Barbara Harpham, Chair of the Medical Technology Group, reviews Lord Darzi of Denham’s independent investigation of the National Health Service.
MTI Expo
Harpham speaking at MTI Expo 2023
The unfulfilled potential of technology was a strong focus in Lord Darzi’s landmark review into the NHS. ‘The last decade’, he wrote, ‘was a missed opportunity to prepare the NHS for the future and to embrace the technologies that would enable a shift in the model from ‘diagnose and treat’ to ‘predict and prevent.’’
Darzi had previously highlighted the vital role technology can play in his 2008 report. Indeed, many of his previous recommendations to facilitate this meaningful transformation using technology are still on the agenda: increased training for staff, a culture of incentivising innovation, use of remote monitoring devices.
But how can we achieve this transformation? As the report acknowledges, this is a multifaceted challenge, driven by factors that encompass everyone from the experience of clinicians on the ground right up to the senior policymakers.
Firstly, the report highlights dwindling capital investment, creating a situation in which acquiring advanced medical equipment and supporting digital transformation is hindered. There is subsequently a need for targeted investment to ensure hospitals are equipped with everything from the latest diagnostic tools and devices to IT and data technology systems.
But to ensure the best use of any strategic investment, it is also important to consider which sections of the health service have succeeded in the implementation of such technology. Referencing the Medical Technology Group’s findings, the report pointed to variation in performance across the NHS, often attributable to the successful implementation of such technology.
Localised uses of innovation, leadership structures and the successful implementation of pathways built around technology have been documented across the NHS. Indeed, Lord Darzi recognised that there were ‘excellent examples’ of such innovation, also pointing to the Federated Data Platform which has shown an impact locally. To make increased funding for infrastructure and technology a success, the optimisation and spread of existing technologies proven to be effective is a priority.
However, introducing new technology into the system is always a learning curve for patients and clinicians alike. Instances where such technology has been introduced successfully is a vital resource for driving transformation. However, an investigation by the MTG revealed that the sharing of such practice by Integrated Care Boards is rare. When it comes to technology, the system is not built to learn from itself.
This is a valuable resource that would form the foundation of a centrally driven effort to identify the best instances of medical technology in the NHS. It's clear from focus groups that such efforts are needed to drive a wider culture of adoption of innovation across the NHS. Clinicians are short of time, and there is a perception from focus groups in the report, backed up by a recent Health Foundation survey that staff require support and expertise when it comes to the adoption of technology.
Darzi also highlights that many of the technologies that could help the NHS provide higher quality and more efficient care in local settings are still largely absent. For example, the report points to the success of automated route planning which could significantly streamline the provision of community-based care. By moving technology into the community, the NHS can improve access, reduce hospital admissions, and enable patients to receive care closer to home.
For the medical technology sector, the key message from this report is clear: the NHS cannot afford to lose another decade of opportunities to fully integrate life-changing technologies into everyday care. While we often talk about the need for transformation, it's important to acknowledge that some areas of the system are already embracing innovation. To unlock the full potential of medical technology, we must collaborate with the patients and clinicians who are leading the way, learning from their successes, and expanding these practices across the entire NHS.
The Medical Technology Group is a coalition of patient groups and industry that works to improve patient access to technologies on the NHS. You can read their recommendations on how to transform the NHS using technology here
