In a speech delivered on Tuesday, Secretary of State for Health and Social Care Matt Hancock raised technology higher on the agenda than ever before and spoke about the importance of people, standards, leadership and scalability.
He talked about leadership and the importance of every CEO leading on digital transformation, backed by a recognised team, not just the IT department. He said everyone needs to own the transformation, it needs to be clinically led and then it has a chance of success.
“Better tech is not a ‘nice to have’ but vital to have for the NHS.”
“I want to set out the future for technology in the NHS and why the techno-pessimists are wrong. Because for any organisation to be the best it possibly can be, rejecting the best possible technology is a mistake.”
“Better technology is vital to have and embracing it is the only way to make the NHS sustainable over the long term. If you’re not convinced, then visit any hospital that lacks an electronic patient record system.”
“An EPR records, in digital form, who all your patients are, what’s wrong with them and how they’re being treated. Not having one is like being John Lewis and doing your accounts on paper.”
“I’ve seen it myself. I was on a night shift a few months ago when an alarm went off because a patient was going into arrest.”
“About 20 people, including the most senior doctors in the hospital, rushed into the room. Then they had to wait for 3 minutes until someone had found the patient’s records and wheeled in a trolley with all the files. Then a consultant had to stand on a chair in the corner of the room, reading out the patient record and struggling with the handwriting.”
Hancock talked about many of the challenges and opinions on tech in the NHS. He said “Here’s two examples from the NHS. And there are many more. First, two thirds of all the patient data held by hospital trusts is generated and held in disorganised form, as freeform electronic documents or scanned letters or pdfs. Or worse still as historic paper documents held off-site in a giant warehouse. Or, for GP practices, in the back room of the surgery. They’re called Lloyd George files. The name says it all.”
“I admire David Lloyd George, but he was in office a century ago. Every time people hear Lloyd George, I want them to think of an admirable leader of the past, not a way to store data in the present.”
“Most trusts desperately want to move their past and current health records into a modern, structured, electronic form, so they can easily look things up, track trends and spot patterns in the data.”
“But this means teams of NHS administrators and clinicians constantly having to pore through all these documents, manually translating human-readable text into machine readable, clinical code.”
“It’s a meticulous, time-consuming and expensive process. It means highly trained NHS staff are stuck in some basement office, sometimes duplicating each other’s work, when they could be out treating patients. It doesn’t have to be like this.”
“At King’s, a brilliant team led by Dr James Teo and Professor Richard Dobson have built a natural language processing tool called Cogstack. The Cogstack AI can perform manual coding and data collection tasks in a tenth of the time that it takes a human analyst. Technologies like these have potential to save millions in the cost of coding and analysing data.”
Structures
Hancock first focused on structures. He said “We need a system that makes it easier to get things done. Because it doesn’t matter if you’re a GP surgery trying to put an iPad-based check-in system on your reception desk, or an innovator trying to make email and not letters the default mode of communication between patients and staff – everyone agrees it takes too long to change anything in NHS technology. It’s not that you can’t deliver great tech in the NHS – you can. We’ve all seen examples.”
“I launched NHSX last summer to bring strategy, leadership and technical expertise to what is probably the world’s biggest and definitely the world’s most exciting public sector digital transformation project.”
“NHSX have spent their first 6 months building the organisation – staffing up, researching the problems we want them to solve, above all listening to users and asking ‘what is the user need?’”
“They’ve also found the time to agree an NHS standard for dose syntax, make NHS content easier to search, and run groundbreaking discoveries on screening and mental health.”
“NHSX’s job, critically as part of both the Department and part of the NHS, is to provide the policy, the leadership and the single front door.”
“Our vision for NHS data architecture is to make it more like the back end of the internet – open, interoperable, easily upgradeable.”
“And NHSX sets the standards to make that happen and sets the policy for services that are delivered across the NHS.”
“NHS Digital in turn serves NHSX, and NHS Digital does amazing work, 24/7, to deliver one of the most complex and sensitive technology systems in the world.”
Scalability
Hancock then focused on scalability, “that’s how we’re overhauling our tech policy machine. And with that structure in place, one big thing I want them all to do is start tackling the issue of scalability.Because too many good ideas in the NHS never make it past the pilot stage.”
“NHS Improvement estimate that it takes 17 years on average for a new product or device to go from successful clinical trial to mainstream adoption. 17 years. That is far. Too. Long.”
“We need a culture that rewards and incentivises adoption as well as invention.”
“So we’re taking what we’ve learnt from the successful Global Digital Exemplar programme and giving more trusts the chance to apply these lessons, with our new Digital Aspirants programme.”
“We want to bust the bureaucracy and we can only do it by listening to those burdened by bureaucracy right now.”
“Make no mistake, AI in the NHS is not some distant prospect like nanobot surgeons or 3D-printed organs. It’s already happening right now.”
“UCLH has used AI to predict and prevent the risk of missed appointments. The East Midlands Radiology Consortium are trialling AI to read mammograms. Dartford & Gravesham are looking at an AI-assisted pathway for same-day chest X-ray triage.”
“Over the next 3 years the Lab will support a £140 million AI Award, designed to speed up testing and adoption of the most promising tools.”
Leadership
Hancock closed the speech focusing on leadership. “One of the lessons I’ve learnt over the last 18 months as Secretary of State is that leadership is at the heart of getting this right. Yes, that means our tech leadership – the CCIOs and CIOs and their teams. I want to see a digital and tech leader on every board, there’s no excuse.”
“We need to turn that community of gifted enthusiasts into a recognised and respected profession – feeling part of a wider movement, knowing that around you, there are others who share your passion to improve things. It means a change in culture so the doctor who leads her trust’s adoption of technology gets as much kudos as the doctor who leads her medical department.”
“Every CEO needs to be comfortable and competent in leading digital transformation, every board needs to know what questions to ask, how to hold their CEO to account, every medical director and chief nurse needs to know how technology is going to transform what their teams do and lead that adoption.”
“If everyone leaves it to the IT department, it will fail. If everyone owns it, if it’s clinically led, if the board and the CEO and the top team all have skin in the game, then, and only then, has it a chance of success. So I’ve directed NHSX to ensure that our Digital Ready Workforce Programme is seriously stepped up in scope and ambition.”
