The NHS “big shift” from analogue to digital will depend on a healthy regulatory environment for the UK digital economy
This week, the UK Government announced a new consultation that will inform its 10-year plan for the National Health Service (NHS). One of the three big shifts it calls for is from “analogue to digital.” With resources constrained, the hope is to improve outcomes through changing key elements in how the NHS operates and updating the technology it employs. The new consultation is an important reminder of how essential a dynamic and innovative tech sector is to the delivery of the new Government’s ambitions, the “missions” it has put at the heart of its programme.
Ministers are right to be ambitious. There are areas such as public cloud IT in which the UK public sector has been a leader in adopting new technology. However, as time goes on new innovations and new examples of what can be achieved in other countries means there are plenty of opportunities to improve. Realising those opportunities will depend on a regulatory environment that allows for a dynamic, innovative UK digital economy.
That means improvements in the NHS depend upon public policy choices beyond the remit of the Department of Health and Social Care and the NHS itself. Many of the services which enable an NHS shift from analogue to digital will be based on innovations developed first for consumers or businesses. Other solutions will be developed for the public sector, reflecting the distinctive needs of the NHS, but by companies that also serve the private sector in the UK and public sector customers around the world. All of this means that the wider regulatory structure is important and barriers to innovation will also affect progress in the NHS.
Last week the Government fired the starting gun on its efforts to attract investment in the UK and strengthen growth. The tech sector was rightly one of those called out as vital to that effort and the Prime Minister emphasised the need for a supportive regulatory environment, including a pro-growth approach from the competition authority and other regulators.
Ministers will need to ensure that public sector organisations looking to deploy innovative solutions are not constrained by legacy commitments, particularly in the public sector. Social Market Foundation (SMF) research sponsored by the Computer and Communications Industry Association (CCIA) found that licensing restrictions for legacy software such as Office 365 and SQL Server would cost public sector organisations at least £300 million over the next 5 years. This exacerbates an enormous wider challenge relating to legacy systems in the public sector, with the head of the National Audit Office describing how in 2020 “Defra estimated that it would need to spend more than three quarters of its digital budget on addressing legacy system issues.”
That cost will divert funds from investment in new IT systems, perpetuate reliance on IT platforms that are not designed for the AI era and raise the cost of new solutions, making it harder for projects to justify themselves. More than that, though, it will restrict organisations that want to work with cloud providers that have specific strengths or bring innovative new services to the market that meet their needs. As the SMF put it, these “practices not only result in direct financial costs but may also prevent the UK from achieving its technological, economic, and security goals.” It is imperative that the Competition and Markets Authority (CMA) announce remedies shortly that address these restrictions holding back the competitive public cloud market.
Beyond that specific barrier to choice in the cloud market, premature or overly broad regulation, without the guardrails that reassure global businesses, will undermine the health of the tech sector more generally. There are early opportunities for Ministers to show that they take the need for regulatory restraint seriously by ensuring that the guidance for the Online Safety Act doesn’t pull services that were never supposed to be in the highest risk categories into the top tier because of an overly broad categorisation; that the exceptional powers created by revisions to the Investigatory Powers Act are subject to proper guardrails; and that clear milestones and expectations for evidence are included in the guidance for the Digital Markets Act. All of these are laws passed in the final years (in some cases days) of the last Government where the new Labour Government can put the Prime Minister’s words into action early by shaping their implementation.
Outside these regulatory choices, progress will also depend on the same infrastructure that powers innovative digital services of all kinds: data centres; logistics hubs; and the right edge devices. This means that planning regulation and efficient procurement will also be vital.
None of this is only valuable as a means to support the NHS. Improvements in the regulatory environment will improve wider economic performance. But the right digital systems present a fantastic opportunity to support nurses to get on with nursing and doctors to get on with treating patients. With a ten year time horizon there is a huge amount the Government can achieve if there is a holistic effort to support that digital transition.
