It’s time to reshape NHS innovation approach, says science and technology council

A report from the Council for Science and Technology has called for the government to harness the use of science and technology in the NHS and said now is the time to reshape its approach to innovation in healthcare.

The report, which follows a letter sent from the council to the prime minister, said there are several challenges within the UK healthcare system, with barriers to the flow of information which affect the quality and integration of care.

“Structural silos exist at several levels,” the report said. “Within the medical field, there is a division into specialisms, within the NHS there is an administrative and financial division into trusts, worsened by a lack of interoperability, and across the wider system there is a separation of health from social care and public health services.

“These structures reduce the ease with which information from one part of the system can be shared with other parts, can complicate a patient’s journey through the system, and may waste time and resources.”

The report added that the Covid-19 pandemic has exacerbated the challenges in the NHS, but has also accelerated the adoption of digital throughout the organisation.

But the uptake of adoption is still “perceived to be low and slow”, it added.

“Barriers include emerging technologies not working with current systems and/or with one another and lack of staff capacity and skills to integrate technologies effectively,” said the report.

“The lack of interoperability leads to datasets being fragmented, data being virtually inaccessible to other relevant professionals, and ultimately not being used for optimum benefit,” it said. “The problems of access and interoperability of data were evident early in the Covid pandemic.

“The absence of an adequate integrated digital service delivery and infrastructure presents challenges to creating a more collaborative and coordinated health system and wastes staff time.”

The report highlighted the wide range of technologies that are “ripe for adoption” and that the combination of biomedical and digital technologies has huge potential to transform the NHS.

“Now is the time to build on this momentum and unleash the power of technology and systems thinking to support better outcomes for patients, the workforce and the nation,” said the report.

It said the government has to support a step-change to improve and maintain population health through initiatives such as using technology to monitor population health risk factors, enabling people to make informed choices and use technology to improve health literacy.

“Digital consultation tools, diagnostics and advances in remote monitoring and increased use of hospital at home allow more treatment and care to be delivered in the community, minimising the necessity for hospital attendances and can enable the development of large representative health datasets across the population,” said the report

“More cost-effective and convenient remote technologies for continuous monitoring, routine testing of individuals and more sophisticated decision support tools can speed up screening and triage.”

The report set out three recommendations for the government, including establishing two demonstrator regions to test the system-wide application and integration of healthcare technologies. The council recommended that the demonstrators should run for five to 10 years to enable “iteration and constructive evaluation”.

It added: “Demonstrators should focus on rapid deployment and real-world testing of established and emerging technologies to learn how to deploy them for maximum benefit, rather than research and development for new concepts. Some of these technologies are already being applied in pockets across the UK health system which must be tested at scale.

“The demonstrators are not just an attempt to deliver a technologically enabled ‘hospital of the future’ but will improve how the overall system delivers outcomes for the future, with success resulting in a revolution in primary care, easy and early access to diagnostics, preventive services, leadership to manage an integrated system, more efficient workflows, arrested decline of degenerative conditions, improved indicators of overall population health (such as lower levels of obesity, smoking, diabetes or better sexual health) and reduced inequality of access, experience and outcomes.”

The report also called for the government to set up a new National Centre for Health System Improvement which would work with the demonstrators to advise, design and evaluate changes to the NHS-wide system, as well as build capacity and skills across the NHS.

“This could involve creating a repository of consistent measures of baseline performance and improvement across the whole healthcare system (ideally also incorporating a four nations approach),” it said. “Demonstrators could liaise and share learnings with NHS England’s sustainable improvement team to assist initiatives in being scaled up in the future.”

The centre should also work to build capacity for technology-driven improvement and tackle the skills barrier to adoption and uptake of technologies, it said. 

The report also called for the National Institute for Health and Care Excellence (NICE) to work with government, regulators and the research community to create and promote an evidence base “to underpin effective use of digital health technologies to explore how digital solutions lead to better outcomes in care and system efficiency”.

It added: “There is a need to build this evidence base, regulate technologies used by public bodies and ensure individuals and health and care professionals understand how such technologies can be used most effectively. This has been effectively implemented for medicines, and now that the potential for the positive impact of technology is understood, the same should be done for technology.”