The NHS is sometimes described as being at a tipping point, weighed down by funding issues and resource constraints. But could this beloved national institution be heading for potentially the biggest and most unexpected digital transformation of our time? Certainly looking at recent headlines, like DeepMind’s collaboration with Moorfields Eye Hospital NHS Foundation Trust published in Nature Medicine this week, the NHS’s use of AI and other technologies seems less like sci-fi and more like reality.

As part of a series of briefings to mark the 70th anniversary of the NHS this year, the Health Foundation, Institute for Fiscal Studies, King’s Fund and Nuffield Trust have recently released a new report: ’What will new technology mean for the NHS and its patients?’ The report highlights the challenges in predicting how technological advances will shape the future of health care, and identifies four trends which show transformative potential.

  1.  Genomics and precision medicine - Due to advances in sequencing technology, treatments involving gene therapy, and those which are based on the genetic make-up, environment and lifestyle of the individual in question (precision medicine), are emerging. For example, NICE this year gave a positive recommendation for a stem cell gene therapy treatment, Strimvelis, for a rare adenosine-deaminase deficiency disease. If developments like this continue, genomics and precision medicine have the potential to vastly improve diagnosis and offer more effective treatments compared to conventional therapies.
  2.  Remote care - Technology is enabling healthcare professionals to increasingly deliver care remotely across all areas of the NHS, including in primary care (through online consultations between patient and doctor, like the ‘GP at Hand’ app available in London powered by digital health provider, Babylon), hospital care (through ‘virtual clinics’ where GPs can connect with consultants), and social care (where care homes can be connected to clinician monitoring hubs). If the current trend carries on as predicted, increased digital interactions will allow for more rapid diagnosis and efficiency of treatment, while reducing unnecessary referrals and A&E admittances.
  3. Technology-supported self-management - Digital technology is allowing patients to self-manage and understand their conditions. This is particularly apparent through a rise in health care and lifestyle apps that, for example, support medication adherence and symptom tracking. Although most apps are consumer products used outside the NHS, the NHS is attempting to make better use of them, for example by reimbursing GPs who prescribe a specific app for chronic obstructive pulmonary disease (COPD). Such self-management is also apparent through a rise in remote monitoring devices where patients collect data, for example their blood pressure or glucose levels, and feed this back to clinicians either manually or automatically. Although prescription of apps and remote monitoring devices is not currently being done on a large scale, there is the potential to do so. Such self-monitoring can allow for early detection of a medical issue, fewer unnecessary interactions with clinicians, improved patient behaviour and a data pool for research.
  4. Data and AI - Vast quantities of data are generated daily from both clinical and administrative sources, as well as from pharmaceutical companies, clinical research and patients directly who are using health care apps and remote monitoring devices. However, unlike in Sweden or Denmark for example, the NHS has no mechanism in place which links these sources together. Such a system could allow for across the board electronic health records offering real time information on a patient’s profile, medical history and even genome, enabling a doctor to have the latest information on a patient. This would also allow for the possibility of automated management plans stemming from electronic health records enabling efficiency of treatment, and a data bank for research. Although AI and machine learning are not widely used in the NHS at present, advancements offer the potential for improvements in several areas, for example in detecting tumours by using algorithms to interpret images from MRI and CT scans, automating back-office functions like scheduling appointments and doctor timetables, supporting patient triage, and boosting research into genomics and drug discovery. Indeed, results of the NHS’s use of AI are hitting the mainstream press now, with several of its collaborations with DeepMind Health, an Alphabet-owned AI company, demonstrating the potential of AI to assist clinicians with their diagnoses. Most recently, DeepMind’s work with Moorfields Eye hospital NHS Foundation Trust is being hailed as a breakthrough in its potential to help clinicians diagnose certain eye diseases with a high degree of accuracy, and before irreversible damage occurs.

The report states that if these trends continue to progress as expected, they offer the potential to transform the NHS while offering significant cost savings. However, whether such potential will in fact be harnessed is another question. Although technological advances may offer the potential to ease the pressures faced by the NHS, whether they will do so depends on how these advancements interact with public policy and regulatory landscape, and their acceptance by the general public.