Department of Health and Social Care
We must drive tech innovation and improvement across the NHS
Secretary of State for Health and Social Care Matt Hancock's speech given yesterday at The Royal Society of Medicine event 'Medical apps: mainstreaming innovation'.
It’s fantastic to be here to talk about apps and innovation because, as you know, this is a subject close to my heart.
I’m pleased to say that together with Netflix, Spotify and Citymapper, the Matt Hancock app now has a combined user base of over 300 million people. And it remains the most popular app by a Member of Parliament on the App Store… as well as the only one. It’s not easy being a tech pioneer.
Sir Tim Berners-Lee, inventor of the World Wide Web, said that 30 years on from his world-changing creation, he still believes it can be improved because: “The future is still so much bigger than the past.”
I share Sir Tim’s optimism about the potential of technology because I believe in the potential of people.
Since I’ve been Health Secretary, I’ve made it my mission to get the best technology available into the NHS for one simple reason: the right tech saves lives, and makes life easier for staff.
And I’ve tried to eliminate outdated, old tech like fax machines, pagers, and dial-up because the wrong tech can make life more difficult for our NHS staff.
Tech is merely a tool though, it’s people, who are, and will always be, our priority.
Because it isn’t just frustrating to be asked for the umpteenth time: “Why are you here?” because medical records don’t follow people around the system. It isn’t just inconvenient for a doctor to be stuck trying to remember multiple logins so they can type up their notes, when they should be with a patient. It’s dangerous.
And I was reminded of that this week by a lady called Dawn Wilson.
Her daughter Tamara was diagnosed with asthma as a baby. Tamara was in and out of hospital with acute asthma as she grew up. She was seen 47 times in 4 years by medical staff.
Almost every time, Dawn would have to tell the doctors and nurses Tamara’s medical history from the beginning because Dawn said: “Every time they were treating her like a new patient”. They didn’t know Tamara’s condition, what medication she was on, what her treatment plan was. Staff at 3 hospitals, 30 minutes apart, with no way of accessing the same records.
Dawn told me she felt staff thought she was being an “overprotective mother”, but she was the only link they had with the previous clinician.
On 10 April 2014 Tamara started experiencing breathing difficulties. An appointment was made to see her GP the following day but her condition deteriorated during the night. Paramedics were called, but sadly Tamara died. She was just 13 years old.
Interoperability: a word we often use when we talk about healthtech. For most people that word means very little.
The coroner said one of the factors in Tamara’s death was the lack of a “coordinating record”. Dawn told me that she believes it would have made a difference. That if our systems could speak to each other, and if Tamara’s records could have been safely accessed by all the clinicians treating her, it would have made a difference.
So when I talk about interoperability, I’m not really talking about IT. I’m talking about saving the lives of people like Tamara. I mean “clinical memory”, a clear and comprehensive record of each individual’s health history and medical needs that can be shared, in absolute confidence, between medical teams across the NHS.
It’s why getting the right tech, getting systems that can talk to each other in the NHS, matters so much. Because the only question when it comes to tech is this: does this tech save lives and improve lives?
We must drive innovation and improvement across the NHS. Combining the best of the healthcare culture with the best of the tech culture. Seeking continuous improvement to save and improve lives.
Better tech to give doctors and nurses the gift of time so they can focus on what really matters: caring for patients. Better tech to give faster and more accurate diagnosis and treatment so we can nurse people back to health sooner.
Ensuring promising prototypes don’t get stuck in endless pilots. Ensuring successful ideas spread from one hospital to another, from one trust to the entire NHS. Building systems that can talk to each other and new developers can build on. And making sure we get the basics right like data infrastructure and patient records.
So this is how we’re going to do it: NHSX.
A new specialist unit that brings together all of our tech leadership from the Department of Health and Social Care, NHS England and NHSI into one place. Setting national policy for NHS tech, digital and data. Setting standards that work across the whole of health and care.
It will be led by the government’s digital policy chief, Matthew Gould, who has a unique breadth of experience and a deep understanding of how to make digital transformation happen.
Like so many people in the NHS, we’re lucky to have him, and I want more brilliant people like Matthew to come and be a part of NHSX and its exciting, bold mission.
