Digitising the NHS: opportunity or liability?
by Charis St. Clair Fisher, Consultant

Back in May, apparently in an effort to look like ‘real people’ on social media, Conservative MPs received some much-needed, if slightly elementary, top tips to up their game on Instagram. But while some have way to go in keeping up with the ‘digital natives’, others are more readily embracing technology. New Health and Social Care Secretary Matt Hancock is one such example – albeit with varying degrees of success.

Despite the Matt Hancock App facing some data privacy issues which would probably not be recommended by his own Government watchdog, Hancock appears keen not to waste his experience at the Department for Digital, Culture Media & Sport, saying recently that he plans to make the NHS “more tech savvy and digital”. With the announced £20bn funding boost there may be more scope for this than previously.

Undoubtedly there are steps forward the NHS can take in advancing its technological infrastructure and defence. This was seen in the WannaCry hack last year which the National Audit Office’s report said could have been prevented with “basic IT security”, and which cost the NHS some £180,000. Steps are being taken in response to this, with an announced extra £150m to bolster cyber security in the NHS. However, it’s not only NHS online security which is behind the curve: recent FoI requests from the Royal College of Surgeons found that over 8,000 fax machines are in use across England, while a CommonTime report suggests that devices such as pagers cost the NHS £6.6m annually.

Public opinion also recognises the need for digital innovation within the NHS. A ComRes poll for Healthwatch England in March found that nearly three quarters of British adults believe their healthcare treatment relies on the ability of healthcare providers to access their patient data quickly (73%) and around half (51%) say that increasing patient data sharing is the only way for the NHS to achieve higher efficiency in the future.

As Britain’s most cherished institution – with 85% believing the NHS ‘rightly a source of tremendous pride for Britain’ – it is also the most trusted organisation to use personally identifiable data appropriately (i.e. the purpose for which it was collected). With 44% expressing a high level of trust (8-10 on a 10 point scale) it comes ahead of banks (38%) and National Government (28%). Indeed, 77% of the public are confident in the NHS to protect their data despite greater awareness of data security issues (53% are more aware) and greater concern about how personally identifiable data is used (57% are more concerned) in the last three years. This is despite a high reported awareness of the ‘WannaCry’ NHS computer hack in May 2017 (85%) and a knock-on effect on public confidence. The NHS therefore may be one of the best placed organisations to use patient data to improve services while enjoying public confidence and trust.

But, as they say, with great power comes great responsibility. In the context of patient data, what it’s being used for and where it is stored, transparency remains vital. In a ComRes poll for the Corsham Institute in June, 88% of British adults said it was important to know how and where their personal data is stored and 91% said it was important to know what measures are in place to keep their data safe.

Data from this research also showed a lack of awareness around where their data is stored now, with only 28% saying they are aware that the NHS uses any cloud-based information storing systems, a practice recommended by NHS Digital guidance. Just 30% of British adults say that they are aware of who has access to their personally identifiable data that is stored by the NHS.

In our digital new world, and particularly in healthcare, it is essential that data security and confidence work alongside digital innovation and advancement. If patients lose trust in where their data is stored it will inevitably make them more reluctant for it to be used for research purposes or medical advancements.

Apps are an obvious and necessary way in which a cash-strapped NHS, facing ever-increasing demands on its resources, can help ease the burden.  As with so many other parts of Government, though, innovation necessitates risk - and personal and sensitive data storage carries exceptional risk. Let’s hope the public are patient enough, and data security robust enough, for NHS tech to catch on.