Speech by Health and Social Care Secretary Sajid Javid at the HSJ Digital Transformation Summit
Health Secretary Sajid Javid's speech at the Health Service Journal's Digital Transformation Summit
Before I start, I wanted to say that my thoughts – like all of you – are with the people of Ukraine after this appalling and unprovoked attack that President Putin has unleashed on them today. I know many of us will be thinking about the Ukranian people and everything going on there.
We will stand with them side-by-side at their time of need and the Prime Minister will be saying more about the steps that we will be taking later today.
I want to thank you very much for inviting me to your conference.
I want to start with the pandemic. This pandemic was a time of urgent necessity, and also a time of incredible invention.
It pushed digital transformation to levels that we never thought possible and gave this country’s digital infrastructure the biggest stress test in history.
A report from Mckinsey that I remember said that in the first few months of the pandemic digital adoption to access health services accelerated by up to 7 years.
As I’m sure you have seen, on Monday in government we published our plan, this country’s plan, for Living with COVID: a 60-page document on living with the virus.
But just because COVID is in retreat, it doesn’t mean that this digital transformation agenda should be too.
Due to the investment that we made before the pandemic and the huge strides forward that we took during the pandemic, we are now in an immensely strong position. In terms of digital transformation this is just the start.
Just as a crisis can spark incredible change, it can also provide an incredible platform upon which to build.
In my previous roles in finance I saw how successive financial crises led to the creation of the G-20 – and there’s lots that we can learn from COVID too.
The shared experience of COVID, I think it’s fair to say, has been game-changing.
As we emerge from this pandemic, both clinicians and patients will have new expectations about health and care, and there is so much that we can learn from the experience of other nations across the world.
We must not just look to build back better, but to build back smarter, drawing on the brilliant advances that we have made.
I think it’s fair to say we have already made a blistering start.
So many of the announcements that the Prime Minister and I have made in recent weeks – when you think about the delivery of the Elective Recovery Plan, the Integration White Paper, the Social Care White Paper, and the Living with COVID Plan – have had technology at their very core.
Today, with so many of this country’s digital leaders here in one place, I wanted to share with all of you my 4 priorities to use the power of digital to drive a new era of recovery and reform.
These are: firstly, making sure the NHS is set up properly for success; secondly, levelling up across the NHS and social care; thirdly, pursuing personalisation; and fourthly, making big breakthrough bets on emerging technologies and data.
So let me start: first, we must make sure that we have the structures in place that support the level of ambition that we all have for digital transformation.
Not so long ago digital would have been strongly siloed within most organisations, as it was seen as something that was squarely within the remit of a Chief Information Officer, a Chief Technology Officer. But times have changed.
Digital transformation is not something that you can delegate. It must be led from the front.
The companies that have thrived most amidst this time of incredible change have been those companies that understood that digital transformation must touch every single part of an organisation. And this can only work if it’s foremost in the minds of everyone at the top table, especially the CEO of the organisation.
It was no coincidence that when I set out the advert for Simon Stevens’ successor I wanted to put digital transformation at the top of the advert, because transformation is not just important for the NHS, but existential.
I know that Amanda Pritchard, and the new Chair of NHS England, Richard Meddings, get this.
When I joined this department, it struck me as unusual that digital leadership was split across NHS England, NHSX and NHS Digital, and that we had bodies that were responsible for digital strategy and implementation that sat outside NHSE, each with their own boards.
I couldn’t imagine any other digitally focused organisation, like a big supermarket or for that matter any FTSE 100 company … I couldn’t imagine these huge complex organisations allowing responsibility for one of the most important levers for change – digital – to sit outside their organisation.
So as you know the Wade-Gery report recommended that we make structural changes to put digital transformation at the heart of the NHS, and I agreed with that wholeheartedly.
We are now in the process of merging NHSX and NHS Digital into NHSE – bringing together all of the NHS’s digital bodies under one roof for the very first time.
I would like to also take this opportunity to thank everyone at NHS Digital and NHSX for the incredible work that they’ve done.
The fact that we have taken this step is a vindication of everything you’ve done to make the case for digital transformation across health and care.
My second priority: with these new structures in place we are in an even stronger position to level up digital provision all across health and care.
I spent last week getting out of Westminster to hospitals and care homes all across the country.
Everywhere I went I saw incredible examples of how digital technologies are already transforming health and care for the better, for instance the state-of-the-art technology powering eye care at the Musgrove Park Hospital in Taunton.
