The NHS has a rotten reputation when it comes to technology. But insiders hope that could be about to change. A newly-launched testbed programme, bringing together patients, clinicians and technology companies, is aiming to tackle some of the health service's most urgent problems. As an ageing population and funding uncertainties further stress its budget, the potential breakthrough couldn't be more timely.
At Davos in January, NHS England CEO Simon Stevens announced seven innovation testbeds that will take a different approach to tackling the impending health crisis. The initiatives will address everything from long-term conditions such as diabetes and heart illness, to mental-health and old-age care.
In many ways the promise is worryingly familiar. In 2013, the parliamentary Public Accounts Committee called the national programme for IT - a project to digitise healthcare records - one of the "worst fiascos ever", reporting the failure would cost more than £10 billion. A library of NHS-approved healthcare apps were revealed to be insecure, and last year the National Audit Office said a data-sharing system for GPs was over-budget, behind schedule and at the time only used by one clinic.
The NHS can't afford to not get technology right: the failures cost billions of pounds, and that doesn't include the missed opportunity cost of using everything from big data to telehealth to improve treatment and keep people healthy out of hospitals. Hence the testbeds.
The testbeds evolved out of a five-year plan for the NHS, unveiled in 2014, that will try and work out how to balance budgets with caring for an increasingly elderly population. Two of the testbeds are focused on internet of things technology, with Surrey and Borders partnership NHS Foundation Trust using smart devices to help people with dementia stay at home longer and West of England's Academic Health Science Network developing a diabetes digital coach.
The other five testbeds aren't as prescriptive: in North East London and in Lancashire and Cumbria, testbeds are looking to support older people with dementia; Heywood, Middleton and Rochdale NHS is working with Google's Verily on prediction and prevention techniques; Sheffield is looking to help people with diabetes, hypertension and other long-term condition treat themselves at home; and the Birmingham and Solihull project is developing tools for managing mental health.
All the projects are designed to help keep people out of expensive hospitals and clinics. A million patients visit the NHS every 36 hours and over the past decade the number of people attending A&E has risen 25 per cent. Alongside that, total hospital admissions have jumped 31 per cent, according to the NHS Confederation. That's only expected to increase as demographics skew older, with the number of people 75 or older up by 89 per cent since the mid 1970s. As long term illnesses affect more people - as of 2013, there were 3.2 million people with diabetes - that's expected to increase to four million within the decade. Budgets, meanwhile, are all but flat, and in 2013-2014 the NHS in ran a £471 million deficit.
Mike Macdonnell is director of strategy at NHS England - which means part of his job is to help "modernise the health system without going broke". It's "partly fair" to criticise the NHS's track record with technology, he says. "Certainly it's not gone as well as we liked, and there have been some very well-publicised problems in the past." But the testbeds will "try to do something different."
How so? Macdonnell points to the idea of "combinatorial innovation" - a phrase he apologises for. "Increasingly, the nature of innovation is - to use a funny word - combinatorial." Patents with a single name are on the decline, while "combination" patents that combine multiple organisations and ideas are on the rise. "This programme seeks to recognise that - putting together different technologies, entrepreneurs and innovators and then, importantly, pairing them in the real-world with NHS services."
For example, in Rochdale, MSD, a division of German pharmaceutical giant Merck, is working with Verily (formerly Google Life Sciences) to figure out how to use predictive techniques to avoid people developing long-term conditions. And to do that, rather than simply put out a call for bids, Rochdale has the two companies getting the advice of patients and clinicians and one another. MSD's director of healthcare services Junaid Bajwa admits the company doesn't have the data science skills necessary for its project in Rochdale, so it's teaming up with Verily. "What if you could reimagine healthcare either from the eyes of a startup or reimagine healthcare from non-traditional systems, such as a pharma?" he asks. "Who would you choose to work with?"
