ILord Ara Darzi’s report on the state of the nation’s health service last week made for bleak reading. In unsparing detail, the eminent surgeon outlined the steady decline that has taken place in the NHS over the past 15 years, a decline in effectiveness that now causes an estimated 14,000 unnecessary deaths a year, he argued. As headline writers for the nation’s newspapers made clear, the NHS now faces a simple truth. It must “reform or die.”
How this change can be achieved, however, is unclear. Our health service needs to be better funded, although the government has warned that little money is likely to be made available for such a monumental transformation. Most of the reforms needed to save the NHS will have to come from within, ministers have stressed. In other words, internal innovation and improved use of existing resources will be central to ensuring that British people receive the right medical care for decades to come.
It’s a daunting task, but such resources are not entirely absent from the NHS. The data it generates every day is a key example. Every time someone visits a GP, is prescribed a drug, goes to the A&E, has a scan, a blood test or a hip replacement, they are generating data. And given that the four countries of the UK have a combined population of 67 million people using the NHS from cradle to grave, this generates a pool of medical information that is unique in its size, detail and diversity.
If organised properly, such a vast database has enormous potential for exploring new treatments, diagnostics and medicines. A process that would make the NHS more efficient could also generate billions by supporting clinical trials and boosting drug development. Unfortunately, this vast repository of medical information is not easily accessible because it is stored in individual silos – hospital by hospital, GP practice by GP practice – with little data made available to central organisations.
Clinical computer systems are slow, unreliable and terribly user-unfriendly, making it almost impossible to understand care patterns or conduct research, said Martin Landray, co-founder of the UK Recovery programme, which has saved thousands of lives during the Covid pandemic. “It’s deeply frustrating to see how far behind the NHS is in areas like personal banking, commerce and the entertainment industry,” he said last week.
Landray’s point is well made, and suggests a clear path for improvement: by reforming the way the health service handles its computer data. However, the NHS’s installation of IT systems has not had a good track record over the past decade, with dozens of cases highlighting failures to ensure that digital data is shared properly. Moreover, such technological reforms would have to come at a time when the NHS has 7.6 million people waiting for routine hospital treatment, compared with 2.4 million in 2010. Reducing the colossal backlog is a top priority. Finding time to reboot its computer systems at the same time will not be easy.
Yet the NHS’s work will improve if data is shared more quickly and effectively. This was evident during the COVID lockdown, when special measures facilitated the flow of data between centres and strengthened the country’s medical response to the pandemic.
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Britain has squandered that lead. By unlocking the country’s goldmine of medical data, the NHS could anchor research at its core and set up clinical trials that are vital to the development of new medicines in this country. It would allow our clinicians to contribute to the discovery of new treatments rather than struggling with a public health crisis while hoping that effective treatments might emerge elsewhere.