But I also heard stories of where there is much more to do, and where outdated silos and systems were causing frustration.
We must see these disparities as just as unacceptable and unjust as disparities in access to education and employment.
Because being able to make the most of digital technologies is critical to the future of health and care.
Just as we deploy the most exciting new technologies at scale, we need to get the right foundations in place: the building blocks that make digital transformation possible.
We have undeniably seen brilliant progress. But this progress hasn’t always been consistent across the board, for example we estimate there is one in 5 NHS trusts that still do not have Electronic Patient Records.
As part of my tour I went to Birmingham Heartlands Hospital, where clinicians on the front line told me how these records have transformed the way they work, saving their time, helping them to deliver better, safer care for patients.
Electronic patient records are the essential prerequisite for a modern, digital NHS. Without them, we cannot achieve the full potential for reform.
So I want to accelerate the rollout of these vital records with a new approach, so that we hit 90% coverage by December 2023 – by the end of next year.
By then I also want the remaining 10% to be in the process of implementing them.
I also want to see a particular focus on social care – where around 40% of providers are still grappling entirely with paper-based records. I want all social care providers to adopt a digital record for social care.
We will work with the sector to deliver this in the most effective way we can, and offer support to those who need it. We have announced at least £150 million to help drive digitisation in social care, and a target of 80% of social care providers to have digital social care records by March 2024.
Because the case for these records is beyond doubt, and I expect every health and social care setting to see this as part of their basic responsibilities in looking after those in need.
After all, when it comes to matters of life and death we must embrace everything that has the potential to make care safer and more seamless.
The shocking events of the past few weeks have reminded us of cyber attacks and how established a form of conflict they’ve now become, and we can only make these digital reforms if we keep the system safe from those who want to cause us harm.
A chain is only as strong as its weakest link, and we are shoring up cyber resilience in all parts of health and care, backed by over £300 million of investment since 2017.
In this period we have prevented 4 major cyber attacks which could have caused a catastrophic impact on the front line.
Cyber attacks like these can impact patient safety just as much as what happens on a hospital ward and so, in an uncertain world, this must be a focus for leaders all across health and care.
Let me move on to my third priority, where we must also keep driving the personalised technologies that have blossomed during the pandemic. Because personalisation and prevention are 2 sides of the same coin.
Through the smarter use of NHS data and the adoption of emerging technologies we can move services from generalised to personalised and give everyone access to the information and the tools that they need to manage their health.
This is the future of health and care and we must drive this forward at pace.
The extraordinary adoption of the NHS app during the pandemic presents a real opportunity.
Two years ago, the prospect that the NHS app would have been the most downloaded free iPhone app in England would have seemed unthinkable.
But this app is now an essential part of life for so many, and 24 million people, that’s over half of adults in England, are now carrying it around in their pocket.
But we need to keep this momentum going – and so by March 2024 I want this to be 75% of all adults in England.
Now to get there we need to show people that the app is for life, not just for COVID, and that it will be a future front door for interacting with the NHS.
This means improving access to existing services and introducing new services too.
When I think about what the app will look like in the future, I see a platform where you can directly communicate with your health provider, where you can see all your test results and documents in one place, and where you can get personalised advice to manage your own health.
Work to get us there is well underway and the NHS is already working on new features, including how we can show estimated waiting times and the results of blood tests within the app.
The NHS app has shown how people are receptive to having healthcare literally in their hands and we have this opportunity, this unique opportunity, to use platforms like apps and websites to access diagnostics and therapies, helping them to manage their own conditions.
We are piloting this approach in mental health and cardiovascular prevention, 2 areas where there is a growing need within the NHS.
As part of this we will be developing a clear and frictionless pathway for promising products, underpinned by clear standards to make sure that technology platforms can talk to each other, so we can get them deployed as quickly as possible with as few overheads as possible.
New technologies can also help us to offer more dignified and independent care to people, in their own homes, keeping them out of hospital if they don’t need to be there.
With an increasingly ageing population – where nearly one in 7 people is projected to be aged over 75 by 2040 – and more and more comorbidities, technology can do so much to help people to live independent lives and minimise the time they spend in clinical settings.
The remote monitoring that played such a starring role during the pandemic gave us a glimpse into what could be done.
They monitored huge numbers of people in their own living rooms, rather than being limited by the capacity of a hospital ward.
