A comprehensive report from the Times Health Commission on Monday identified a ten-point plan for health that highlights a key role for digital technologies.
The first item on the ten-point plan recommends creating “patient passports” as a form of digital health account for patients.
The patient passports would be accessed through the NHS App to book appointments, order prescriptions, view records and test results or referral letters and contact clinicians.
Such passports would store medical records on people’s phone or medical card, and easily accessed when they arrive at their hospital, GP surgery or pharmacy.
The report notes that similar systems are already in place in Spain, Singapore, Estonia and Denmark, and can empower patients and reduce bureaucracy.
Examining the current state of technology in the NHS, the report says there are “between 40 and 60” different types of electronic patient records within the NHS, while just one in ten hospitals around are entirely paper-based.
Other recommendations on the ten-point plan include reforming the GP contract to focus on wider health outcomes and ensure prompt appointments and continuity of care, creating a national care system and incentivising NHS staff to take part in research.
The key conclusion of the report is the need for the NHS to evolve from a “reactive sickness service” into a “more proactive health service”
More than 600 witness testimonies
The Times Health Commission was set up in January 2023. Its members visited medical facilities and care homes in the UK and abroad – including visits to Japan, Ireland, Israel, Denmark and Spain – to learn from best practice before issuing its 10-point plan.
It heard expert evidence from more than 600 witnesses and commissioned economic analysis, business surveys, opinion polls and focus groups to “get as full a picture as possible of what is working and what is not functioning properly,” the report said.
The notion that the funding model for the NHS needs to be changed was disputed in the report, which noted that Israel, although funded by a social insurance model, credited the source of its healthcare success as “widespread adaption of technology.”
The commission documented cases of technology best practice, such as Europe’s first robotic surgery school, which is operating across the northeast of England in a collaboration between Newcastle Surgical Training Centre and Intuitive, which produces the Da Vinci surgical system.
The report highlighted the experience of countries such as Israel, Singapore and Estonia where data is electronically shared, patients are able to sign in for hospital appointments digitally and even record their own vital signs in specially designed kiosks.
By contrast, it says, the NHS has “spectacularly underinvested in technology over many years, repeatedly raiding the capital budgets that fund IT projects to chuck money at the latest winter crisis.”
It quotes Tim Ferris, former national director of transformation for NHS England until last September, to capture the extent to which technology spending in the NHS lags behind that of other institutions. While one large international bank is known to spend 12% of its budget on tech and data, and several large healthcare organisations in the United States are spending 4 to 5%, Ferris said several NHS trusts estimated their tech spend in the 1.5% range.
More resources needed to carry out 10-point plan
Clinicians and suppliers welcomed the report but noted that the health service will require significant support to carry out its recommendations.
Dr Jennifer Dixon, chief executive of the Health Foundation, said: “The Times Commission’s report contains some important and practical recommendations. The Commission is right to focus on the potential for AI, technology and better use of data to transform care. This will require a proper strategy including investment, effective regulation, and, crucially, support for staff and the public to manage the changes ahead.
“We also particularly welcome the recommendations to implement a cap on social care costs without further delay and introduce legally binding duties to improve the nation’s health. The NHS is not a broken model, and the poor state of the nation’s health is entirely avoidable. The next government should take these recommendations seriously and, crucially, provide the investment that is so desperately needed.”
“This report is a huge step in the right direction,” added Jonathan Boakes, managing director UK at Infinum. “Yet, the reality is the proposals put forward are a mammoth task, and the NHS simply can’t do it on its own. To truly revolutionise the NHS, external support and expertise are going to be crucial.”
Boakes observed that one of the report’s recommendations advises a shift to a more personalised approach to healthcare, something achievable only with data and technology like AI.