In our latest briefing on the NHS Long Term Plan we examine its approach to utilising data.
The broad vision is to make digitally-enabled care mainstream across the NHS in order to modernise and improve care, but also to realise efficiencies. This should also be seen alongside the Government’s Code of Conduct for Data-driven Health and Care, published towards the end of 2018, as representing a consistent aspiration to embrace the benefits of technology. Commissioners and providers, including those in the medical technology sector, now have clearer opportunities than ever before to turn the NHS into a modern, cutting-edge service.
There are five key strands to the Long Term Plan’s approach to data, which we examine briefly in turn.
The goal is to develop and enable technologies which all patients can embrace and use easily. This includes the NHS App which will provide a “front door” for people to access the NHS digitally, in a manner which is integrated with local and national services. There is a specific initiative to facilitate digital access to maternity records for 100,000 women by 2019/20, and all pregnant women by 2023/24. The Plan also seeks to build on the success of the Diabetes Prevention Programme, by rolling out further digitally-enabled models of therapy for depression and anxiety disorders, as well as therapies for children and young people. The key is to provide easily accessible, technology-based health solutions which put the patient at the forefront of their own care and treatment.
Supporting health and care professionals
The Plan acknowledges that the technology widely used within the NHS very much inhibits professionals from doing their jobs more effectively. It aspires to develop a digital solution which allows staff to capture all information at the point of care (including upskilling the workforce to allow them to use those tools), and within three years to enable mobile digital services for all staff working in the community. The Plan recognises the clear benefits which the digitisation of healthcare support systems would have for the NHS’ workforce, including being able to spend more time with patients and also reduce avoidable healthcare interventions.
Supporting clinical care
Technology will be harnessed so that patients can access and interact with health and care services, through a range of digital options. The NHS App will enable a simple, online triage system to allow patients to manage their own health needs but also direct them to the appropriate service if required. AI will be used to augment the efficacy of those systems, although it is emphasised that in-person services will always be available for those who need or want it. Crucially, the Plan states that over the next five years every patient will be able to access a GP through virtual consultations and, where appropriate, elect for a virtual outpatient appointment rather than having to attend in person. All hospitals will be expected to move away from paper records, and will have to advance to a ‘core level of digitisation’ by 2024.
Improving population health
The use of health data at a population level to identify, develop and target health interventions is a keen area of focus already for many in the health sector and the Long Term Plan embraces this. In particular, population health management solutions will be deployed during 2019 to support Integrated Care Systems in understanding the areas of priority for their population and match NHS services accordingly. De-personalised data will be extracted from local records to improve the quality of population health data, alongside a pledge to work with industry and developers to stimulate innovation and integration through supporting products. This is clearly an area of real opportunity for both the NHS and medical technology providers. The focus on population health as a solution requires the optimisation of the hugely valuable and rich resource of data held by health bodies. Using data in this way, across organisational boundaries does require careful consideration of information governance, particularly when it comes to designing the technical solution – this must be considered in tandem with the legal framework for data sharing.
Improving clinical efficiency and safety
The Plan states that by 2021, pathology networks will have been able to exploit technology in order to turn tests around more quickly and improve access to more complex tests. By 2023, diagnostic imaging networks will be able to make use of new assistive technologies to support more timely image reporting. These are specific examples, but the vision is to use digital technology as much as possible to support the NHS in delivery of high quality specialist care. This will be achieved through mandatory compliance with published open standards to enable interoperability and continual improvement, commissioning ‘open source’ solutions so that the developer community can continue to evolve them, and making central capabilities available to local health systems.
The stated aims of the Plan to move into a digitally-enabled health and care system represents another positive indication that the NHS is ready to move towards the exciting opportunities available to it, however, funding for the IT infrastructure and associated transformation to enable this to happen will be critical. Alongside this, there are a number of legal and regulatory hurdles to clear in order to realise this vision. Those that we often encounter when advising in this area include:
- compliance with data protection and common law duties of confidentiality;
- the regulatory implications of bringing technology products to market;
- procuring services in a lawful manner; and
- commercial contracting arrangements which ensure appropriate risk and gain-sharing.