As the Spectator held its inaugural health summit last week, the fraught issue of NHS funding was once again on the front pages. Jeremy Hunt, the Health Secretary, proposed a 10-year funding deal for the NHS. Two days later Theresa May announced there would be a ‘long-term funding plan’. However, while a multibillion pound cash injection may help, this isn’t going to fix the bigger problem: that is, a rapid rise in demand for healthcare, in part because of an ageing population. So what else can be done? Can technology make the NHS more efficient?
The summit’s keynote speech, by health minister Lord O’Shaughnessy, made the case for data as the potential saviour of the NHS. Its patient dataset is unique, he said, as it encompasses all citizens across their lifetime. ‘That is an asset that no other country can bring together.’
The Government, he explained, is seeking to set up five regional data hubs that would gather patient information from every setting. The goal, he said, was that ‘everybody’s health history will be available at a touch of a button to whoever is looking after them’ – rather than, as is the case now, folders being transferred between departments with the potential of records being lost.
Such data, mined for its insights by artificial intelligence, can then be used to rid the system of inefficiency, O’Shaughnessy argued, by allowing the NHS to plan better, with ‘the right staff and the right specialisms in the right place at the right time’.
But improving productivity is just one dimension. Such data will be invaluable to researchers, too, releasing a ‘wave of innovation through the NHS the like of which we have never seen before’. It was of ‘massive economic value’, he said, which required Government to adopt an ‘investor mindset’.
All of this, O’Shaughnessy said, relied entirely on public trust that data could be stored securely and legally. He explained that a health app, to be launched later this year, will allow people to opt out of having their data shared beyond their personal care.
If O’Shaughnessy outlined a sunny vision of the future, then the subsequent panel discussion dug down into some of the tricky reality of introducing technology into the NHS.
The first focus for the discussion, entitled ‘How can the NHS improve its uptake of new technology?’, was pathology. The advent of digital pathology means consultants can now diagnose disease by looking at a high-res image on a computer rather than down a microscope at a slide. Yet most pathology in the NHS is still done the old-fashioned way, with slides that are stored, potentially lost and, when a second opinion is needed, posted to another consultant in a different part of the country.
Professor David Snead, a consultant pathologist in Coventry, described the benefits of digital pathology. First, he said, AI can raise all pathologists ‘to the same level playing field’. Pathologists ‘will not miss things because the computer will help them to find them’, he explained. Second, AI can reduce the amount of time pathologists spend looking at each slide by flagging up the region of interest. ‘Each slide will take us two or three minutes of careful viewing to find one focus of malignancy. AI can do that before you’ve even picked the slides up.’
Not all NHS trusts, it seems, can afford to go completely digital. One pathologist, speaking from the floor, said the cost of making pathology digital went beyond his trust’s yearly budget. ‘Our director of finance will say “if I spend this much on pathology, can I take it out next year?”’
Neil Mesher, CEO of Philips UK and Ireland, a company which develops digital pathology systems, said industry could help. ‘We don’t have bottomless pockets either, but we can be a bit more flexible,’ he said. ‘Part of the role I think that industry needs to play is in helping to find different solutions to provide the best for patients.’ He suggested industry and the NHS should work together to ‘unlock the power of people and data’ to overcome barriers preventing the adoption of new technology.
Nicole Mather, life sciences consultant for Deloitte, pointed out that partnerships between large companies and the NHS were becoming more common. ‘Over the last five years there have been increasing examples of multinationals who have that financial flexibility partnering with the NHS to invest in capital in order to demonstrate that their systems can be embedded.’
The challenge, she said, is that a new piece of technology often requires a new process. ‘You have to develop that process in partnership with the trust.’ Indeed, closer collaboration between the NHS and industry is a key part of the Government’s life sciences strategy.
Ian Campbell, director of Innovate UK, a public body that is helping to implement that strategy by funding business innovation, explained that spending decisions by NHS commissioners needed to be based on evidence. ‘The better the data, the clearer the outcome, the quicker the uptake will be,’ he said.
He said Innovate UK was seeking to establish pilots for digital pathology and digital radiology. ‘If we can set up five or six centres in the UK that demonstrate the benefits of digital pathology then we have been reassured that the NHS is very much interested in finding the means to adopt that at a more national scale,’ he explained.
Trying to change pathology departments nationally, in a single step, he said, ‘would be destined to fail.’
Digital pathology offers a glimpse of the potential of artificial intelligence. Professor Snead said he believed AI would be transformative. Over the next 10 to 15 years, he said, ‘it’s going to be continually changing radically how laboratories work’. Mesher agreed that a wave of innovation was ahead. ‘We are at a potential inflection point,’ he said, ‘that is unique in our history.’
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