- An independent report on behalf of the Secretary of State for Health and Social Care, 11 February 2019
This report aims to examine
• how technological and other developments (including in genomics, artificial intelligence, digital medicine and robotics) are likely to change the roles and functions of clinical staff in all professions over the next two decades to ensure safer, more productive, more effective and more personal care for patients;
• what the implications of these changes are for the skills required by the professionals filling these roles, identifying professions or sub-specialisms where these may be particularly significant;
• the consequences for the selection, curricula, education, training, development and lifelong learning of current and future National Health Service staff.
Digital healthcare technologies, defined here as genomics, digital medicine, artificial intelligence (AI) and robotics.
The Review proposes three principles to support the deployment of digital healthcare technologies throughout the NHS:
1. Patients need to be included as partners and informed about health technologies, with a particular focus on vulnerable/marginalised groups to ensure equitable access.
2. The healthcare workforce needs expertise and guidance to evaluate new technologies, using processes grounded in real-world evidence.
3. The gift of time: wherever possible the adoption of new technologies should enable staff to gain more time to care, promoting deeper interaction with patients.
Digital technologies will have an impact on patients, carers and the wider community, health workforce, and health service leadership.
Recommendations
The Review Board recommends:
The citizen and the patient
- In a similar way to other public health education initiatives, programmes aimed at engaging and educating the public about genomics and digital healthcare technologies should be developed. (P1)
- The NHS should work with patient and carer organisations to support appropriate patient education. (P2)
- Local arrangements should be established to provide needs-based targeted education and support through existing patient support provision, where possible. (HI1)
The Genomics Panel recommends:
The citizen and the patient
- The NHS, in partnership with relevant regulatory bodies, should establish a clear, robust framework by which healthcare professionals use genomic data, which safeguards patient confidentiality, and inspires the support and confidence of citizens and the wider community. (G1)
Healthcare professionals
- All healthcare professionals should receive core training in genomic literacy to help them understand the basis, benefits and ethical considerations associated with genomics. (G2)
- Lifelong training should be available to healthcare professionals with emphasis on continuing support in this rapidly evolving field, including access to dynamic ‘just-in-time’ digital updates and online genomic information resources. (G3)
- Accredited genomic training for healthcare professionals should be established in key clinical specialities to incorporate genomic testing and genomic counselling into their practice. (G4)
- Capacity should be built within the NHS Genomic Medicine Service through support for specialist healthcare professionals including genomic counsellors, clinical scientists and specialists in genomic medicine. (G5)
Health system
- An attractive career pathway should be developed for bioinformaticians, including expansion of Higher Specialist Scientist Training for clinical bioinformaticians. (G6)
- A framework for genomic leadership should be developed across clinical specialities and primary care settings to encourage and disseminate best-practice and to simplify patient referral systems. (G7)
- Academic institutions should ensure genomics and data analytics are prominent in undergraduate curricula for healthcare professionals, and that there should be expansion of undergraduate capacity in genomics, bioinformatics and data science. (G8)
The Digital Medicine Panel recommends:
The citizen and the patient
- NHS online content should be a vital trusted source of health information and be resourced appropriately. (DM1)
- The NHS should expand research and development programmes, working closely with patients to co-create digital technologies and ensure that emerging technologies meet their needs. (DM2)
Healthcare professionals
- NHS organisations should invest in their existing workforce to develop specialist digital skills, including the assessment and commissioning of digital technologies, through the Digital Academy, continuous professional development (CPD), sabbaticals and secondments. (DM3)
Health system
- The NHS, working with regulators, should develop and commission courses to increase the number of specialists in the evaluation and regulation of digital technologies. (DM5)
The Digital Medicine and AI & Robotics Panels recommend:
- The NHS should create or increase the numbers of clinician, scientist, technologist and knowledge specialist posts with dedicated, accredited time, with the opportunity of working in partnership with academia and/or the health tech industry to design, implement and use digital, AI and robotics technologies. (DM4/AIR5)
The Organisational Development Working Group recommends:
The citizen and the patient
- NHS organisations must ensure that patients, citizens and staff are involved in the co-design of transformation projects, particularly in identifying how digital healthcare technologies can help to improve both patient experience and staff productivity. (OD1)
- NHS organisations must ensure that patients, citizens and staff are involved in the co-design of transformation projects, particularly in identifying how digital healthcare technologies can help to improve both patient experience and staff productivity. (OD1)
Healthcare professionals
- Senior roles should be developed with responsibility to advise on the opportunities offered by digital healthcare technologies and identify local skills gaps. (OD2)
- Healthcare professionals will need to access training resources and educational programmes in digital healthcare technologies to assess and build their digital readiness. (OD3)
Health system
- Each organisation should assign Board-level responsibility for the safe and effective adoption of digital healthcare technologies at scale, with a focus on clinical outcomes and on promoting effective and consistent staff engagement. (OD4)
- NHS Boards should take responsibility for effective knowledge management to enable staff to learn from experience (both successes and failures) and accelerate the adoption of proven innovations. (OD5)
- The NHS should strengthen systems to disseminate lessons from early adoption and share examples of effective, evidence-based technological change programmes. (OD6)
- NHS organisations should use validated frameworks to implement technological solutions and ensure staff are trained to use these. (OD7)
- The NHS should support collaborations between the NHS and industry aimed at improving the skills and talent of healthcare staff. (OD8)
- The NHS should work with stakeholders across sectors to review the regulation and compliance requirements for new digital healthcare technologies, including the provision of guidance and training on cyber security, data privacy and data anonymisation, learning from the experience of other international healthcare systems. (OD9)
