Lord Darzi: Seize the opportunity

Source: NHE Sept/Oct 2018

Professor the Lord Darzi of Denham is the Paul Hamlyn chair of surgery at Imperial College, a surgeon working in the NHS and, from 2007-09, was health minister under Labour. Here, he highlights the importance of innovation in the NHS, and the exciting prospects it might bring if we’re brave enough to seize the opportunities ahead.

Seventeen years ago, I performed the first operation in the UK using a surgical robot. As it happens, that is the average time it takes for an innovation to spread around the NHS. Today, updated versions are widely available, giving surgeons a magnified view of the operative field and allowing them to cut and stitch with great precision, reducing errors, improving care and speeding recovery.

But 17 years? It is far too slow. That is why the joint government-industry group, the Accelerated Access Collaborative – which I chair – was launched last year to identify the most transformative medical innovations and ensure they are available on the NHS up to four years earlier than at present.

Investment is vital to realise these gains. British doctors and scientists discovered DNA, pioneered the first heart and lung transplants, and led developments in modern genomics. We are now on the cusp of a new revolution in robotics, artificial intelligence, and digital applications powered by the NHS’s unrivalled sources of data in which British doctors and scientists are again leading the way.

In my Review of Health and Care, published by the Institute of Public Policy Research in June to mark the 70th anniversary of the NHS, I argued that we must stop approaching health and social care as liabilities to be managed and see them for what they are: tremendous national assets that not only enable us to lead the best lives we can, but which are also vital determinants of our economy.

The life sciences sector employs a quarter of a million people, generating £64bn in revenue each year, and is estimated to have contributed 50% of the increase in life expectancy in recent decades – a double dividend. There is therefore the potential to create a virtuous circle by simultaneously growing health and wealth in the UK.

However, in the decade following my earlier report, ‘High Quality Care for All,’ published in 2008 when I was a minister in Gordon Brown’s government, the system was starved of investment and was showing the strain. Though quality was maintained or improved – a remarkable achievement given the pressures, as revealed in my interim report in April – the years of austerity took their toll and access declined. The stories were depressingly familiar: patients left on trolleys, operations cancelled, staff posts unfilled, deficits rising…

Now we have a chance to reverse the trend with Theresa May’s announcement of a £20bn birthday present for the NHS in July. It will never be enough, but it is undeniably a large sum, and the priority now is to see that it is wisely spent.

History shows that it is developments in science and technology that have had the biggest impact in transforming care, from hip replacements to heart transplants, magnetic resonance imaging (MRI) to effective drug treatment for HIV/Aids. Innovation is the key to the NHS’s future. Without innovation, it cannot survive.

New technologies are changing the way care is delivered and how it is provided. People spend hours on their smartphones daily but typically see a doctor or health professional just once a year. Mobile apps to help patients track changes in their health and respond appropriately are bringing quicker treatment and lower costs.

Young doctors are absolutely engaged with the digital era and its potential to improve care. One of the big safety gaps in hospital is when one team hands over care to another. Digital innovations will sort this out. Then we can start to tackle the productivity challenges and better utility of the workforce that we face.

In my Review of Health and Care, I set out a radical plan to streamline the NHS and make social care free to ensure the health and care system is fit for the 21st century. A key part of the plan is a ‘tilt to tech’ to achieve a digital-first health and care system.

Underinvestment, lack of interoperability, and problems with security highlighted by the WannaCry ransomware attack – which disabled hospitals and GP surgeries across the country in May 2017 – have hindered progress. But the potential benefits are huge.

Brexit poses a significant threat to innovation in health and care, with changes to immigration and regulation potentially allowing us to fall behind. And the UK economy faces a number of structural challenges that could inhibit growth in the sector, including a lack of investment compared to other developed countries. Policymakers must be ambitious in addressing these challenges in the coming years in order to unlock the opportunities innovation in health and care presents to our economy, public services and society.

To take one example: by embracing full automation of administrative and repetitive tasks – whilst offering all staff affected the right to retrain – we calculated that the NHS could save £12.5bn a year (and £6.5bn in social care) and free staff to focus on treatment and caring.

From fully automated triage of patients attending A&E to bedside robots assisting with meals, transport and mobility, from biosensors allowing remote monitoring of patients at home to systems that alert clinical staff when a hospital patient’s condition is deteriorating, there are enormous gains in prospect – but only if we have the courage to seize the opportunities.

Top image: Johnny Green via PA Images


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