Nicola Blackwood, author of PUBLIC’s new report The Promise of HealthTech and former Health Innovation Minister, introduces the UK’s HealthTech ecosystem, explaining the opportunities – and barriers – for innovators who want to work with the NHS.
Healthcare is facing the kind of transformation not seen since the discovery of antibiotics and anaesthetics. There is scarcely an area of medicine that will not be changed – and improved upon – by new technologies, as PUBLIC’s new report The Promise of HealthTech demonstrates.
You can already get consultations online, search for a GP on an app, and use your smartphone to monitor your own health. Chatbots are being deployed by the NHS in London and Liverpool to answer medical questions and triage patients. Scannable wristbands with medication and patient data, digital care records, and electronic observation charts are being trialled at Leeds Teaching Hospitals NHS Trust.
In the future, much more will be digitised. The list of potential changes is long – from the use of VR in medical training to video games to treat ADHD and other neurological conditions including autism, depression, and traumatic brain injuries.
Perhaps most important – and with applications across all medical fields – are the advances in artificial intelligence and genomics. These will deliver more accurate diagnoses and design treatments suited to you as an individual.
A future awaits where medical information, gathered at the point of care or even at an earlier stage through apps, wearables, digestibles, home-based devices and sensors, is analysed using sophisticated machine algorithms to provide real-time, actionable analytics.The result of these innovations will be transformative for the health and well-being of millions of people.
To many, the list of new technologies will sound like science fiction. When I was Health Minister I was often asked if patients in places like the A&E department in Barrow-in-Furness or Hornsey Cottage Hospital – small rural hospitals far away from a technology-bustling place like Imperial College Hospital in London – would really benefit from digital change.
But many tech-driven startups are already beginning to demonstrate how they can offer patients better care, while at the same time delivering a service much more efficiently. And they are not confined to large cities such as London or Manchester.
Examples abound: Echo is helping patients get their prescriptions simply and with no upfront cost while, at the same time, nudging them to keep up with their treatment regime. Doctify has transformed the way that patients can find doctors and book appointments. In turn, Lantum helps hospitals find part-time staff like doctors and nurses, easing the all-important process of compliance checks.
Social care-focused Cera uses technology to help both carers and those cared for. And Flynotes is looking to digitise medical consent, such an important step as we move into a new era of well-regulated health data sharing.
These, and many other startups, offer more than just the opportunity to improve healthcare: they help to deliver efficiencies, improve self-management of chronic conditions, offer personalised treatments, and upgrade preventative measures. When properly integrated with effective digital infrastructure and data analytics, personalised care plans and clinical engagement, they are the best hope of meeting the extreme demographic, financial and popular pressures facing the NHS.
The good news is that nearly everyone – from the Health Secretary and the NHS England Chief Executive to surgeons, GPs, and nurses on the frontline – agrees that new technologies are essential for the NHS.
Critically, too, the HealthTech market is finally beginning to deliver the breadth and quality of companies required. There is a real and growing opportunity for digital health companies to start up and scale in the UK. The UK market size was £2 billion in 2014 and is expected to grow to £2.9 billion this year.
Interestingly, there is a real similarly of outlook on both the demand and supply side: people are primarily motivated by a vision of delivering better care, more affordably. Everyone wants to save the NHS. Indeed, many HealthTech startups are either founded, backed or supported by medical professionals.
That is the good news.
But the bad news is that a number of barriers exist that inhibit the take-up – and especially the scale-up – of new technologies across the NHS. Despite often compelling clinical and financial evidence, few of the startups working in the NHS today have achieved real, systemic uptake. The cost-effectiveness of new technologies has yet to be universally accepted. Past failures provide ample ammunition for sceptics. Officials fear legal challenges from incumbents if they choose new solutions. Everyone wants to play it safe.
There is no way other way to put this: the NHS is digitally risk-averse.
That is not to say that NHS staff are technophobes, and there are some outstanding examples of good practice across the country. But taken as a whole, there is a collective failure of the organisation to provide the requisite opportunities to scale new technologies.
This risk aversion is evident in decision-making processes and procurement systems, as well as in attitudes which combine to block innovation and to limit pilots, even if few are consciously opposed or deliberately obstructive.
I set out to understand these barriers in detail in conducting research for The Promise of HealthTech. From my time as Health Minister I had a particular vantage point. But I wanted to understand what the NHS looks and feels like from the innovators’ perspective.
To this end, we conducted the largest ever survey of British HealthTech startups, querying hundreds of digital health companies, as well as interviewing NHS professionals and key decision-makers across the health and care landscape.
From this, we identified the six areas where reforms are most needed: how the NHS requires evidence and evaluates new products; how it then regulates new products; how it procures new solutions; how it enables new purchases to operate across the system; how it ensures the highest standards of data security; and how it recruits and trains a workforce that can understand, adopt and help scale new technologies nationally. Reforms need to start here.
The Promise of HealthTech also seeks to help startups to succeed in the NHS; it is a report to founders, CEOs and innovators. It is meant to help them, to provide a sort of NHS user manual. And we also shine a spotlight on the HealthTech27 – our list of the most promising companies across nine areas of key opportunity in the coming years.
The UK faces an optimal situation. We are approaching a true inflection point. The NHS needs digital transformation. Its leadership wants it, as do its patients. Now the market can finally provide it.
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