NHSX: The New Unit 'to Oversee a Digital Health Service'

Peter Russell

February 20, 2019

A new unit will be created to oversee the transition to a digital future for the NHS and care system in England, the Government announced.

Named NHSX, the unit would have strategic responsibility for setting the direction on technology across organisations.

The unit's creation was seen as a further step towards a modern technical architecture for health and care services to sweep away systems designed for a pre-internet age. For the first time, a single organisation would be tasked with overseeing digital, data, and technology structures that have previously been split across multiple agencies, teams, and organisations.

The unit's chief executive officer would be accountable to the Secretary of State for Health and Social Care and the chief executives of NHS England and NHS Improvement.

NHS Long-term Plan

The ambition for NHSX, which has set up its own Twitter account, would be to diagnose diseases earlier, free up staff time, and empower patients to take greater control of their own healthcare, according to the Department of Health and Social Care (DHSC). It said the unit would draw on experts in technology, data, and cyber security to build on key aspects of the Government's long-term plan for the NHS.

Matthew Swindells, deputy chief executive of NHS England, said: "The NHS long-term plan builds on the significant progress of the last 3 years and marks a transformational shift to a more digitally focused NHS from the introduction of the NHS App to digitising care across the NHS to joining up GP and hospital records so clinicians treating patients have access to all the information they need, wherever they are."

Sarah Wilkinson, chief executive of NHS Digital, added: "The program of digital transformation ahead of us is extraordinary in terms of its scale, its complexity and the extent to which it can change lives.

"It will require sophisticated strategic planning, strong leadership, and very tight partnership between organisations across the system. This new joint venture between the organisations who currently define digital strategy and commission digital services will create cohesion in these activities by concentrating work and capabilities in one unit."

The NHSX Remit

The DHSC confirmed that included among NHSX's responsibilities would be:

  • Setting national policy and developing best practice for NHS technology, digital and data - including data-sharing and transparency

  • Setting standards – developing, agreeing and mandating clear standards for the use of technology in the NHS

  • Ensuring that NHS systems can talk to each other across the health and care system

  • Helping to improve clinical care by delivering agile, user-focused projects

  • Supporting the use of new technologies by the NHS, both by working with industry and via its own prototyping and development capability

  • Ensuring that common technologies and services, including the NHS App, are designed so that trusts and surgeries do not have to 'reinvent the wheel' each time

  • Making sure that all source code is open by default so that anyone who wants to write code for the NHS can see what they need

The DHSC said that developing digital training for staff would be a vital part of the unit's remit to ensure that health and social care staff were technologically literate. That formed a key recommendation of the Topol Review published earlier this month which outlined how early training for NHS staff could lead to implementation of technologies at a faster pace and on a greater scale than anywhere else in the world.

AI Code of Conduct

The DHSC also published an updated version of its code of conduct for artificial intelligence (AI) systems used by the NHS. The code contains a set of 10 principles outlining what is expected from suppliers and users of data-driven technologies.

The code tackles a number of emerging ethical challenges associated with the use of data-driven technologies in the NHS and the wider health care system, including the possibility that AI could cause unintended harm to patients should their rights or privacy be compromised.

It was first published in September 2018 but has been refined following consultation with industry experts, academics, regulators, and patient representative organisations.

A further update is expected at the end of the year.

The DHSC said that AI was already being used across the NHS to improve the early diagnosis of heart disease and lung cancer, to reduce the number of unnecessary operations performed due to false positives, assist research by better matching patients to clinical trials, and support the planning of care for patients with complex needs.

Specific examples included a research agreement between Moorfields Eye Hospital in London and Google DeepMind into an algorithm to detect early signs of age-related macular degeneration and diabetic retinopathy.

Also, an AI system was developed by Imperial College London that can predict survival rates for patients with ovarian cancer.

Dr Simon Eccles, chief clinical information officer for health and care at the DHSC said: "Parts of the NHS have already shown the potential impact AI could have in the future of the NHS in reading scans, for example, to enable clinicians to focus on the most difficult cases.

"This new code sets the bar companies will need to meet to bring their products into the NHS so we can ensure patients can benefit from not just the best new technology, but also the safest and most secure."

The Health Secretary Matt Hancock said: "AI must be used responsibly and our code of conduct sets a gold-standard set of rules to ensure patient data is always protected and the systems we use are some of the safest in the world."

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