Health Minister on digital - ‘I want to gut the internal wiring of the NHS’

Profile picture for user ddpreez By Derek du Preez March 27, 2019
Nicola Blackwood gave a speech this week on the government’s digital strategy for the NHS, where she said we need to “move on” from the National Programme for IT.

Image of a doctor with an iPad
The National Health Service (NHS) is at the early stages of introducing a new technology strategy, which aims to introduce interoperability, open standards and ensure a smarter approach to using health data. Health Secretary Matt Hancock has warned that vendors that don’t fall into line with the new approach will risk being phased out.

The aim of the strategy is to put patients at the centre and to eliminate some of the pain NHS Trusts are experiencing, by introducing new operating models, aided by digital technologies.

A new digital department for the NHS - dubbed NHSX - has also been created to help drive this forward from the centre, much like the Government Digital Service did for Whitehall departments.

However, given the failings of top-down technology strategies in the NHS in the past, most notably the multi-billion pound waste of money that was the National Programme for IT, it’s unsurprising that some are hesitant and looking on nervously.

This week Health Minister Nicola Blackwood gave a speech at Delving into Digital, an event hosted by the Association of Medical Research Charities, where she provided some more detail on the government’s approach and looked to alleviate fears of the same mistakes being made again.

Commenting on the launch of the new strategy, Blackwood said that it’s time to forget past failings;

“I have found the twittersphere’s reaction to this important. The techies – predictably – love it. Their reaction can be summed up more or less in 3 words “about bloody time”. The wider public though (even some in the NHS if we’re honest) too often still see investment in healthtech as a zero sum game.

“On one level, this is understandable frustration born out of painful experiences we could all name.

“But digital solutions today are light years on from the clunky offerings of the past that gave us the National Programme for IT, and it is time we move on from that now.”

However, the Health Minister did admit there are barriers to adoption within the NHS, which she cited as:

  • The need for a consistent understanding across the NHS, regulators, industry and the public about what good evidence for health tech looks like.
  • The need to gain and retain public trust in health data sharing.
  • The need to train, challenge and win over the NHS workforce to digital - from boards to wards

Some examples

Blackwood used her speech to provide some examples of how the NHS is already making attempts to reduce friction within the health service, using digital tools.

She cited how the government has made a commitment that every NHS patient will be able to access digital primary care services. Also, in acute care patients will be given the opportunity to access services digital, and thus potentially avoiding daily, weekly or monthly hospital visits.

Blackwood said that she also wants to see transformation akin to that provided in Tower Hamlets by e-clinics for those with chronic kidney disease, where single patient pathways are provided with rapid access to specialist advice by consultants. Since the e-clinics began in 2015, she said, 50% of referrals are managed without the need for a hospital appointment and the average waiting time for a real clinic appointment has fallen from 64 days to 5.

The Health Minister added that she wants to “gut the internal wiring of the NHS” and deliver “real interoperability of health data and technology”.

It’s all about trust

Blackwood said that NHSX goes live in 12 days and that the organisation will play a “vital role” in driving forward the government’s agenda, bringing together partners from across the health and care system to “radically improve the digital provision and organisation of services”.

However, the Health Minister noted that the government does have to build trust, particularly around patient data, if it wants to get this right. She said:

“But we must be very clear – we do not have a right to patients’ data, or their engagement in our digital programmes and activities. We must earn this by gaining and retaining their trust.

“Our responsibility as an internationally trusted health and care system is to use all the tools at our disposal to improve the quality and safety of care, including data-driven technologies, in a safe, ethical, evidenced and transparent way. For this reason, we have developed our 10 principles in a code of conduct to enable the development and adoption of safe, ethical and effective data-driven health and care technologies.

“The code is designed to recognise that, while data-driven health and care technologies will undoubtedly deliver huge benefits to patients, clinicians, carers, service users and the system as a whole, it is our duty to capitalise on these opportunities responsibly.

“If we do not think about issues such as transparency, explicability, and bias, it is also possible that the increasing use of digital technologies within the health and care system could cause unintended consequences.”