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Content ArticleThe health service is facing workforce shortages and growing backlogs of care, as well as future increases in demand. In response, policymakers and providers are looking to advances in health technologies and data to improve quality and efficiency and reshape services to better meet future needs – most recently with the announcement of £100m to advance the use of artificial intelligence in health care. Ensuring new uses of health technologies or data have the backing of the public is critical if these are to become business as usual. As seen with the care.data scheme and the General Practice Data for Planning and Research programme, lack of public support can significantly constrain innovation and service transformation. So how does the UK public feel about the use of health technologies and health data? To explore this further, in March 2023 the Nuffield Trust commissioned a nationally representative public survey to investigate attitudes towards health technology and data uses and the key factors affecting these views.
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Content ArticleIn this blog, journalist Rory Cellan-Jones reflects on some major challenges the NHS currently faces. Sharing insights from a recent meeting with medtech companies and a lecture by economist Professor Diane Coyle, he shares concerns that productivity in the health service has decreased as a result of the pandemic, and that medtech companies face barriers in selling their solutions to the NHS. He highlights a growing consensus that policymakers need to think beyond immediate firefighting and look at how to transform the NHS over the long term.
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Content ArticleThe NHS’s deal with the US tech company Palantir raises privacy concerns, but a unified database could be a medical gamechanger writes Martha Gill in an article for the Observer. Governments have been trying to stitch together our patchwork system for decades. Billions have been lost in these attempts. However, they always run up against the same problem: people just don’t want to share their medical data, even when assured it will be anonymised. When the government aimed to build a collection of anonymous GP health records, around a million patients opted out. The latest of these attempts has closed a loophole: patients cannot now opt out. But this has enraged civil liberties groups, which are concerned about the company chosen to merge, clean and provide tools for sorting through the data.
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Content ArticleIn May 2021, the Irish public health service was the target of a cyber-attack. The response by the health service resulted in the widespread removal of access to ICT systems. While services including radiology, diagnostics, maternity and oncology were prioritised for reinstatement, recovery efforts continued for over four months. This study describes the response of health service staff to the loss of ICT systems and the risk mitigation measures introduced to safely continue health services. It also explores the resilience displayed by frontline staff whose rapid and innovative response ensured continuity of safe patient care.
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Content ArticleDigital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the NHS. But recent developments in universal digital health interventions, including a national smartphone app and online primary care services, allow measurement of digital inequality across a nation. This study in BMJ Health & Care Informatics aimed to measure population factors associated with digital utilisation across 6356 primary care providers serving the population of England. The authors concluded that the study results are concerning for technologically driven widening of healthcare inequalities. They highlight the need for targeted incentives to digital in order to prevent digital disparity from becoming health outcomes disparity.
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Content ArticleRetrospective chart review is the standard for estimating prevalence of adverse events. Manual review of the electronic health record (EHR) is resource intensive. This study from Garzón González et al. describes the construction and validation of electronic trigger set, TriggerPrim, to rapidly identify charts with potential adverse events in primary care. The resulting set has five triggers: ≥3 appointments in a week at the PC center, hospital admission, hospital emergency department visit, prescription of major opioids, and chronic benzodiazepine treatment in patients 75 years or older. Use of TriggerPrim reduced time in the EHR by half.
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News Article
Patient privacy fears as US spy tech firm Palantir wins £330m NHS contract
Patient Safety Learning posted a news article in News
The NHS has sparked controversy by handing the US spy tech company Palantir a £330m contract to create a huge new data platform, leading to privacy concerns around patients’ medical details. The move immediately prompted concerns about the security and privacy of patient medical records and the suitability of Palantir to be given access to and oversight of such sensitive material. NHS England has given Palantir and four partners including Accenture a five-year contract to set up and operate the “federated data platform” (FDP). The British Medical Association, which had previously voiced concern about the NHS’s alleged lack of scrutiny of bidders on “ethical” grounds, said Palantir’s winning bid was “deeply worrying”. NHS England sought to allay such concerns. It stressed that none of the companies in the winning consortium would be able to access health and care data without its explicit consent; that it would retain control of all data within the platform; and that it would not include GP data. It said the new software would be protected by the highest possible standards of security through the deployment of “privacy enhancing technology”. Read full story Source: The Guardian, 21 November 2023 -
Content ArticleA service providing bilingual medication information is helping to reduce healthcare inequalities and medical errors. Pharmacies across London are benefitting from the support of Written Medicine; a service providing bilingual dispensing labels in patients’ language of choice.
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Content ArticleHealth at a Glance provides a comprehensive set of indicators on population health and health system performance across OECD members and key emerging economies. These cover health status, risk factors for health, access to and quality of healthcare, and health system resources. Analysis draws from the latest comparable official national statistics and other sources. Alongside indicator-by-indicator analysis, an overview chapter summarises the comparative performance of countries and major trends. This edition also has a special focus on digital health, which measures the digital readiness of OECD countries’ health systems, and outlines what countries need to do accelerate the digital health transformation.
