On August 23, 2021 the UK Government published its report entitled “Harnessing technology for the long-term sustainability of the UK’s healthcare system” (the “Report”). The Report calls for system-wide adoption of technology in the UK health system to enable transformative change that will benefit the health and wellbeing of the UK and promote economic growth. However, the Report cautions that technology alone cannot overcome the inequalities that lead to disparities in health outcomes and that digital tools for health should be accessible to all, or risk exacerbating health inequalities as a result of a “digital divide”. The Report notes how the COVID-19 pandemic has both exposed the limitations of the current system and highlighted the capability of the UK National Health Service (“NHS”) for responding with flexibility and agility. The Report also makes several recommendations to the UK Government, including to set up “Demonstrators” to test the system-wide application of healthcare technologies.
The Report arrives ahead of the expected publication of the UK Government’s review into the use of health data for research and analysis (see our earlier blog here), and outlines the opportunities presented by technology in the context of public healthcare systems.
The Report highlights two main “priorities” for public health systems regarding the wide-spread adoption of technology:
- Supporting a step-change to improve and maintain population health, centred around new ways of engaging and supporting individuals and communities enabled by data and evidence. The Report proposes four areas where technology can play a role for health promotion: (i) enabling more effective monitoring of population health risk factors, (ii) enabling individuals to make informed choices about their health, (iii) using digital engagement to improve health literacy, and (iv) enabling engagement with hard-to-reach individuals and vulnerable groups, for example through remote monitoring of self-administered medication.
- Re-engineering the health systems to support integrated “pathways” for prevention, treatment and care and better outcomes for individuals. The Report notes that technology can be used (i) to minimise the need for in-person hospital attendance, to free-up clinicians’ time “to ensure face-to-face consultation for most complex cases or those who are digitally excluded”, and (ii) to enable greater accessibility to health-checks, including allowing for more routine monitoring of health indications.
The Report goes on to make three key recommendations to the UK Government:
- The UK Government should set up at least two scale “Demonstrators” to test the system-wide application of healthcare technologies. A “Demonstrator” would be a given region that would be used to trial the full range of technology solutions intended to be applied to the whole UK healthcare system. This testing is intended to last for a duration of 5-10 years, and enable rapid learnings around the challenges involved in widespread adoption of the relevant technologies. The Demonstrators are also stated to provide an opportunity for “private sector innovators to work in partnership with local health systems innovators to test new approaches enabled by technology and to gather know how and evidence of efficacy in a clinical setting”.
In Annex C, the Report sets out the principles for the development of a Demonstrator, which includes, among others:
- establishing a regulated, unified data strategy that delivers for individuals, the NHS, and innovation; and
- ensuring that implementation of new technologies is accompanied by strong research systems to establish the efficacy and underpin trust.
The Report highlights the importance of evidence-based approaches to adopting new technologies, and calls for common standards to be developed around what evidence is needed before the rollout of a technology into the health system.
- The UK Government should establish a “National Centre for Health System Improvement”. This centre would provide oversight to the Demonstrators and support the integration of technologies within them, working to “advise, design and evaluate system changes”, as well as building “capability and capacity for technology-driven improvements to the healthcare system”.
- The UK Government should work with the National Institute for Health and Care (“NICE”), regulators and the research community to promote the development of an evidence base to underpin effective use of digital health technologies as part of care pathways. The Report calls upon the UK Government to work in collaboration with research and professional bodies to develop common standards regarding evidence required before the rollout of a technology into the healthcare system and to ensure that the correct tools are implemented. Exemptions from the standards are also envisaged, with such exemptions to be developed by Demonstrators and NICE working together.
The team at Covington will continue to monitor developments.