Last week’s report by Lord Ara Darzi on the state of the country’s health service made bleak reading. In relentless detail, the distinguished surgeon outlined the steady decline that has taken place in the NHS over the past 15 years, a decrease 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 brought about is unclear, however. Our health service needs to be better resourced, although the government has warned little money is likely to be made available for such a monumental transformation. Most of the reform that will be needed to save the NHS will have to come from within, ministers have emphasised. In other words, internal innovation and improved use of existing assets will be central in ensuring British people receive proper medical attention in the coming decades.
It is a daunting task but such resources are not entirely lacking in the NHS. The data it generates daily is a key example. Every time a person sees a GP, or is prescribed a medicine, or goes to A&E, or has a scan, blood test or hip replacement, he or she generates data. And given that the four nations of the UK contain a total population of 67 million people who – from cradle to the grave – make use of the health service, this generates a pool of medical information that is unique in its scale, detail and diversity.
Properly organised, such a mammoth database holds vast potential in the exploration of new treatments, diagnostics and medicines. A process that would make the NHS more efficient could also generate billions by aiding clinical trials and boosting drug development. Unfortunately, this huge repository of medical information is not easily accessed for it is stored in individual silos – hospital by hospital, GP surgery by GP surgery – with little data being made available to central organisations.
Clinical computer systems are slow, unreliable and devastatingly user unfriendly, making it almost impossible to understand patterns of care or undertake research, said Martin Landray, co-founder of the UK Recovery programme that saved thousands of lives during the Covid pandemic. “It is deeply frustrating to see how far the NHS lags behind areas such as personal banking, commerce and the entertainment industry,” he remarked last week.
Landray’s point is well made and suggests an obvious avenue for improvement: by reforming the way the health service handles its computerised data – however, the NHS’s installation of IT systems has not had a happy record over the past decade, with dozens of cases highlighting failures to ensure digital data is properly shared. In addition, such technological reforms would have to take place at a time when the NHS has 7.6 million people waiting for routine hospital treatments, compared with 2.4 million in 2010. Reducing the colossal backlog is a key priority. Finding time to reboot its computer systems at the same time will not be easy.
Nevertheless, making sure data is shared more swiftly and effectively will improve the work of the NHS, as was illustrated during the Covid lockdown when special measures eased the flow of data between centres and boosted the nation’s medical response to the pandemic.
Britain has let that lead slip. Freeing up the goldmine of medical data that the nation possesses will allow the NHS to embed research into its core and create clinical trials that will be vital in the development of new drugs in this country. It would enable our clinicians to contribute to the discovery of new treatments rather than struggle with a public health crisis while hoping effective treatments might emerge from elsewhere.