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News Article
Hunt tech adviser calls for ‘new central investment’
Patient Safety Learning posted a news article in News
The NHS requires a ‘new central investment’ to achieve digital maturity and realise the potential of emerging technologies, according to the person who was commissioned by Jeremy Hunt to examine the issue in 2015. Bob Wachter was commissioned by the then health and social care secretary in 2015, and authored the 2016 report Making IT Work, which called on all NHS trusts to achieve the “realistic target” of a good level of digital maturity by 2023. While Professor Wachter told HSJ that there had been “reasonably good” progress, he said it was “not quite what I would have hoped for” seven years on from his report. He acknowledged that factors such as the pandemic and the subsequent economic situation slowed progress, but added that he was “a little bit worried” at the state of digital maturity in some areas, including interoperability and reliability of key systems such as electronic patient records. Read full story (paywalled) Source: HSJ, 1 November 2023 -
Content ArticleIn late 2015, the National Advisory Group on Health Information Technology in England was formed to advise the Department of Health and NHS England on its efforts to digitise the secondary care system. Our recommendations fall into two broad categories: 10 overall findings and principles, followed by 10 implementation recommendations.
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News Article
Millions of patients given access to GP records under new rules
Patient Safety Learning posted a news article in News
Millions of patients will be handed the power to view their own medical records and test results online after the NHS overruled opposition from the doctors’ union. From 1 November every GP surgery in England will be contractually obliged to give all patients over the age of 16 access to their health information on their phones. It means patients will no longer have to ring up their surgery or book a GP appointment to get details of blood test results, medications and repeat prescriptions, but instead they can access them by logging in to the NHS app. The British Medical Association (BMA) had threatened to go to court over the plans, arguing that granting people access to their records would add to GP workloads and could put patients at risk. However, Jacob Lant, the chief executive of the charity umbrella group National Voices, said: “Ensuring everyone has access to their own medical records through the NHS app is an important step in building a more equal partnership between patients and clinicians. “It gives people much easier access to the information they need to prepare for appointments, and having quick access to test results can help patients manage their conditions better. Using technology in this way has the potential to help millions, and free up capacity of staff to help those who are less able to make use of digital services.” Read full story (paywalled) Source: The Times, 31 October 2023 -
Content ArticleData-driven health systems is the term we use to refer to technologies that collect, process, and analyse data about people to present health information in new ways, make predictions, or reach a particular outcome. Over three years, the Ada Lovelace Institute, in partnership with the Health Foundation, explored how the accelerated adoption of data-driven systems and digital health services interact with health inequalities in the UK.
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News Article
The app that promised an NHS ‘revolution’ then went down in flames
Patient_Safety_Learning posted a news article in News
Babylon Healthcare won NHS contracts after being championed by Matt Hancock but the company’s AI tech was oversold and it has now collapsed. The NHS spent millions of pounds on a flawed AI chatbot whose creator used aggressive sales techniques and overpromised what it could do, former staff have claimed. Babylon Health, a tech start-up championed by Matt Hancock and advised by Dominic Cummings, promised that its AI chatbot could keep patients who didn’t need to be seen by a health professional out of the overstretched NHS. But the technology was not as sophisticated as the company claimed, with former staff now claiming that what began as a crude tool based on “decision trees written by doctors, put into an Excel spreadsheet” never realised its promised potential. Concerns — including the fact the app missed clear signs of a heart attack or dangerous blood clots — were raised. Read full story (paywalled) Source: The Times, 28 October 2023 -
Content ArticleThe importance of big health data is recognised worldwide. Most UK National Health Service (NHS) care interactions are recorded in electronic health records, resulting in an unmatched potential for population-level datasets. However, policy reviews have highlighted challenges from a complex data-sharing landscape relating to transparency, privacy, and analysis capabilities. In response, authors of this study, published in The Lancet Digital Health, used public information sources to map all electronic patient data flows across England, from providers to more than 460 subsequent academic, commercial, and public data consumers. Although NHS data support a global research ecosystem, they found that multistage data flow chains limit transparency and risk public trust, most data interactions do not fulfil recommended best practices for safe data access, and existing infrastructure produces aggregation of duplicate data assets, thus limiting diversity of data and added value to end users. They provide recommendations to support data infrastructure transformation and have produced a website to promote transparency and showcase NHS data assets.
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Content ArticleThis document from the Patient Experience Library aims to map the evidence base for patient experience in digital healthcare. We shine a spotlight on areas of saturation, we expose the gaps and we make suggestions for how research funders and national NHS bodies could steer the research to get better value and better learning.
