On 14th February 2019, hot on the heels of the launch of the Topol Review, a UK-wide industry exchange network (IXN) for the NHS was created. While many of us will have spent the day scrabbling for Valentine’s gifts of short-term value to appease those we cherish the most, this ground-breaking initiative provides the promise of a long-term, future-facing solution to two of the most pressing challenges facing the UK’s best-loved institution: how do we start to build a future facing NHS workforce, and, how do we identify and design healthcare technologies that truly meet local and national healthcare needs? It’s a proposal that has our hearts fluttering with excitement.
As the Topol Review highlighted, healthcare technologies have the potential to dramatically improve healthcare as we know it. Many clinicians and scientists find this potential incredibly exciting; however, numerous friends and colleagues, despite embracing digital and AI technologies in their personal lives, struggle to see the NHS changing dramatically, not in the next decade at least.
Both views are understandable. For too long the NHS clinical workforce has suffered from a system-wide lack of education and expertise regarding healthcare technologies, an IT infrastructure that is often not fit for purpose, and procurement of technological solutions from industry that haven’t addressed local needs. Rather than easing clinician workload, the history of technology implementation in the NHS is that it often brings added burden.
So, how might a UK-wide industry exchange network for the NHS help? Our opinion is that the development of user-centred, patient and clinician-driven technology must be married with the evolution of a diverse, modern workforce with the necessary skillset—one strategically designed for the NHS to get the best out of collaborations with academia and industry.
The concept of an industry exchange network was pioneered by the Department of Computer Science at University College London (UCL) where it has been in development and operation for over seven years as the UCL IXN. In one of the world’s largest problem-based learning initiatives for Computer Science engagement, over 500 candidates (undergraduate and Masters level) on the UCL IXN work on different levels and scales of real-world Computer Science problems every year. They are supported by over 300 industry partners including Microsoft, IBM, NTT Data and ARM to name but a few. Their outputs are proof of concept technologies which can be progressed if considered likely to be of true benefit.
Since the creation of the government-backed Apperta Foundation CIC (which supports the NHS with Open Source technologies) up to a third of UCL Computer Science students on IXN projects have worked with NHS mentors, addressing local clinical or health system problems. The NHS mentors and industry partner clients work together to generate suitable projects; each project has a named technical mentor from industry, an academic supervisor, and an NHS clinician mentor. The UCL IXN is complemented by the Great Ormond Street DRIVE initiative which provides the dedicated physical space for computer scientists and clinical staff to come together in a safe, non-clinical arena to develop and test their new technologies. Many student projects conceived and developed through the UCL IXN have been contributors to NHS technologies (from mental health chatbots, to a web-based treatment and management system for hepatitis C, and machine learning readiness tasks for clinicians), yet you would struggle to find a clinician aware of the industry exchange network’s existence.
Crucially, the potential benefits of the industry exchange network model reach far beyond the technology that is developed. These models encourage open collaboration between the NHS, academia and industry. They allow individuals with complementary skills to experience working with the NHS with the hope that they will continue to work with and in the NHS in the future. It allows clinicians to see the potential for technology in healthcare, to learn about technology, and to be encouraged to co-design and develop technologies that will improve the care they provide and the system in which they work.
Following the example of the UCL Computer Science industry exchange network model, the “IXN for the NHS” will provide a framework for other UK universities and industry partners to contribute, with their STEM (science, technology, engineering and mathematics) programmes working on projects with the NHS. The IXN for the NHS will have a grounded centre to facilitate interoperability, efficiency and innovation. However, this initiative needs to be allied with NHS career paths for STEM students who want to continue working in/with the NHS, having been introduced to this through the industry exchange network.
We believe the NHS has a bright future, one augmented by technology, but powered by a diverse, modern workforce. Delivering wide-scale change through healthcare technologies is a wicked problem, but we hope the 7-year-old IXN concept may just be about to teach the 70-year-old NHS a new trick or two.
David Cox is a Neonatal Grid Trainee and was the Clinical Fellow for the Artificial Intelligence and Robotics workstream of the Topol Review. @drdjcox
Dean Mohamedally is the Chair of the IXN for the NHS, and a Principal Teaching Fellow at the Department of Computer Science at University College London. @dr_deano
Competing interests: None further declared