The National Health Service (NHS) oversees health services in England, and under that government’s direction sets strategic objectives for the health care system as a whole. The other constituent countries of the United Kingdom (UK) – Scotland, Wales and Northern Ireland – similarly have their own public-health agency each. Any UK resident may obtain health services through any of these independent organizations – either for free or at a much lower price than through a private provider.
Last year, NHS celebrated its 70th anniversary. The milestone prompted a national conversation about the role and future of that organization. In part in response to that debate, the agency prepared and recently released “The NHS Long Term Plan,” outlining its vision for servicing public health in the next decade. A previous strategic document, “NHS Five Year Forward View” (2014), created a foundation for the current planning by setting in motion some of the initiatives that are now being projected to be spread to the entire system.
One of the areas where NHS sees an opportunity for modernizing service delivery and making health care more sustainable financially in the long term is with “digitally-enabled primary and outpatient care.” For example, the Long Term Plan estimates that by redesigning the services using digital tools the number of outpatient visits would be reduced by 30 million over the next five years, saving over a billion pounds. For patients, the practical benefits would include shorter wait times, less need for travel to receive care, and more control of the treatment choices.
NHS envisions a sweeping set of reforms to bring about the digital transformation – from digitalizing services and documents (e.g., medical records, appointments and prescriptions), to the use of artificial intelligence in support of clinical decision making, to the linking of “clinical, genomic and other data” to develop new treatments. In the process, NHS also promises to protect privacy, ensure security and interoperability of IT systems, provide necessary education, and support software developers and innovators. NHS has already started work on standards for digital data and technology.
To enable a broader public discussion and participation, NHS will convene an NHS Assembly in early 2019, which will play an advisory role as NHS implements its Long Term Plan. The creation of the NHS Assembly has been met with support by pharmacists, nurses and NHS providers. NHS has also developed a provisional list of potential legislative changes for the Parliament’s consideration.
Specific timelines and shorter-term priorities will, however, depend on the results of the Brexit process, which is still unfolding. In light of the uncertainties, academicians, medical professionals, patients, NHS itself and the general public are debating the future of NHS more vigorously than ever.