Keir Starmer vows to create a ‘digital NHS’ following damning Darzi review
The prime minister promises to move from an analogue to a digital NHS after Lord Darzi’s rapid review of the health service found an NHS in disrepair, with outdated IT and low productivity
Prime minister Keir Starmer has pledged to perform “major surgery” on the NHS, promising a 10-year plan, underpinned by digital technologies, to solve the current failings.
The prime minister said the plan will be completely different “from anything that has come before” and promised a move from “an analogue to a digital NHS” and from “sickness to prevention”.
“Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it,” Starmer said.
“The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.”
The prime minister’s comments come after a rapid review of the NHS by Lord Darzi, conducted over nine weeks, found an NHS in crisis, with a broken system and too much of the budget being spent in hospitals.
The Darzi review said that while most sectors of the economy have been drastically transformed by digital technologies over the past decade, the NHS “is in the foothills of digital transformation”.
“The last decade was a missed opportunity to prepare the NHS for the future and to embrace the technologies that would enable a shift in the model from ‘diagnose and treat’ to ‘predict and prevent’,” the review said.
“There must be a major tilt towards technology to unlock productivity. In particular, the hundreds of thousands of NHS staff working outside hospitals urgently need the benefits of digital systems. There is enormous potential in AI [artificial intelligence] to transform care and for life sciences breakthroughs to create new treatments.”
Calls for increased focus on community care
With an ageing population and an increase in long-term conditions, there have been several previous attempts to move care out of hospital and into the community, keeping patients at home longer through the use of technology. However, success has been limited and sporadic.
A recent report by the King’s Fund found that digitally enabled community care is being hampered by a lack of investment and siloed approaches to technology implementation.
There must be a major tilt towards technology to unlock productivity. In particular, the hundreds of thousands of NHS staff working outside hospitals urgently need the benefits of digital systems
Darzi NHS review
Darzi said in his review that while programmes such as virtual wards, which allow patients to be “admitted” while remaining in their own homes, have the potential to reduce hospital admissions and reduce the length of stay for those admitted, the right resources are often not there.
“These include the right professionals with the right skills – and the modern facilities, digital infrastructure, and diagnostics to support them,” the review said.
A key issue is that while there have been many technological innovations in the NHS, none have “radically reshaped services”.
“The NHS, in common with most health systems, continues to struggle to fully realise the benefits of information technology. It always seems to add to the workload of clinicians rather than releasing more time to care by simplifying the inevitable administrative tasks that arise,” the review said.
“The extraordinary richness of NHS datasets is largely untapped either in clinical care, service planning, or research.”
The review said that while the NHS has made significant investments in technology, such as the Federated Data Platform, investment in IT tends to focus on acute hospitals rather than other providers.
“Take community-based services such as district nursing or mental health home treatment. Technology platforms that have existed in the private sector – such as automated route planning – for more than 15 years are rarely found in the NHS,” the review said.
“There are many possible technologies that would support more efficient, higher quality, safer care in the community. But they are largely absent. Given the shift in the disease burden towards long-term conditions, there is a greater need for information systems that work across different settings.”
Darzi also said the NHS App, which has reached a record number of users, is not living up to its potential, and only 1% of GP appointments, a key feature of the app, are managed through it.
“The Covid-19 pandemic led to a rapid increase in registrations for the NHS App, with nearly 80% of adults now registered. But less than 20% use it monthly. The NHS App is not delivering a ‘digital-first’ experience similar to that found in many aspects of daily life, although there is huge potential,” the review said.
The government has pledged to quickly come up with its 10-year plan, which is likely to be launched in the first half of 2025.
Health and social care secretary Wes Streeting, who commissioned the Darzi review, said the findings will inform the plan to “radically reform the NHS and get patients treated on time again”.
“The damage done to the NHS has been more than a decade in the making. We clearly have a long road ahead. But while the NHS is broken, it’s not beaten. We will turn the NHS around so it is there for you when you need it, once again,” he said.
Read more about the NHS and technology
The digital health check, originally planned to be deployed in spring 2024, will be piloted at three local authorities, covering 130,000 people.
Tony Blair Institute calls for digital health record unit to drive creation and implementation of electronic patient records to deliver health and care improvements and ensure the NHS is ready for the era of artificial intelligence.