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Content ArticleModern health systems must embrace digital technologies to address challenges like ongoing shortages in the global health and care workforce, significant diagnostic backlogs and the requirements of diverse and ageing populations. The COVID-19 pandemic and the exceptional advances in artificial intelligence (AI) and machine learning (ML) have accelerated the drive towards digitalisation of health systems. However, making digital health technologies work in practice remains challenging in terms of how these technologies are designed, how their performance and safety in operation are assured and how their impact on staff and on patients is assessed, writes Mark Sujan in this BMJ Editorial.
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EventuntilWith a strong national drive to standardise on a handful of EPR systems what are the risks of creating monopolies? What are the risks of vendor-lock in for future innovation, costs, choice and interoperability. Join our panellists as they debate this key industry topic. Find out more
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Content ArticleNHS England provides regular updates on progress with the implementation of the Digital Clinical Safety Strategy to show how they've captures insights about digital clinical safety, how they are training their workforce to support safety in this area and how they use technology to drive safer care.
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Content Article
The benefits of giving patients a central role in developing healthcare solutions have been widely demonstrated, but meaningful engagement is still far too rare, particularly in digital healthcare. In this blog for World Patient Safety Day 2023, Clive Flashman, Chief Digital Officer at Patient Safety Learning, looks at the benefits and barriers to engaging patients in developing digital healthcare solutions. He looks at why healthcare innovators struggle to include patients at an early stage of development and suggests some ways that NHS England could help facilitate coproduction through its existing patient engagement and innovation structures.- Posted
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News Article
Nottingham University Hospitals Trust failed to send 400,000 letters
Patient Safety Learning posted a news article in News
An NHS hospital trust in Nottingham failed to send more than 400,000 digital letters and documents to GPs and patients, BBC News can reveal. A former employee has told of "a lack of responsibility" over a new computer system. Patient body Healthwatch said it was "deeply concerned" by the scale of the incident and the impact on care. The trust says a full investigation took place in 2017 and found no significant harm to patients. But it has now said it will carry out a review of that investigation and take any further action needed. The healthcare regulator the Care Quality Commission (CQC) said it was not aware of the incident and would be following up with the trust. This is the second major incident in England involving unsent NHS letters uncovered by the BBC recently. Read full story Source: BBC News, 30 September 2023 -
News Article
NHS data breach: trusts shared patient details with Facebook without consent
Patient Safety Learning posted a news article in News
NHS trusts are sharing intimate details about patients’ medical conditions, appointments and treatments with Facebook without consent and despite promising never to do so. An Observer investigation has uncovered a covert tracking tool in the websites of 20 NHS trusts which has for years collected browsing information and shared it with the tech giant in a major breach of privacy. The data includes granular details of pages viewed, buttons clicked and keywords searched. It is matched to the user’s IP address – an identifier linked to an individual or household – and in many cases details of their Facebook account. Information extracted by Meta Pixel can be used by Facebook’s parent company, Meta, for its own business purposes – including improving its targeted advertising services. Records of information sent to the firm by NHS websites reveal it includes data which – when linked to an individual – could reveal personal medical details. It was collected from patients who visited hundreds of NHS webpages about HIV, self-harm, gender identity services, sexual health, cancer, children’s treatment and more. It also includes details of when web users clicked buttons to book an appointment, order a repeat prescription, request a referral or to complete an online counselling course. Millions of patients are potentially affected. Read full story Source: The Guardian, 27 May 2023 -
Content ArticleCommercial aviation practices, including the role of the pilot monitoring, the sterile flight deck rule, and computerised checklists, have direct applicability to anaesthesia care. Checklists are commonly used in the operating room, especially the World Health Organization surgical safety checklist. However, the use of aviation-style computerised checklists offers additional benefits. In this editorial, Jelacic et al. discuss how these commercial aviation practices may be applied in the operating room.
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Content Article
In October, the Healthcare Safety Investigation Branch will tweak its name, become independent from NHS England and the UK government, and gain new powers to strengthen investigations. With the announcement of the change in status, Health Secretary, Steven Barclay, reported it would be leading an investigation into inpatient mental health. This follows swiftly on the heels of the Strathdee rapid review into data on mental health inpatient settings, which itself was launched in response to well-documented failures in these settings. The aim of this new investigation into mental health is simple: to improve safety. In this blog, Karen West, Head of Transformation (Mental health) at Oxehealth, and Professor Dan Joyce from the University of Liverpool, discuss the importance of data in patient safety improvement and explain why inpatient mental health data is so difficult to collect and what can be done to improve this. -
Content ArticleThe adoption of virtual consultations, catalysed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. This study aims to evaluate the impact of virtual consultations on the quality of primary care. It found that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalising on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
