Health tech experts share their thoughts and insights on the NHS at 75, the impact of digital health and technology, future game-changers and the challenges that lie ahead.
The NHS holds a special place in the hearts of the British public. Since its inception in 1948, it has been a symbol of equality and solidarity.
Considered a groundbreaking initiative when introduced by Labour’s minister for health Aneurin Bevan, it transformed healthcare from a privilege to a right accessible to all.
Throughout its 75-year history, the NHS has faced numerous challenges and has adapted and evolved to meet the changing needs of society.
The COVID-19 pandemic and a decade of austerity, however, have brought its future into doubt as waiting lists soar and workforce shortages are predicted to continue rising over the coming years.
A recent poll conducted by the Health Foundation sought to understand the public’s views on the NHS and its future.
The poll highlights that the NHS remains a major source of national pride for the British public.
In fact, more people identify the NHS as a reason to be proud of their country than its history, culture, system of democracy and the royal family.
This was primarily due to its founding principles: being free at the point of use, affordable and funded through taxation.
Only 25 per cent of the public, however, believe that healthcare will continue to be largely free at the point of delivery in the next 10 years.
The poll also revealed a lack of confidence among the public regarding the NHS’s preparedness to meet key challenges in the coming years.
Only 28 per cent believe the NHS is ready to utilise new technologies like artificial intelligence to improve treatment and care, while there is similar apprehension regarding the NHS’s ability to meet the demands of an ageing population, with only 17 per cent believing the NHS to be prepared.
It is clear that the NHS remains a major part of British national identity, but the public harbours doubts about its future sustainability.
Health Tech World heard from five industry experts about their take on the NHS turning 75 and the role that technology will play in preserving and shaping its future.
“We are extremely lucky to have the NHS as it celebrates its 75th anniversary,” Jane Rendall, UK managing director of the medical IT and cybersecurity company Sectra, says.
“It is sometimes too easy to underestimate the value it brings, but having started my career in the NHS […] I’m proud of how the NHS is there for so many people when they are in need.
“Staff go above and beyond the call of duty for patients and their families, often in ways that might not happen in more commercially driven organisations.”
Ian Wharton, founder and CEO of Aide Health – a digital health service for long-term conditions – echoes this sentiment, emphasising the life-saving impact of the NHS.
“The NHS saved my life as a child, so I have everything to owe to it,” he says. While acknowledging the challenges the NHS faces, he stressed that it is an institution to be “immensely proud” of.
Wharton also points out the NHS’s progressive use of technology throughout its history.
From pioneering telemedicine initiatives in the late 1990s to the current adoption of AI for diagnostics and imaging, the NHS has an impressive history of embracing digital solutions to improve healthcare services throughout its lifetime.
“There is much discussion today about how the NHS struggles with innovation, but its history tells a different story,” Wharton adds.
“For example, the world’s first “test-tube baby” was born in the UK as a result of NHS-funded research.
“In the late 1990s, the NHS developed one of the world’s first forms of telemedicine with NHS Direct, giving people access to nurses 24/7.”
Dr Rizwan Malik, consultant NHS radiologist, director of SMR Health Tech Consultancy and member of the Highland Marketing advisory board, shares Wharton’s view, highlighting the huge strides made over the last three decades in radiology.
“I qualified in 1998 and I think it would be reasonable to say that [in that time there has been a transition from an analogue to a digital era,” Dr Malik says
“If we look at my own speciality, for example, we had a few bulky X-ray machines and CT scanners, while MR was very much the preserve of research at high-end academic institutes.
“Now, every single district general hospital should have access to them.
“Imaging was undertaken at specific sites. Films were printed and they had to be viewed on viewing boxes.
“Now, this is all digitised [which means] you can disassociate where an image is undertaken from where it can be viewed.”
Addressing the challenges
The NHS faces unprecedented challenges as it strives to meet the evolving needs of the population.
Financial constraints, an ageing population and increasing demands on healthcare services pose complex hurdles that technology will inevitably play a role in addressing.
“The NHS is a remarkable institution to work for,” says Dr Mark Ratnarajah, a practising NHS paediatrician and UK managing director for C2-Ai.
“But right now, it also finds itself in a challenging position.
“75 years is a point of reflection to consider what we want the NHS to do and achieve.
“We should ask what our roles are as citizens and as healthcare professionals to ensure we have a health service able to support not just us, but patients for the next 75 years.”
There is no easy answer to this, Dr Ratnarajah admits. But, rethinking current care models could be a good place to start.
He believes that services are already beginning to orientate around patients rather than the hospital as boundaries blur between social, primary and secondary care.
“The pandemic was a good example of where we moved into new models of care delivery using telemetry, video consultation and alternative modalities for therapy,” Dr Ratnarajah says.
“There has been a greater bio-psycho-social approach to care for patients – with the emphasis being more than just about the physical need, taking the social, healthcare and resilience of the patient into greater consideration.”
The impending challenges of an ageing population
Rajiv Tanna, co-founder and chief product officer for the home care software Birdie, believes that adopting a healthcare-at-home model will be the key to avoiding an impending crisis in adult social care.
Technology and data is set to play an increasing role in offering insights for early diagnosis and preventative care, helping alleviate strain on the NHS.
“Technology enables healthcare professionals more insight into a person’s overall health and wellbeing,” Tanna says.
Speaking on the unique challenges of an ageing population, he adds:
“We strongly believe this unique challenge requires a new service approach which leverages technology to enable us, as a society, to provide our older relatives with the care they deserve.”
While he is hopeful about the future, Tanna acknowledges the “systemic challenges” that the NHS faces, which hinder the accessibility and implementation of technology-driven service changes.
