NHS Long Term Plan

Lord Scriven Excerpts

Thursday 31st January 2019 Lords Chamber

[Lord Scriven (LD)]

A plan for personalised and predictive systems of healthcare linking together genomics, big data, artificial intelligence and digitisation—is this real or just fantasy? This is the NHS, which recently said no fax machines by 2020, yet the plan trumpets that by 2024 all secondary healthcare organisations will be digitised. This statement may in time be found to be a different type of artificial intelligence.

The NHS will embrace these new ways of working but the Government need to be realistic on the route map and the investment needed to do this. To make this happen the NHS needs to attract, train and retain a digital-literate workforce and have open-source systems that have operability across the health and social care systems. I see nothing in this plan about digital linkages between health and social care.

Also, the NHS must be trusted on cybersecurity. Last year, every trust tested by the NHS failed on agreed cybersecurity standards, yet the plan says that there will be fully digitised secondary care by 2024. What risk assessment has been done on this target when it comes to data and cybersecurity? What work is ongoing and with whom to ensure operable seamless systems between health and social care?

The plan states that within three years community staff will have access to mobile digital services. A 2018 survey showed that in community nursing this could not happen as in 81% of cases poor connectivity at the patient’s home stopped it. In 33% it was thwarted by uploaded data that could not talk to other systems it needed to. What other non-NHS departments and mobile network companies are part of this plan to make mobile digital working happen and is the three-year timescale realistic?

This service change will need a workforce that is digitally literate, yet the plan has only eight lines on a digital workforce: unfortunately, it gives a top-down approach through the digital academy. Let us be clear: for this to work, the NHS needs at every level a workforce that is digitally literate and equipped to exploit the personalised and predictive care system that the plan articulates. What workforce planning is happening over and above the digital leadership academy to ensure full digital skills for healthcare staff?

To date, £2.8 billion investment is agreed for IT and digital change until 2021. However, the Health Service Journal in 2018 reported that government estimates showed that £13 billion of investment was needed, of which 60% is revenue not capital. What investment over the £2.8 billion has been agreed for the plan’s digital transformation?

The plan is ambitious for a digitised personalised and predictive care system but it needs to be based on realistic plans and firm investment to make it happen. I hope the Minister can answer the questions I pose to show that this is the case and not just aspiration wrapped in hope.