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Inside BT’s mission to boost NHS connectivity

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BT on the future of AI in healthcare, digital transformation and the tech-enabled future of the NHS

Both BT and the NHS have undergone monumental change since first joining forces in the immediate post-war years and to this day, the two organisations remain closely linked. 

BT’s connectivity and infrastructure solution can be found in every health economy in the country, and it is a vital bridge between the health service and the commercial sector. 

As the NHS grapples with some of the biggest challenges in its 70-year history, the telecoms company is set to play a pivotal role in delivering interoperability and digital transformation. 

Health Tech World sat down with BT’s director of Healthcare Professor Sultan Mahmud to dig deeper into the monumental challenges ahead, the importance of collaboration between the NHS and commercial sector and the tech that is set to transform the nation’s healthcare system. 

Health Tech World: You have spent much of your career in the NHS. Can you tell us about your career to date and what led you to your current role as director of healthcare at BT?

Prof Sultan Mahmud: I spent 25 years in the NHS working across primary care, secondary care, community services, digital, IT, operation roles and half of my time in the NHS as an executive director.

In the last five years of my NHS career, I led across digital. For me, there’s nothing like it. 

I came to BT, essentially, because it’s a national company, the leading telecom in the land, the fifth most trusted brand in the country and it has a big set of apparatus. 

It has a commitment to making sure we do the right things, especially in the NHS and the public sector.

We’ve got to serve a social purpose for transforming services. 

I also know that BT has transformed quite a lot of global customers and FTSE 100 customers by taking them on a digital transformation journey.

When they made the pitch to me, they said, ‘We want someone who’s absolutely rooted in the NHS and cares for it deeply’.

The pitch was compelling.

We’ve been with the NHS since 1948 through thick and thin and we’ve always stood up and tried to help. 

You have this long relationship going back to 1948 but I presume it’s not all completely rosy.

Have there been any barriers and friction?  

Well, the National Programme for IT was a bit of a dog’s breakfast, let’s be honest. 

The NHS want people to understand, in detail, what our problem statements are and then think of the solution.

We don’t like people saying, ‘I’ve got the best thing since sliced bread. Would you like some?’

The difference on this side is that the NHS is a difficult market.

We know lots of startups, particularly in England, who do well in the Nordics and other places.

But when they start here, they don’t get a foot in because the procurements are not slick. 

There are too many pilot projects that never get rolled out and implemented and then suddenly, there’s no more money and the livelihoods of the health tech community are being impacted.

We take that seriously. 

We’ve onboarded an ecosystem of partners who obviously want the BT brand and protection, but also want to retain their sovereignty.

We are a vehicle for getting some of those really exciting companies into the NHS.

Are these well-established, large players or are there opportunities for smaller, nimbler companies? 

We work with a lot of SMEs. We’ve onboarded some really brilliant partners into the BT family.

For example, AXON Diagnostics works with a technology which takes a diagnostic image and streams it to a £500 laptop anywhere with a secure connection. 

A consultant can read that with high fidelity and then act and report on it.

Now, if you think about the workforce issue, that’s a massively enabling technology.

              Professor Sultan Mahmud

This company was doing well. BT has invested in them.

We put our money where our mouth is, supporting them into developing customer relationships and expanding their base.

That adds pounds, shillings and pence, as well as goodwill into the healthcare market, which is vitally important if the NHS is to retain its prestige as one of the leading health systems in the world.

This can improve the throughput of radiology significantly.

What are your main priorities in the role? 

We know that there’s a significant need to improve connectivity and infrastructure in the NHS. That’s our first and foremost focus. 

The second one is around specific customer pain points.

There are 7.7 million people on the waiting list. 1.7 million of those are diagnostic waits. We’re really committed to making those networks work.

Then, we know the power of AI. We have an enterprise-grade AI platform with our partner Deep Sea.

There are 49 FDA and CE marked algorithms on this solution. Whatever PAC system you have, it plugs on top of anything.

We can then read the images with up to 99.9 level per cent of accuracy and report. 

Now, it doesn’t take the job of the clinician. The clinician has the first and final say but this acts like a kind of co-pilot. 

Can you go into more detail on future-ready infrastructure in the NHS?

Cloud provisioning in the NHS is not where it needs to be.

We know that there are specific challenges that it creates in terms of data provisioning, so the moving to a public cloud is important, but also expensive. 

We’ve got a range of solutions to train infrastructure with hybrid cloud solutions.

We’re working with the likes of AWS, Microsoft and Google for the direct cloud services.

We have an ecosystem of partners in the hybrid cloud space: Dell, Equinox, Rackspace.

We work in verticals like that, and we architect a multi-hospital or multi-system cloud infrastructure. 

We started that with the likes of Liverpool University Hospital Trust and the provision is there for 20 or 30 organisations to put their [data] on that system.

There are pounds to be saved for the NHS, but also lots of sustainability […] benefits.

The second thing is, we’ve got a national data platform that Palantir have been awarded.

We’re working with some of the organisations who are saying, ‘this is a great system, but the pipes it sits on need to be much better’.

Better connectivity and networking is a crucial thing and nobody has a better network than BT.

Mission critical systems are better on BT because of the pedigree we have, but also the engineering base.

There are barriers in terms of where the technology is now.

But what about other barriers, like resistance from leadership within the NHS, for example?

One of the main barriers at the moment is elective recovery.

There is a need for the commercial sector, like BT and others, to interlock with the NHS on a really close basis.

That doesn’t mean that everyone has to get a contract, but I think there should be good, strong partnerships where we work together to co-create solutions. 

Is health an area where you really have to be collaborative with other major tech players?

I think collaboration and partnership is the only way we’re going to deliver.

If you think about the EPR vendors, the people who implement APIs, the global hyperscalers like Google, Amazon, Microsoft – these are all important entities. 

Underneath that, there are also hardware providers and service and design providers that we all need to work together with.

We all have different strengths.

I think permission needs to be given around commercial relationships, because all the names I’ve mentioned are supporting the NHS because it’s 10 per cent of GDP. 

The NHS needs to be bullish about partnerships, saying, ‘here are our problems, come in and have a chat’.

That way you’ll sort the wheat from the chaff and you’ll move really quickly, 

The new government will need to really encourage the NHS and the commercial sector to work closely without fear of reprisal.

Because you’re not breaking any rules by collaborating and defining problem statements, if you keep that public. 

As an organisation, are you engaged in the whole conversation about the future of AI?

The thing with AI is there is a lot of noise around it. Most of the opportunities are around back office and management.

If you think about how long it takes to recruit someone in the NHS, AI can do that recruitment in terms of the paperwork and admin really quickly – better than humans. 

If you think about areas such as procurement and pricing, AI can do an awful lot in finance, HR, admin and clinical coding.

It can do this really quickly and find savings. 

AI is going to change the world. There’s no question about that.

A lot of the basic stuff that AI and ML can do is admin. It’s low hanging fruit, it doesn’t have a regulatory barrier, but the NHS needs to move quicker.

That low hanging fruit, we should just get on with.

In terms of replacing people’s jobs, some of that is based on large language models and people who understand the science know that that is some way away.

We have ethics built into everything that we do.

Anything that comes into the NHS will have a thorough ethical and governance process underpinning it through BT’s standard processes, which are quite a high bar.

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