“Given the systemic challenges the NHS currently faces, from elongated discharge processes to chronic staff shortages and a lack of funding, a lot of those service changes or technologies either haven’t come to fruition yet or aren’t accessible for the majority of older people,” Tanna says.
Another critical challenge is the management of chronic diseases, both in the ageing population and among younger patients.
Tackling this growing issue requires a comprehensive and patient-centric approach, Wharton says. Leveraging technology will be vital.
“To build better patient experiences for long-term health, we need world-class design and technology,” Wharton says.
“We firmly believe that patient-first technology to improve a person’s ability to self-care—and ultimately reduce healthcare utilisation—will be integral to a thriving NHS in the future.”
Several game-changing technologies are set to shape the NHS in the coming decades.
Jane Rendall considers how already digitally mature diagnostic services in the NHS might build on the foundations already laid.
She sees the potential for a more diagnostics-driven service, breaking down barriers between specialities and enabling combined diagnostic insights.
This could revolutionise patient understanding and disease management.
Rendall explains: “There is an opportunity to move towards a more diagnostics-driven service.
“Instead of the older models, where pathology, radiology, ophthalmology, dermatology and many other ‘ologies’, might have been separate things – there is an opportunity to break down barriers further.
“Rather than a radiology report or a histopathology report, we could move to a combined report at the disease level that combines and enriches diagnostic insight.”
Precision medicine and genomic advancements also stand out as potentially transformative forces.
Wharton and Rendall believe that genomic medicine could revolutionise healthcare delivery, enabling personalised medicine, earlier diagnosis and better prevention strategies.
“Genomic medicine will transform healthcare delivery with more personalised medicine, earlier diagnosis and better prevention,” Wharton says.
The “inevitable” adoption of AI
“It goes without saying,” Tanna adds,” that artificial intelligence will be a game-changer for the health and social care sector.”
He envisions AI empowering patients and supporting healthcare professionals in coordinating and delivering better patient outcomes.
The technology is still in its early stages of development, but as it advances, there is set to be an inevitable transition towards a data-driven and technology-enabled healthcare system.
Before that can happen, however, the sector must complete its ongoing shift to a cloud-based, mobile-first system, Tanna says.
Malik agrees that the NHS has pioneered the use of AI, especially in imaging, and points to the potential of wearable devices and remote monitoring technologies in empowering patients to take charge of their health.
Tracking vital signs, monitoring chronic conditions and providing real-time feedback to patients and clinicians could enable early detection of health issues and encourage self-care.
But before that can happen, effective solutions are needed for effectively managing and using this vast amount of data at scale.
This feeds into a common thread of moving towards more preventative services.
Dr Ratnarajah emphasises the importance of scaling innovation to build resilience in healthcare.
He believes that understanding individualised patient risks and adopting anticipatory models of care could bring about significant improvements in healthcare delivery.
Taking advantage of the data we already have
For Dr Ratnarajah, the technologies that will make the biggest impact are not new data systems or healthcare apps but instead how exisiting data is used more effectively.
“There is a lot of conversation around interoperability and often that has connotations around the responsibilities of big tech,” Dr Ratnarajah says.
“But the real opportunity is to adjust that conversation to make sure that people have access to the intelligence [in order to] to recognise individual patient needs, at the time that they need it.”
Dr Ratnarajah highlights the NHS organisations that are pioneering the use of augmented intelligence to risk stratify waiting lists.
This involves building a greater understanding of individual risks and needs rather than relying on a genralised understanding of the ‘average patient’.
Understanding this individualised patient risk at scale could usher in a new paradigm of personalised health.
The regions that have introduced AI technologies for managing waiting lists have already begun to see results.
These organisations are seeing a faster clearing of their elective backlog, reduced A&E attendances and reduced pressures on intensive care units.
The result is a saving of 125 bed days for every 1,000 patients on waiting lists.
“There has been a concerning increase in patients dying or presenting as an emergency in A&E while on waiting lists,” says Dr Ratnarajah.
“Prioritising patients based on their clinical need has been an important solution in some parts of the country, and the opportunity is now to scale the underpinning technology so that similar pathways can be developed in other areas.”
Malik adds that much can be learned from resource-poor countries that, due to a lack of doctors, have brought health tech and digitisation to the fore.
“In sub-Saharan Africa, or the far-East, or even the Indian sub-continent, there aren’t enough doctors, so they have had to rely on health tech and digitisation to make sure patients have some semblance of healthcare delivery in a timely and effective manner,” he explains.
“Rather than thinking we always have to export, there is a lot we can ingest from these countries that have had to learn how we can deliver healthcare in a very different manner.”
“The best days of the NHS are ahead of it”
The future of the NHS lies in harnessing the potential of technology and digital innovation.
If it can embrace the likes of AI, machine learning, telemedicine, wearable tech and data interoperability, the “best days of the NHS are ahead of it,” says Jonathan Abraham, CEO and co-founder of the AI-powered patient management system Healum.
“Unlike a lot of naysayers and doom mongers, I think that because we’ve got a national system and because so much has been invested in the standards and technology solutions in interoperability, we’re way ahead of fragmented systems like the US.
“Actually, it gives us a great opportunity to provide really good tech-enabled services that treat more people and enable the system to […] transform its productivity so the average person working in the NHS can deliver two or three times more, and people are able to get really good access to proactive, personalised care.
“I’m really hopeful and see the NHS as a beacon of doing that across the globe.”
The 75th anniversary of the NHS serves as a reminder of its accomplishments and as a call to action for preserving its future.
“I take this back to the founding principles of the NHS,” Dr Malik says.
“Perhaps there will be a time, sooner or later, [when] we have to ask whether we do still want the principle of free healthcare for our society. I would suggest the answer is yes, absolutely, yes.”
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