It’s no good embracing medical technology without listening to doctors


Cold means crisis for our health service. As the temperature falls, the pressure on the NHS rises. But the secretary of state’s prescription for the problem risks failing.

Matt Hancock has got lots of things right: he’s secured billions for the NHS in the coming years, and delivered £420m in recent weeks to help with winter pressures. And he’s made it a priority to drive the uptake of technology in the NHS. He’s right to do so: from artificial intelligence innovations to the latest flu-screening swabs, new devices and techniques could help make the annual winter crisis a thing of the past.

Mr Hancock has gone all guns blazing against the NHS status quo, courting controversy by backing individual apps like Babylon’s GP at Hand, despite limited clinical evidence about their quality. He has banned fax machines and announced a shake-up of GPs’ IT framework. This would see online access to medical records, universal booking systems and software capable of communicating with the rest of the healthcare system. These staples of modern business are the bare minimum we should expect from a healthcare system in 2019.

Yet these proposals may be doomed to fail like so many NHS IT projects before if the misunderstandings between service providers and technologists are allowed to fester. Charging forward like a bull in a china shop won’t get the NHS to reform. It requires care.

Demos spoke to healthcare professionals and technology innovators about the challenge of ending the annual winter crisis. We found that both sides were as ambitious as the secretary of state — but many felt their problems were being ignored.

Healthcare professionals felt that current technology was not designed with the realities of clinical practice in mind and that these innovations would struggle to be adopted.

Innovators found it difficult to understand what doctors wanted, to get the feedback they needed from real patients and ultimately to get around a table to discuss how their solutions could be integrated into the NHS. They also questioned whether institutions like NICE treated diagnostic or administrative tools with the same regard as drugs.

This is not the result of lazy doctors or bureaucratic obstruction — the system is simply under immense pressure. Overstretched NHS staff trying to maintain standards of care for current patients have few resources available to scope out new solutions or to work with the private sector to integrate them.

So where to start? Mr Hancock’s vision for the future of healthcare includes open standards for data and interoperability of technologies. Imposing standards top-down without a clear understanding of what patients want or what technologists can deliver could lead to a cohesive system, but will it be one that NHS providers want to or even are able to use?

Committing new resources to enable a collaborative standard-setting process, bringing doctors, patients and technologists together, could be a great first step. And while we’re at it, we should explore more ambitious proposals such as a chief innovation officer in every trust or start-up hubs within the NHS itself.

There is a whole world of innovations out there, from point-of-care diagnostic tools to transformational advances in artificial intelligence and genomics just waiting to improve the lives of patients and take some strain off our overworked staff.

But the health secretary’s plan for an NHS tech revolution will hit the buffers if the fundamental lack of communication is not addressed. If we want to see a radical overhaul of our healthcare system, it is crucial that the two sides take proactive steps to understand each other.

This article first appeared in the Times Red Box (£) on 8th January 2018.