-monetary value to tech companies. The NHS trove of patient data is often cited as one of its most valuable assets, and healthtech and AI companies are keen to access it to further develop technological solutions and diagnostic programmes. Partnerships like that of Google’s DeepMind and Moorfields Eye Hospital have enabled the development of software proven to be as accurate as world-leading eye experts in detecting over 50 different eye diseases. The DHSC highlights DeepMind in its policy paper and describes it as technology that has “the potential to transform the way professionals carry out eye tests.”.
Moorfields is not paying DeepMind anything, but DeepMind is benefitting enormously from the partnership – through harvesting the patient data, it is designing and building diagnostic AI programmes that have the future potential to be adopted around the world.
With the DHSC increasingly cognisant of the importance of safe-guarding patient data, it is important for companies like DeepMind to provide reassurance they are adhering to the new guidelines. Whilst the lack of funding might initially seem discouraging for the healthtech and AI industry, there remain significant benefits and opportunities to working with the NHS and an ever more accessible environment to doing so. If companies create a compelling case for their value, efficiency and safety and if commissioners are receptive to change, the long-held dream of a technologically advanced NHS may just be realised.
Victoria Wilkinson