NHSX will have 3 early priorities:
First: ensuring tech saves time for staff so they can focus on patients.
Second: giving patients the tools to access information and services directly.
And third: creating a system that means patient information can be accessed, safely and reliably, wherever it is needed.
I want us to create a culture at NHSX that’s aspirational, hopeful, optimistic, and realistic. Full of people who respect one another and every single member of the NHS family. Fair, open, honest.
With the door always open to new ideas and new people, creating a diversity of thought, constantly welcoming innovators with an outward-looking approach: a microcosm of what excellence looks like. Radically simplifying the system for developers and NHS decision-makers.
Consistent language for all computers so patient records can be shared easily, time spent transcribing notes is cut, and human error is reduced.
Unique barcodes for every piece of clinical equipment so essential kit can be tracked in real-time, cutting waste and saving hospitals up to £3 million a year.
To test a new way of working, tech experts from NHSX will be embedded in national cancer, mental health and urgent care teams to bring the benefits of modern technology to every patient, clinician, and carer.
We will empower the best digital minds in the NHS, and create an ecosystem where healthtech entrepreneurs are actually excited about working with this innovative, creative, forward-thinking organisation called the NHS.
And the needs of our users will be at the heart of everything we do because the ‘X’ in NHSX stands for user experience.
It’s why all of our standards will be designed and developed together. That means involving everybody that uses the NHS: patients, clinicians, our tech workforce, healthtech suppliers and wider civil society.
All of our standards will be published on the web, so that anyone who wants to write code for the NHS can see what our needs are before they begin. Our regulatory approach will be designed for speed so apps can be improved quickly or removed quickly.
There’s now more than 70 apps on the NHS Apps Library helping people with a range of conditions from diabetes to breast cancer, to mental health and pregnancy.
There’s over a 100 new apps currently being assessed, including apps to help people with autism, to giving patients live information on A&E waiting times.
And we’re continually learning and improving as we roll out the NHS App across England. Working with patients and frontline staff as we connect up the app with GP practices across the country.
More than a million GP appointments a month are now booked through apps. More than 3 million repeat prescriptions are booked online now.
And that’s only with a quarter of the population currently using online medical services. So the potential is huge.
Just take diabetes: there’s 13 different apps available on the Apps Library, offering support on everything from blood glucose levels to diet, weight loss, and self-management for people with type 1 and type 2 diabetes. Living with diabetes can be incredibly tough, but the right technology can make a huge difference.
This week we announced an expansion of wearable monitors for tens of thousands of people with type 1 diabetes, helping them to monitor their own condition, and save them unnecessary and stressful trips to hospital or their GP.
So working with developers, to give people more choice over the apps and digital tools they can use, is crucial. Because ultimately this is all about people.
We care about tech because we care about people. That’s the mindset we all need to have in the NHS.
Well, imagine a future where the NHS App invites you to a cancer screening. You’ve been identified at risk because of medical information and lifestyle data you’ve chosen to share.
You arrive at hospital and an algorithm takes seconds to compare your scan against millions of images. You get the results there and then. No waiting days for the post or checking your inbox nervously. You know exactly what the next steps is: working with medical experts to develop a personalised care plan. And this could happen years before you may have gone to the GP with your first symptoms.
That’s the future I want to see in the NHS. And to get there we need something bigger than just a technological change: we need a culture change.
For too many staff, outdated NHS tech is a hindrance rather than a help. It takes up time rather than saves time. And I understand the frustration. I know the systems of the past haven’t been good enough.
If you’re a nurse, at the end of a long and taxing shift, and the thing that’s preventing you from getting home to your family is a computer that keeps on saying ‘no’, an IT system that won’t play ball, then of course, you’re going to feel like the tech is a hindrance rather than a help.
But the right tech, working in the right way, can and does release time. Because good tech is seamless. It’s something staff shouldn’t even have to think about. The only thing staff should be thinking about is their patients.
So it’s vital we get this right and I’m confident that with NHSX bringing together, driving forward, this tech transformation, we’ll start to create the culture change we need to see in the NHS: innovative, open to change, forward looking. Tech-focused only because we’re people-focused.
Believing in the power of technology because we believe in the power of people.
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