2024 Look Ahead: Spotlight on Digital Health
It is never not interesting in the world of Digital Health, and 2023 was no different, particularly within the NHS.
With the merger of NHSX and NHS Digital into NHS England, there were significant organisational and personnel changes, not to mention the ongoing financial pressures within the system. Keeping up to date with the changes and their impact on the continued digitisation of the system was critical to ensure that members could understand and plan for the challenges and opportunities within the system.
Our Digital Health Group ran five meetings across the year, addressing key challenges within the system, welcoming guest speakers from NHS England, the Department of Health and Social Care, Integrated Care Systems, the NIHR and NICE, whilst working to progress our core objectives that cover regulation, market access, data, AI and Cybersecurity. We also jointly led additional workshops with NHS England on Digital Technology Assessment Criteria (DTAC) and cybersecurity.
2023 was also the year in which AI hit the headlines in a big way. Admittedly, ChatGPT launched in 2022, but the effects rippled well into 2023 with government putting significant emphasis and funding behind the technology. This impacted health as well.
Of course, AI has been with us well before ChatGPT came along and the NHS AI Lab (which thankfully survived the NHSX merger) has been supporting many technologies. Notably, last year we started working with AI Lab and the Royal College of Radiologists (RCR) on AI in Imaging. This was part of a project to ‘mainstream’ the technologies that had been incubated, particularly in centres of excellence, and to build on the wide and varied pilots that were running across the NHS.
Two issues I heard consistently from members last year were the delays caused by inconsistent Information Governance (IG) processes and the variable application of DTAC. Both continue to cause considerable administrative burden and costly time delays, and we are working hard to rectify this. One route where we have consistently raised these concerns directly with the NHS, and also with Ministers, is via our seat on the Life Sciences Council. I am pleased to say this persistence was rewarded when Vin Diwaker, NHS England’s Medical Director for Transformation, took an action from the Council and there is now a formal review of DTAC ongoing, which ABHI have contributed to via a workshop as well as bilateral conversations.
The importance of data cannot be understated, and the potential asset that the NHS has is significant, but only if that data can be made accessible and usable. The Data for R&D programme being run by NHS England is therefore a critical programme, and ABHI were instrumental in the formation of a new ministerial-led health data group (catchily named, the Health Data Industry Subgroup – HDIS). We have also been in constant contact with the NHS England team leading on this. However, there is still a lot to do, which is why this programme will remain a core focus for us in 2024. The importance of data access was an important consideration in ABHI’s decision to join the UK Health Data Research Alliance, as announced last week.
Funding and reimbursement remain a significant issue, with the financial pressures in the NHS seeing reduced funding for tech as money is diverted to fill funding gaps elsewhere. A streamlined route to market with transparent assessment programmes, and known funding mechanisms, remains the goal. Some steps have been put in place, such as the NICE Early Value Access programme, but things are far from optimised.
Our overall aim is to affect changes in policy and practice that will ensure the UK health and care system can rapidly and systematically adopt new technologies and deliver the benefits to be gained for both the NHS and UK economy.
Focus areas in 2024 will be:
Data for Research: Delivering the ability to access and analyse full NHS data assets through the sub national Secure Data Environment (SDE) network. This needs to be supported by a consistent and internationally competitive access policy, pricing and a ‘single front door’ for IG. We have in place regular bilaterals with the NHS England team and regular meetings of the user forum, which includes Trade Association colleagues from ABPI and BIA, as well as HDRUK, the AMRC and the NHS England team. Additionally, this will remain a priority topic on HDIS Group.
Market Access: We will draw together the various programmes, IG, DTAC and access roadmap, to ensure alignment, reduce duplication and consistent application at Trust level. We will be working across the various NHS England teams running the programmes, and the DHSC/NHS England Joint Policy Unit, to develop a working process that can be rolled out across the NHS. We already have joint workshops with NHS England in place this year for some of the key elements and are also liaising with NHS Confed as their members are equally concerned by current processes.
AI: We will continue our work with the NHS AI Lab and the RCR through our recently formed member group on AI Diagnostics to ensure that mechanisms are established to support the adoption of AI into ‘business-as-usual’. This will be alongside our work on regulation of AI as a medical device as part of the wider ABHI work on regulation and Software as a Medical Device.
A huge thanks to all the members of the Digital Health Group and particularly our chair and vice chairs for their time and commitment in shaping our activities. Engagement in the Digital Health Group has gone from strength-to-strength and I look forward to a productive year in 2024. If you would like to get involved in this activity, and help shape our work, please do get in touch.