On top of this they can also play a crucial role in tackling the COVID backlog, allowing hospitals to focus on those who need it most.
Over 270,000 people have long-term conditions supported by the NHS through digital technologies, and this approach must not be seen as some kind of short-term response to a crisis, but a model for how care can be given.
We have seen the brilliant use of virtual wards throughout this pandemic and I’m pleased that the recent NHS England planning guidance gave them a very important role too.
Norfolk and Norwich NHS Foundation Trust set up their virtual ward a year ago this month. It’s already freed up over 6,000 bed days for inpatients – and the initiative has patient satisfaction levels of 99%.
We’ve had such positive feedback from patients who can recuperate in their own home with their loved ones, safe in the knowledge that their condition is being monitored round the clock by their clinician.
I want us to intensify the pace of the rollout of virtual wards so we can make sure that these services are available across the whole country, and we’ve made up to £450 million available over the next 2 years to support this.
Finally, my fourth priority: we must make the most of emerging technologies and data.
One of the most revealing experiences that I have had during my time in this role is when I visited a hospital, Milton Keynes hospital, and I saw how they had become the first hospital in Europe to use surgical robots for major operations.
These robots, used under the supervision of human surgeons, have led to a lower risk of infection for patients, faster recovery times and less time in hospital.
It was an incredible glimpse of the future and I want to do everything I can to encourage the development of the most state-of-the-art technologies here in the UK.
One of the great lessons of the pandemic was the opportunities that are on offer when government, the life sciences, academia and industry… when we all come together.
During my tour last week I went to Cambridge Biomedical Campus – the largest centre of medical research in Europe, with pioneers from across different sectors working side-by-side.
Thanks to this spirit of partnership so many of the breakthroughs that made headlines all across the world were forged in this country. Including the RECOVERY trial, which led to the discovery of the world’s first proven treatment for COVID-19 in just 100 days, which has now saved at least a million lives all across the world.
The Galleri trial is also showing great potential to transform how we detect cancer, and once again it’s happening right at the heart of the NHS.
NHS data is making the whole world safer and healthier.
In fact, Data Saves Lives is the name of our data strategy for health and care. We published it in draft last year to start getting some views from far and wide, and the final version will follow this spring.
We are also looking at how we can make it easier for patients to access their own data and GP records, including mandating access as they have done in the United States.
But the benefits of NHS data can be so much broader.
Thanks to this country’s single, national healthcare service, the NHS has a precious resource in the form of data that can offer so much insight to pioneers in the life sciences, including some of the world’s largest genomic datasets.
But we know that there is more to do to build trust in the use of data and reassure the public that it will be used securely.
So, for instance, making it smoother and safer for researchers to access and use data through requiring the use of trusted research environments.
The Goldacre Report, which I have received recently, has also been tasked with looking at this and we will publish this report soon.
I also want to address the stark diversity gap in these clinical trials, and make sure that representation reflects the true make-up of the UK.
Many leading names in life sciences choose to base themselves here because we have such a diverse population, something we can celebrate.
But when you look at the make-up of clinical trials many groups are under-represented, which presents the unacceptable risk of treatments being developed that aren’t effective for all communities.
After a chapter in this country’s history where we have seen so much progress, we cannot live with such blatant injustices.
I’ve already kickstarted work on this through launching a review of the impact of potential bias in medical devices which will be led by Dame Margaret Whitehead, a leading expert on health inequalities.
And I’d urge you all, as senior leaders, to think about what you can do to encourage more equal representation when it comes to these pioneering projects which, after all, are matters of life and death.
Now I want to end by saying that I don’t see digital transformation as a flash in the pan, a quick fix at a time of crisis. It is fundamental to the mission to clear the COVID backlog, and to the long-term health and happiness of this country.
It matters more now than it did when this pandemic began.
This is not a time to slow down and look in the rear view mirror. It’s a time to accelerate.
So I’m delighted to announce that in the spring we will be publishing for the first time a comprehensive Digital Health Plan, the next chapter of this story of digital transformation.
It shows how we will be driving this digital change across all these areas I’ve talked about today, and many more, building on the varied lessons from this pandemic.
It was a time of adversity – World War 2 – that led to universal healthcare we now enjoy in this country, and the NHS was created after that, the NHS that we all know and cherish.
Let’s make sure that this time of adversity kicks off a new era of digital transformation.
To help the NHS – and this country – thrive long into the future.
Thank you very much.