5. Improving clinical efficiency and safety

5.28. Digital technology can support the NHS to deliver high quality specialist care more efficiently. Early examples of what will be a much more profound shift include:

  • By 2021, pathology networks will mean quicker test turnaround times, improved access to more complex tests and better career opportunities for healthcare scientists at less overall cost. Mandated open standards in procurement will ensure that these networks are ready to exploit the opportunities afforded by AI, such as image triage, which will help clinical staff to prioritise their work more effectively, or identify opportunities for process improvement;
  • By 2023, diagnostic imaging networks will enable the rapid transfer of clinical images from care settings close to the patient to the relevant specialist clinician to interpret. This open standards-based infrastructure will enable both the rapid adoption of new assistive technologies to support improved and timely image reporting, as well as the development of large clinical data banks to fuel research and innovation.

5.29. Decision support and artificial intelligence are developing all the time. These technologies need to be embraced by the NHS, but also subjected to the same scrutiny that we would apply to any other medical technology. In the coming years AI will make it possible for many tasks to be automated, quality to increase and staff to focus on the complexity of human interactions that technology will never master.

5.30. We have seen that the NHS is a potential target for cyber criminals. We will ensure NHS systems and data are secure through the implementation of security and monitoring systems across the whole estate, the education of all staff, and the design of systems and services to be resilient and recoverable. We will mandate and continually update cyber security standards and behaviours for our systems and staff.

5.31. To achieve these digital advances, we need to create the right environment and infrastructure for innovation to thrive by:

  • creating a secure and capable digitally literate workforce;
  • requiring every technology supplier to the NHS to comply with published open standards to enable interoperability and continual improvement;
  • making solutions that are commissioned and developed by the NHS available as ‘open source’ to the developer community so that they can build on and enhance them to meet the evolving needs of the NHS and our patients;
  • ensuring that LHCR data platforms provide open and free APIs for developers to create new solutions that can compete with and, where appropriate, replace the traditional solutions used by the NHS;
  • making available a set of central capabilities that are rapidly deployable and can be used as the basis for future local innovation and development, such as the NHS Login or the national record locator service.

Milestones for digital technology

  • During 2019 we will introduce controls to ensure new systems purchased by the NHS comply with agreed standards, including those set out in The Future of Healthcare.
  • By 2020, five geographies will deliver a longitudinal health and care record platform linking NHS and local authority organisations, three additional areas will follow in 2021.
  • In 2020/21, people will have access to their care plan and communications from their care professionals via the NHS App; the care plan will move to the individual’s LHCR across the country over the next five years.
  • By summer 2021, we will have 100% compliance with mandated cyber security standards across all NHS organisations in the health and care system.
  • In 2021/22, we will have systems that support population health management in every Integrated Care System across England, with a Chief Clinical Information Officer (CCIO) or Chief Information Officer (CIO) on the board of every local NHS organisation.
  • By 2022/23, the Child Protection Information system will be extended to cover all health care settings, including general practices.
  • By 2023/24 every patient in England will be able to access a digital first primary care offer (see 1.44).
  • By 2024, secondary care providers in England, including acute, community and mental health care settings, will be fully digitised, including clinical and operational processes across all settings, locations and departments. Data will be captured, stored and transmitted electronically, supported by robust IT infrastructure and cyber security, and LHCRs will cover the whole country.