The NHS cannot embrace AI until core IT systems are in place

The NHS will struggle to embrace technological advances in areas such as AI because its core systems are too slow and “devastatingly user-insensitive”, according to one of the UK’s leading scientists.

Prof Sir Martin Landray, co-founder of the UK Recovery trial which saved thousands of lives during the Covid pandemic, said it was “deeply frustrating” that the health service was lagging so far behind other sectors such as banking and entertainment in its use of data and technology.

The use of technology in healthcare was a key part of Ara Darzi’s review of the NHS last week, which will form the basis of Labour’s reform plans for the next 10 years. Lord Darzi said the NHS was far less productive than it could be, and that part of the solution would be a “pivot to technology” by investing in IT systems, particularly in community services rather than acute hospitals.

“Lord Darzi rightly points out the opportunities for increased productivity and quality of care,” Landray said last week. “But cutting-edge technologies like AI, patient portals and digital support systems require trusted, secure and well-connected data (and the foundational systems to store and manage it).”

He added: “Currently, the fundamentals of clinical desktop and office systems are slow, unreliable and hugely user-unfriendly, adding cost, time and frustration. Meanwhile, data sits in silos – hospital to hospital, GP to GP, with little to no central availability of mental health or community care.

“For years, the potential of technology and the richness of the underlying data has been talked about. Yet, as a practising NHS clinician and researcher, it is deeply frustrating to me to see how far behind the NHS is in areas such as personal banking, commerce and the entertainment industry.”

In an interview with The Times Darzi pointed out on Saturday that only 1% of GP appointments are managed through the NHS app, while 80% of people in England have registered through the app.

“If 80% of a bank’s customers use its app, the bank would not be happy if only 1% of them could access their checking account via the app,” he said.

The NHS is looking at ways to integrate data and is setting up a federated data platform. The seven-year, £330m project faced resistance after the contract was awarded to Palantir, a US company co-founded by billionaire Peter Thiel that works closely with the CIA.

Darzi noted in his report that some parts of healthcare are making good use of technology, with 56% of NHS hospitals already using AI tools to examine X-rays and other scans.

“From the discovery of new treatments to novel diagnostics and biomarkers to routine process automation, there are countless ways in which health care can undergo extraordinary changes,” he wrote.

Layla McCay, director of policy at the NHS Confederation, said some NHS organisations were already offering “advanced treatments” to patients.

“But not all healthcare organisations have the same level of digital maturity, with some lagging behind due to an urgent need for investment and support,” she said, adding that a technological revolution would “not come cheap”. “Some of this involves replacing ageing equipment, with reports of NHS staff having to wait too long for computers to boot up or load,” McCay said. “But while digital infrastructure is important, there is a lack of focus on the skills and capacity to use and manage technology. The latest digital and technological innovations will only benefit patients and increase productivity if staff are well trained and confident in using them.”