The NHS is in crisis, facing severe workforce shortages, appointment and elective backlogs, and underfunding. These pressures are reducing the quality of care for patients and leading to staff burnout and poor retention. But while the focus is on front-line services, there is little attention on innovation, which would improve population health, reduce preventable disease and deaths, and ease workforce pressures in the long run.
At a roundtable sponsored by biopharmaceutical company Bristol Myers Squibb (BMS) last month, clinicians, parliamentarians and life sciences industry representatives discussed how greater investment into innovation could help solve some of the NHS’s chronic issues.
The use of tools such as data analysis and artificial intelligence were discussed as crucial in shifting the NHS from a “sickness” to a “prevention” service, by enabling earlier detection, diagnosis, and treatment of diseases, such as cancer and cardiovascular diseases.
Data collection is a challenging area, with privacy concerns at odds with the need to design effective prevention services. Dan Poulter MP, a practising doctor and chair of the All-Party Parliamentary Group (APPG) for Global Health, said that data collection was justified if it was used “for the benefit of the NHS” rather than the private sector, and if penalties were in place for misuse. “Collecting appropriate data about the people we’re looking after [to] feed into general knowledge about [improving] population health is important,” he said.
Data analysis could also be used to address NHS workforce shortages and design more personalised treatment plans for patients. Emily Bauer, haematology/oncology business unit director at BMS, spoke about two tools that the company has developed in partnership with the cancer charity Macmillan, which are currently being trialled in NHS trusts.
One is a prehabilitation initiative, which helps doctors design bespoke interventions for cancer patients before they receive treatment, reducing the need for clinical interventions later. The other is a workforce forecasting tool, which analyses an NHS trust’s existing staff composition to help them adapt skills and align staff training with new treatments. This could support the NHS to adapt training requirements and staff skill mix, while managing the trust’s financial costs, as it utilises existing staff rather than relying on new hires.
Genomics – the study of the genes in our DNA – was discussed as another transformative area that would enable clinicians to find out precisely what type of cancer a patient had, for example, and create ultra-personalised treatment plans.
[See also: How to save the NHS]
However, the public sector is not keeping pace with medical advancements. “All governments want to improve innovation in the NHS,” said Anthony Browne MP, the vice-chair of the APPG for life sciences, but while the science “gets more exciting and complicated”, the “institutional challenges” don’t change. A key barrier to implementation is a lack of “diffusion of innovation beyond areas of best practice”, said James Morris MP, a member of the Health and Social Care Committee. NHS trusts vary in technological proficiency – the Health Service Journal found that one in seven trusts in England do not have an electronic patient record system.
Chronic underfunding is making it difficult for trusts to invest in innovation. According to the HSJ, NHS England’s technology budget has fallen to under £1bn. “When you have to make a choice, do we invest in… [repairing] crumbling infrastructure, technology and innovation, or do we put it into front-line patient care?” asked Poulter. “Front-line patient care is always going to win. There isn’t the money in the system for the NHS to focus on this.”
It was highlighted that NHS senior leadership need to be incentivised to invest in innovation; for example, by making chief executives aware of how a workforce planning tool would help their trust save money, or how a diagnostic tool would improve Care Quality Commission ratings.
Workforce shortages are also stifling the roll-out of new treatments. “The urgent keeps pushing out the important,” said Browne. “Doctors spend all their time trying to treat patients on their list, so learning how to do something differently and adopt it is really slow.” Investment in technology needs to be accompanied by “proper workforce planning to understand how that’s going to be staffed,” added Poulter.
Taiwo Owatemi MP, a member of the Health and Social Care Committee, called on the government to develop a “clear vision” for digital transformation. NHSX was disbanded in 2021, and no single organisation now takes responsibility for best practice in technology. She added that NHS trusts should have an “innovation lead” who could learn from other trusts and advocate new practices.
Indeed, collaboration was emphasised as crucial to embedding innovation. Bauer of BMS stressed the importance of skills-sharing between the life sciences sector and the NHS. Physical proximity enables this; healthcare “clusters” of hospitals, university research institutes and pharmaceutical companies enable different professions to easily learn from each other. Caterina Uva, strategy and operations lead at BMS, spoke about the importance of forums; for example, BMS set up a clinical network of oncology consultants which acts as a “formal structure” for cancer experts to share best practice.
While NHS front-line services urgently need attention, greater investment into innovation could drastically streamline services, reduce staff workloads, and reduce disease and death in the long run. To truly address the capacity challenges facing the NHS, innovation must be recognised as a vital piece of the puzzle.
Approval code: May 2023 | NO-GB-2300140