Damning House of Lords report on long-term sustainability of the NHS calls for ‘strong leadership and a radical culture shift’ to incentivise innovation and improve public engagement over use of patient data

Training and leadership are needed to shift NHS culture around tech – Photo credit: Flickr, Pete, public domain.

The House of Lords Committee on the Long-term Sustainability of the NHS has said that there is a “worrying absence of a credible strategy” to encourage large-scale use of innovative technologies across the health service.

The committee’s report The Long-term Sustainability of the NHS and Adult Social Care, published today (5 April), slammed the “short sightedness” of successive governments for failing to properly plan “beyond the next few years”.

It recommended that a new body independent of government, the Office for Health and Care Sustainability, be established to oversee long-term planning, as well as calling for the government to “recognise the NHS will need more money”.

Among its criticisms is that the government lacks an adequate strategy for encouraging health care providers to innovate and make the most of the technology and data available to them.

The peers said that, if the NHS was to redress the balance, it would need “strong leadership and a radical culture shift”, with rewards and penalties used to enforce the message that innovation was a priority.

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“It is not clear who is ultimately responsible for driving innovation and ensuring consistency in the assessment and the adoption of new technological approaches,” the peers said.

“The government should make it clear that the adoption of innovation and technology, after appropriate appraisal, across the NHS is a priority and it should decide who is ultimately responsible for driving this overall agenda.”

They recommended that the government identify the bodies that are “falling behind” on this agenda and “make it clear that there will be funding and service delivery consequences for those who repeatedly fail to engage”.

This, it said, could involve “relocating services to places that prove to be more technologically innovative”.

However, it also noted that there were some enthusiastic proponents within the healthcare sector, but that they were being held back by the lack of standardised systems or difficulties in getting new technologies working with existing systems.

“We desperately need to embrace technology. Healthcare professionals love technology generally; it is just getting standardised, joined-up systems that we can use across the board,” Helen Stokes-Lampard, chair of the Royal College of General Practitioners, told the committee.

“We want to be able to communicate with each other efficiently and effectively. It needs resource to do that, because IT will help us enormously with our jobs. When I hear that midwives are spending 50% of their time on admin tasks, we know that if we had better IT systems that could be reduced massively.”

The peers also called on the government to provide appropriate training for staff within the NHS to help with the uptake of new technology, and emphasised that “the development of strong leaders to support this agenda within the NHS will be critical to its success”.

It said that the testing and adoption of new health technologies “should be formally integrated into medical and non-medical NHS leadership, education and training at all levels”.

In addition, the peers said that NHS England needed to develop a system to “identify and financially reward organisations and leaders who are instrumental in driving the much needed change in levels of productivity, the uptake of innovation, the effective use of data and the adoption of new technologies”.

‘Learn lessons from Care.data’

The committee also looked at the NHS’ use of data, saying that the benefits of data-sharing were “obvious”, and that the high-profile failure of the patient information sharing scheme Care.data – scrapped last summer – was a “missed opportunity”.

The failure of the scheme – which the chief executive of the civil service John Manzoni recently branded a “misstep” that had held the sector back – is an example of the “inevitable consequences of failing to grapple with important issues relating to personal privacy”, the committee said.

“NHS Digital and all those responsible for data sharing in the NHS should seek to engage the public effectively in advance of any future large-scale sharing of personal data,” the peers said.

“Public engagement on data sharing needs to become a priority at a local level for staff in hospitals and the community, and not be left to remote national bodies.”

NHS England last year announced a series of measures that aimed to encourage healthcare innovation, following the recommendations from the Wachter review that called for a phased approach to innovation in the NHS.

These included a set of digital exemplars that would be used to demonstrate how other organisations in the NHS could make the best use of technology. The chosen NHS Trusts, which each receive £10m, were announced last week in NHS England’s update to its Five Year Forward Plan.