From rocket science to babylon: my career in quality improvement

Paul Bate is Director of NHS Services for babylon, a company using artificial intelligence (AI) and smartphones to transform health services. He is a member of the first cohort of Sciana: The Health Leaders Network, a new initiative supported by the Health Foundation and international partners, which is bringing together outstanding leaders in health and innovation across Europe.

Paul has held an impressive range of roles and responsibilities within health care. We spoke to him about how improving the quality and accessibility of care became a theme for his career, taking him from policymaking within 10 Downing Street, to regulation at the Care Quality Commission (CQC), and now to using AI to enhance primary care services.  

Tell us how you first became interested in improving the quality of health care?

My work in health started around 15 years ago. Under the Labour government I oversaw delivery of the big targets for waiting times and MRSA. It’s fair to say this resulted in much better access to health services for millions of people, and improved patient safety, and I am dead proud to have been part of that.

It was that work that first gave me the bug for improving quality. I was hooked and just wanted to keep going on that journey.

I ran my own consultancy with a couple of colleagues for a while, and then took the job as Number 10 Health Advisor, working directly for David Cameron and Nick Clegg. I wanted to make a difference to the way policy was made, and consequently shape service delivery. We launched some big quality improvement drives, particularly around things like dementia care and the Friends and Family Test.

With the second Francis report into Mid-Staffordshire, it became very clear that although a lot of effort had been put into improving access to NHS services, there were systemic failings around quality. I wanted to be part of changing that. So when the opportunity came up to work at the CQC and be part of the main board, I took it and helped redesign the regulatory and intelligence frameworks. With CQC ratings, we now have a system that shows where outstanding quality of care is being provided, against a framework that is very specific to each care setting.

I was thinking about how to carry on my journey through quality improvement and realised the thing I hadn’t done was to be part of a provider. I saw a huge opportunity for technology in the NHS, particularly how AI could support primary care to improve things both for patients and for the people delivering care. And by far the best organisation I could find doing that was babylon.

That’s quite a journey. How is your involvement in Sciana now further influencing your passion for improvement?

The Sciana network is all about bringing together people who want to make a big difference nationally and internationally. And that is a joy. A joy to be among like-minded people who have a strong desire to improve quality, to debate the big issues and how to solve them, and to share work that has had very concrete outcomes.

I’ve already had follow-up meetings with colleagues from the UK and Germany. And ideas are starting to come together. For example, there is a hackathon (an event where people work in groups on technology projects, with the goal of creating a functioning product by the end of the event) planned for later in the year with a health care technology focus.

The best thing I think I can do is bring the learning back into my job. For example, I’m learning some amazing new things about 3D printing in medicine, giving me a much wider understanding of the opportunities for technology to revolutionise health care.

Tell us more about your plans to use artificial intelligence to improve care for patients?

babylon exists to put accessible and affordable health care in the hands of every person on the planet. We do that by bringing together AI with smartphones and medical expertise. These three elements in combination mean that people can access affordable and high quality health services using their phones to conduct online consultations.

Our partnerships with the NHS offer a range of services, from the fully digital AI symptom checker and health monitoring services, to babylon’s online GPs. General practices can offer this as an option for patients, with follow up face-to-face sessions if needed (which tends to be in about one in five cases).

That’s really transformational for patients, who get near-instant appointments without the need to travel, and for GPs, who get to spend more time seeing the people who really need their expertise.

1 year into the job I am still loving it. It just feels like such a huge and exciting opportunity.

It’s all a very far cry from rocket science, where I started my career with a PhD in particle physics! And the simple reason for that is that for me health care quality improvement continues to be a life-affirming and fascinating thing to do. Being supported by the Health Foundation and being part of the Sciana network makes that even better.

The second cohort of Sciana is now open for applications until 29 September 2017.