Alan Mak: We should aim for a digital-first NHS

Posted On: 
14th May 2018

A digital NHS can save lives through shared data – so it’s vital we make the positive case for using anonymised patient information, writes Alan Mak

We will only unlock the immense value of patient data if we have open and honest discussions about how and why data can be used for care and research, writes Alan Mak
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When British scientist Sir Richard Doll published his ground-breaking research into the link between smoking and lung cancer it changed society forever. In the space of 60 years since Doll studied 20 London hospitals, observing that smokers were far more likely than non-smokers to die of lung cancer, numbers taking up the habit has plummeted, cigarette advertising has been banned and plain packaging introduced.

The work done then is just one example of how over its proud history, the NHS has used data to drive medical advancements – protecting millions from deadly illnesses.

But as the NHS approaches its 70th anniversary, and the Fourth Industrial Revolution in healthcare accelerates, there is even more potential for medical data to save lives. In the hospitals of tomorrow artificial intelligence (AI) powered by anonymised patient data will be able to assess the risk of hereditary illnesses, diagnose cancer with more accuracy than humans, and detect diseases years before they develop.

For instance, AI that can diagnose scans for heart disease and lung cancer is already being developed following successful trials at John Radcliffe Hospital, potentially saving billions of pounds and protecting patients from undergoing unnecessary operations. Of 60,000 heart scans carried out each year, 12,000 are reportedly misdiagnosed.

Yet in order for the healthcare AI of the future to become truly effective, the NHS has to upgrade its systems for an era when data is king.

Currently far too many records are stored in paper form, with doctors and nurses still using fax machines and pagers as a common method of communication.

As I argue in a report, published by the Centre for Policy Studies earlier this month, the government should set a target that all interactions within the NHS are paperless within a decade. In other words: we should aim for a digital-first NHS.

Yet it’s vital that the NHS not only makes all communication between clinicians and patients digital but takes advantage of the wealth of data that it can potentially access.

In my report I recommend that data centres for medical research, which were suggested as part of the Life Sciences Industrial Strategy, are expanded to cover the entire population of England within ten years.

As a universal health service our NHS is in a position that few countries around the world can match, with patient records that were described recently by the House of Lords AI Committee as “unique source of value for the nation”. To realise this potential, the key is being able to translate a message to the public that sharing anonymous data has a wider benefit to society.

In particular, the Government needs to learn from the programme, the last attempt to create a centralised data research system, and support the view that machine learning is best with big data sets.

This will, of course, be easier with a younger generation that willingly shares its data online every single day with American technology firms such as Facebook or Google – but research highlighted in my report shows that four in five people say they would be happy to share their medical records for research purposes if they were anonymised.

Some patients will never feel comfortable about their medical data being used for research, and that’s why the patient should be given control of how they want their data to be used. Patients could opt-out of the system in the same way they can from the organ donation scheme.

To make this work, patients need to have easier access to their medical records – and the Health Secretary has already confirmed that he plans to make the UK the first country in the world which will give patients access to patient data through an app – another recommendation in my report.

But while it’s right to recognise the huge benefits that new technology such as AI can bring to the health sector, it’s also vital that the staff, which are at the heart of what makes the NHS such a cherished organisation, are ready for the revolution.

Trusted doctors and nurses are an integral part of the overall NHS experience and the role of technology is to help them, improving productivity and freeing clinicians from administration tasks.

However, we shouldn’t necessarily expect a professional clinician to immediately pick up new technology. Indeed, highly specialised technology could take years to fully master.

For the next generation of doctors and nurses these technologies will become second nature. In the meantime, the NHS must prioritise the upskilling of current staff to be ready to use new technology. In particular, further investment must be made into continuing professional development (CPD) for NHS professionals.

Just as the 2017 Conservative Party Manifesto pledged a National Retraining Scheme for workers in jobs threatened by technological change, the NHS should put in place a similar scheme for doctors and nurses who will be tasked with managing and using new, advanced 4IR technologies in the future, including AI, VR and AR.

The scheme would have two objectives: firstly, help clinicians whose specialist work is being replaced by automation, and secondly, enable doctors and nurses to develop the technical skills to use the medical technologies of the future.

The NHS is in an unrivalled position to take advantage of the unprecedented change in the world of healthcare – almost uniquely among health services around the world it has the potential to harness data to improve patient outcomes. While the most important challenge to overcome is developing paperless systems, just as vital is winning the argument of the benefits of sharing data.

We will only unlock the immense value of patient data if we have open and honest discussions about how and why data can be used for care and research, and how personal information is safeguarded. It’s down to all politicians, NHS leaders, doctors and nurses to make a positive case for how shared data can save lives. 


Alan Mak is MP for Havant and Chair of the 4IR APPG. His report, Powerful Patients, Paperless Systems, was published by the CPS on 1 May