It's time for a 'digital first' system, Lord Darzi review of health and care warns

Findings from the final report of the Lord Darzi Review of Health and Care indicate advanced technologies offer an opportunity to shift the model of care from 'diagnose and treat' to 'predict and prevent.'
By Leontina Postelnicu
12:29 pm
Doctor looking at mobile device

Politicians and policymakers should draft a ‘comprehensive strategy’ to ensure the NHS and social care system harnesses technology and innovation at pace, a final report from the Lord Darzi Review of Health and Care warns.

It calls for a 'digital first' approach and asks the system to leverage the use of innovative apps and devices, with an increased focus on prevention and promoting healthy behaviours, arguing that advanced technologies, including machine learning, offer an opportunity to change the care model to ‘predict and prevent’ rather than ‘diagnose and treat’: “By applying novel technologies to integrated big datasets generated by the NHS, we will be able to predict illness and act early to prevent it. “This means that care can move from a reactive to a proactive stance, actively reaching out to patients to help them secure and sustain their health.”

It argues that new pathways that would improve patient access to ground-breaking diagnostic tools and treatments should be developed, and today (19 June), it has been confirmed that Lord Ara Darzi has been appointed as chair of the new Accelerated Access Collaborative, aiming to bridge the gap between the NHS, government and industry and speed up access to innovation.

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“If we look back to today from the vantage point of 2030, not seizing the opportunities of tech to transform health and care would be a matter of enormous regret. We must act now with determination to make it happen," the review cautions. 
Recommendations include:

  • Setting up a £500m competition for innovative digital health solutions
  • Asking the government to commit by 2022 to 'going paperless', with a focus on interoperability and cloud-based systems and ensuring that every trust in the country spends 5% of its turnover on IT by 2022 
  • Doubling the £1.8bn investment currently available for digitisation
  • Mandating NHS trusts to have a Chief Technology Officer at board level, along with a team of clinician-informaticians. 

The review also criticises the NHS’ approach to data sharing, arguing that it is built on ‘a flawed understanding of public attitudes':

“Most ordinary people assume that there is an ‘NHS computer’ that contains all clinically relevant information.

“They would be horrified to learn that the health service has tied itself in knots about making clinically important information available to frontline staff who need to see it.

“When people hear about ‘data sharing’ they do not imagine this is from one NHS clinician to another (which they support). They understandably assume it is about selling their data for profit outside the NHS or allowing nosey neighbours to see their private records (which they oppose)."

To build a truly joined-up health and care system, it calls on the government to:

  • Develop a new information governance scheme based on privacy, quality, efficiency, and access
  • Instruct all local health economies to create an integrated data set.

Previous findings released ahead of the publication of the review indicated that investing in a ‘far-reaching’ automation programme could save the NHS nearly £13bn a year, a tenth of its annual running costs, as reported by BJ-HC last week.