Advances in health care technology offer huge potential to improve the NHS but are no ‘silver bullet’

Technological advances – from the applied use of genomics, to the use of video consultations with a GP – offer real opportunities to improve health care. But NHS leaders and policymakers should be mindful of significant barriers that stand in the way of their greater spread.

That’s according to a review of four technological trends affecting health care published by the Nuffield Trust, the Health Foundation, the Institute for Fiscal Studies, and The King’s Fund. The briefing “How will technology affect the NHS and its patients?” forms part of a series of pieces of analysis produced by the four organisations for the BBC’s week of programming for the NHS’s 70^th birthday[1].

The briefing looks at the uptake and potential of the following trends in technology: genomics and precision medicine; remote care like video appointments with a GP; technology supported self-management such as apps and wearables; and data analytics and artificial intelligence (AI).

It highlights how some of these advances are beginning to take off in the NHS – such as video consultations with a GP, ‘virtual clinics’ to connect family doctors to specialist advice, and using data from apps and wearables to provide rich information to health care professionals. But some of the advances with the biggest potential, like the use of AI to interpret scan results or the use of precision medicine, are a long way off being mainstream in the NHS.

The briefing also draws on new polling commissioned by the Health Foundation for the BBC’s project, which asked 2000 UK adults aged 15+ about their attitudes to technological innovations currently used in the NHS and their views on the use of health care data [2].

Key results from the polling include:

• There was widespread support for video consultations with a family doctor:
  • 63% of UK adults were willing to have a video consultation with their GP for a minor ailment; 55% for advice on an ongoing problem or condition; and 43% for immediate or emergency medical advice.
  • There was little variation across age groups, with 63% of 15–24 year olds being willing to consult with their GP via video for a minor ailment compared to 56% of over-65s.
  • More people in higher-income households were willing to use a video consultation in every scenario we tested. For example, 71% of those with a household income of £25,000 or more were willing to use video consultations with a family doctor for a minor ailment, compared to 54% of households earning less than £11,500 per year
• More than half (57%) would be willing to share data with the NHS via a lifestyle app or fitness tracker. While support was higher among younger age groups, just under half (47%) of over-65s were open to the idea.
• The majority (69%) believed the benefits of using machine learning (an enabler of AI) to improve diagnosis either outweigh or are equal to the risks. This was true across all age groups, although men (76%) were generally more positive than women (63%).
• The polling showed a low level of understanding about the use of health data: 17% of people had heard of, but knew nothing about how the NHS uses their health data, and 24% knew nothing about how commercial organisations, such as drug companies and medical equipment manufacturers use it.

The briefing points to some of the main barriers to technological advances achieving their full potential in the NHS, which include: the upfront cost, for example for innovations like precision medicine; that they may require health professionals to work in new ways or even in entirely new roles; and patient attitudes towards new innovations – particularly those which require data to be shared across and beyond the NHS.

Commenting on the briefing, author and Nuffield Trust Senior Policy Analyst Sophie Castle-Clarke said:

'If the technological trends we have examined continue to progress, they have the potential to completely transform health care. Patients could see improved access to specialist advice, a better synergy between the information they collect daily about their own health and that held by the NHS, and, eventually, personalised treatments based on their own characteristics. 

'What’s more, our polling suggests that there is perhaps more willingness than we realised amongst the public of all age groups to embrace video consultations and health apps. That’s a positive sign. 

'But technology is rarely the saviour of health services in the way that politicians hope – at least in the short-term. It takes time to implement, often requires large changes in the way health care professionals work, and choosing where to invest poses real dilemmas for a cash strapped NHS.'

Further information

1. To mark the BBC’s coverage of the NHS’s 70th birthday in July 2018, researchers from the Health Foundation, Institute for Fiscal Studies, The King’s Fund and the Nuffield Trust have joined forces for the first time, using combined expertise to shed light on some of the big questions on the NHS. Today’s report is the last, with previous briefings on how good the NHS is, NHS funding, public expectations of the NHS and social care published earlier this week.

2. Research was conducted on CAPIbus, Ipsos MORI’s weekly face to face survey. 2,083 adults 15+ were interviewed across the UK between 11th and 29th May 2018 in participant’s homes using a Computer Aided Personal Interviewing (CAPI) methodology.

Data have been weighted to age, working status, government office region and social grade within gender, with household tenure and ethnicity according to known population profiles.

3. ‘How will technology affect the NHS and its patients?’ is authored by Sophie Castle-Clarke (Nuffield Trust) with contributions from Adam Steventon (Health Foundation), Elaine Kelly (Institute for Fiscal Studies), Richard Murray (The King’s Fund), Matthew Honeyman (The King’s Fund).