Tech in the NHS—get ready for a digital revolution

How to get the UK’s biggest industry—the NHS—improving faster is a central question in politics. It’s not just that the NHS regularly tops the lists of public concerns. It’s also that with a £120bn budget in England, and already taking up 20 per cent of public sector spending, funding growth for the NHS is squeezing out investment on other public services. How best to increase productivity and quality of treatment to afford the NHS in future and sustain public satisfaction?

All governments have been active and health reforms have been a constant round of centralisation, devolution, targets, market-style incentives, performance management, investment and austerity. There has been no clear winner over the last 30 years regarding what has made most progress. Now all eyes are turning to the technology revolution to help, championed by Health Secretary Matt Hancock, aided by the government’s industrial strategy, and set out in the NHS’s own Long Term Plan in January. 

The opportunities are huge. Digital medicine, such as remote care enabled by smartphone apps and wearable devices, will mean faster diagnosis, better access for patients, and self-management. Examples include the NHS App which provides advice, checks symptoms and connects people with healthcare professionals. Under the Long Term Plan, digital-first primary care will become an option for every patient—replacing some of the 307m consultations at GP surgeries each year. Technology could reduce the need for one third of hospital outpatient visits within five years. 

Of course the technological innovation does not stop there. It stretches beyond the digital realm into high science. The increasing ability to safely edit the genome will lead to more effective treatments. AI will mean faster, safer diagnoses. Robotics will enhance precision surgery, and vastly improve prostheses. There are even quantum technologies—using properties of atoms—which have the potential to revolutionise the NHS, for example, through better imaging. 

These innovations will have a profound impact on patients, NHS staff, the shape of care, and costs. What are the challenges to this huge agenda? 

The first is securing investment. The industrial strategy provides a useful framework for the life sciences sector. Yet capital spending in the NHS, necessary for new kit, is about half the OECD average as a share of GDP and since 2010-11 has declined in real terms. Then there is Brexit, which threatens the necessary networks among European scientists to collaborate for scientific and technological discovery. Meanwhile, the NHS itself needs to be more assertive over its needs for Research and Development, which differ from the priorities of the research community or UK enterprise. How best to use Skype safely in consultations, or automate routine administrative tasks? 

There is also the question of how to secure faster uptake of innovation. Hancock has famously banned fax machines from the NHS, but quick disruption can be counter-productive. Taking the time to make changes may well be faster in the long run. 

Against this challenging backdrop, we must ensure that the technology revolution does not leave some groups behind, when over a third of 65-74 year olds are not using the internet at all. 

What’s certain is that the excitement of the new should not divert investment from other health-enhancing areas like education, housing, social care, good jobs.

We’re not alone—other countries across the OECD club are working together on much of this agenda. The issues would stretch any government. The question is, are we up to it? The forthcoming spending review will be the next test of government commitment.

Read more from our NHS and technology report