TFM 2019: Unlocking NHS service transformation with data

Ahead of his appearance at TFM 2019 this September, Sam Shah, director of digital development at NHSX, detailed the issues of data, privacy and safety that emerge with digitising 22,000 individual healthcare organisations

In February, health and social care secretary (and outspoken technological evangelist) Matt Hancock announced a new initiative to spearhead the NHS’s digital strategy. The unit, NHSX, has a range of responsibilities, including improving user experience for both clinicians and patients, alongside developing open standards and scouting the next breed of emerging technologies.

As an experienced director and practising primary care clinician, the initiative’s director of digital development Sam Shah certainly has a resume to match the scale of the task, and is someone who speaks lucidly and regularly about the challenges facing the NHS’s digital development.

“The number one priority at the moment is focusing on some of the programs that will help improve access to services for patients,” Shah explained.

“And another part of the goal is around working with industry partners to develop partnerships and relationships. The other is really horizon scanning as to how we might tackle and solve some of our problems in a different way.”

No ordinary enterprise

Spanning the whole of England and comprising 23,000 organisations, the NHS is a bewilderingly complex system – and one that is growing all the time. Due to its scale, diversity, and necessarily safety-conscious approach, executing the digital transformation goals of this “federation” (as Shah refers to it) is a different proposition compared to your average enterprise.

“Digital transformation, to me, is really about transformation in the health system that can effectively achieve something different, with the best outcome for the patient,” he said.

“Because patient safety is the first priority and because we’re not one entity, it’s very hard to take an enterprise-based approach. We have so many organisations providing clinical care, that it can be difficult to make all our changes work in the best way possible for patients, in a way that is right for how they currently live their lives.”

“That data should be available in a form that patients can readily access, so they can look into the service that meets their needs.”

Digital expectations

Like how consumers can instantaneously access transaction history from their favourite online retailers, Shah also envisages an NHS where patients can access their own health data online.

A growing number expect this data to be freely flowing and accessible, but the NHS is rightly cautious of transmitting it in a secure fashion. To that end, NHSX gives clear guidance to providers about how they should transmit patient data, including using the NHS’s secure network, encrypting files and proper identity and access management.

“It has to be kept in a very secure way and it has to be managed in a way that maintains privacy, and it has to be stored in a way that is that safe and can be read in the same format each time,” Shah said.

All in all pressure from patients has been beneficial for the NHS, he said.

“Patients are much more exercised and pushing us towards the system they want. And that’s been quite good. GP Services Online benefited from a big push from patients to transform the system.”

At some point, Shah wants to see an NHS that leverages the latest technological innovations spellbinding other sectors, such as distributed ledger technology, artificial intelligence, extreme reality and quantum computing. We are clearly decades away from seeing blockchain on the NHS, but it’s promising that an organisation long derided for being behind the curve is being spearheaded by someone who thinks ahead of it.

Shah is also is fully aware of the challenges that need to be prioritised, such as improving the data layer, infrastructure standards and open APIs. Once this foundation work has been done, then NHSX can get around to identifying the digital enablers for service transformation, he said. Shah has already identified three and is optimistic that they will soon be part of the NHS’s furniture.

“Getting service data accurate and making it available across the whole system is one, getting data about appointments and bookings available across the entire system is another. The third is making sure that patients can access the right data about themselves when they need it.”

“We’ve got an amazing leadership team and that will really help us get there. It’s always challenging in a complex system like this. But I think each time you make progress, that’s a good thing,” he said.