https://healthtech.blog.gov.uk/2019/07/08/nhsx-building-solid-foundations-for-the-future/

NHSX: building solid foundations for the future

A screen with a picture of the NHSX website and post it note which has "survey results" written on it

On 1 July NHSX officially launched, with our core ambition being to give patients and staff technology that will:

  • reduce the burden on clinicians and staff, so they can focus on patients
  • give people the tools to access information and services directly
  • ensure clinical information can be safely accessed, wherever it is needed
  • improve patient safety across the NHS
  • improve NHS productivity with digital technology

As our new Chief Executive, Matthew Gould, has said the first thing that we are going to do is focus on standards and platforms. This is vital if we are going to deliver a common technology language across the NHS as a whole.

However, it’s very important that we don’t make these standards only fit for the technology of today but also consider what is on the horizon and what is in the pipeline of development across the wider health and care system. 

In line with the priorities of NHSX and those of the Accelerated Access Collaborative to identify the best new innovations and make sure the NHS is ready to use them, we needed to understand the current state of development of those technologies utilising AI. 

It is for these reasons that we launched our state of the nation data-driven ecosystem survey back in May.  By asking questions about what is being developed, as well as “why” and “how”, we hope to make any decisions about these necessary standards and horizon scanning in an evidence-based way. 

We have now closed the survey and are getting into the analysis which we will publish in a report that will inform and give shape to our plans for the next 12 months of work. However, we wanted to give you a sneak peak of some of the results.

Reassuringly out of the 162 respondents, it seems that data-driven developers are thinking along NHSX lines: 67% of respondents are developing a solution to be used by clinicians and 47% for those who live with a long-term condition, with the primary aims of improving system efficiency (69%) and delivering a better experience of care (53%). 

It’s also clear that the standards we have already put in place are beginning to be recognised  with 70% of those developing their solution in accordance with the behaviours set out in the Code of Conduct.

Similarly standards obviously help to stimulate innovation with 48% of solutions being focused on diagnostics and 59% on secondary care where data is already more likely to be in a structured and standardised format than it is in community or primary care settings. 

Yet the results also reveal that we have our work cut out and that the data-driven evolution is not going to happen overnight. Less than a third of developers think that their solution will be ready for deployment at scale in the NHS within a year and approximately a quarter still think this is fairly unlikely in 5 years’ time. 

This is partly because of the time it takes to train and validate AI models but also because there is still a lack of clarity surrounding the regulatory, ethical and legal requirements that these developers will need to meet before we consider their solution safe for NHS use: 

  1. the primary reason developers gave for not following the behaviours of the Code of Conduct is not knowing it existed
  2. 50% sought ethical approval or advice from a health regulator before beginning development … meaning that 50% did not
  3. 50% are not seeking to have their solution classified as a medical device, with 53% of these stating that this is because they do not believe medical device classification is applicable to them 

Time to get to work. 

Jess Morley is a tech adviser to the Department of Health and Social Care specifically focused on policy relating to the use of data-driven health and care technology. She is also an MSc student at the Oxford Internet Institute and a Research Assistant at the Digital Ethics Lab.

Dr Indra Joshi is the Digital Health and AI lead for NHSX, overseeing the digital health initiatives within the NHS with a focus on digital health standards, data, evidence and strategy for AI.

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