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House of Lords Hansard
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15 July 2019
Volume 799

Question

Asked by

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To ask Her Majesty’s Government what steps they are taking to increase the use of automation in the National Health Service.

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My Lords, the Topol review, published earlier this year, outlines recommendations for preparing the health and care workforce, through education and training, to adopt new technologies such as artificial intelligence and robotics. It is clear that the use of AI will not replace clinical staff but instead allow them to be more human. The use of new technologies will ensure that patients receive safer, more productive, more effective and more personalised care. The recommendations of the Topol review have informed the interim NHS people plan, which sets out how we prepare the workforce to build an NHS that is fit for the future.

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My Lords, the success of any organisation is dependent on the people within it. I believe that the most precious asset that the NHS has is its human resource of dedicated staff, but in these days of sophisticated IT, and now artificial intelligence, can my noble friend tell the House what developments can be safely and securely harnessed by the NHS?

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Tremendous innovations are being introduced, including in robotics and AI-based automation, particularly in diagnostics, which have the potential to transform how healthcare is delivered in the NHS, but the role of automation to carry out basic administrative and repetitive functions, and of robotics in surgical operations in particular, is due to increase over the next decade. The main purpose of this automation in health is not to replace staff with machines or to reduce the role played by humans in providing care but, rather, to enable staff to spend more time delivering personalised care. But it is also to improve the productivity of health services and systems so that we can ensure that the NHS becomes more sustainable in future.

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My Lords, the noble Baroness, Lady Seccombe, made a valid point about the need for human beings to be involved in the delivery of healthcare, but the use of AI and other technology is also very exciting, as is the fact that it features so largely in the long-term plan. Are the experiments in automation taking place across the country, where are they taking place, when will we see the results and who is delivering automated healthcare and AI? Is it the NHS or are private contractors being commissioned to do this work? I accept that the Minister may not be able to answer all those questions in detail, but if she cannot, I would appreciate a letter being placed in the Library.

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The noble Baroness is absolutely right: this is a very exciting area of ongoing work and a key part of the grand challenges which we put in place as part of the life sciences strategy, part of which is the AI and early diagnosis initiative, which aims to transform the prevention, early diagnosis and treatment of chronic diseases. NHSX’s work across government is to deliver that mission, creating an ecosystem of safe and effective development of AI and the regulatory infrastructure so patients and clinicians can be reassured that where it is introduced, it will be safe. There will be lots of research and development of those innovations. We are at an early stage of implementing them, but there are five centres of excellence across the country. I will be very happy to place a letter in the Library updating the House on progress with the AI mission and these exciting developments.

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My Lords, while the delivery of automation and AI has much to commend it to the NHS, CyberMDX reported last week that anaesthetic machines can be hacked and controlled from afar, including silencing alarms that would alert anaesthetists to danger. Four months ago in Israel, a cybersecurity firm demonstrated that computer virus malware could add tumours to images of scans. What protections, such as digital signatures and encryption, does the NHS now put in place, following the malware alarm two years ago, to ensure that automation and digital services cannot be attacked by malevolent forces?

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The noble Baroness is correct to say that patients and clinicians have a right to expect their data to be held securely. Since the WannaCry attack in May 2017, we have taken steps to ensure that NHS security measures are of the highest standard. This includes £60 million to improve cyber resilience in local infrastructure, support for NHS organisations to update their Windows operating systems, procuring a new cybersecurity operations centre, and boosting the national capability to prevent, detect and respond to cyberattacks. We are also committed to achieving much greater operational visibility across all NHS digital systems. This is one of the ways in which we can respond to attacks. Lastly, we expect the highest ethical standards from all data-driven systems and that is why we have introduced the code of conduct for data-driven health and care technology. That is how we will ensure that we have some of the best AI and data-driven technologies.

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My Lords, does my noble friend agree with one of the key points made by Professor Topol that one of the benefits of artificial intelligence is the “gift of time”, as he has put it? In other words, patients can spend more time with their doctor if certain more routine things are automated. Will my noble friend make sure that that is one of the key aims of bringing automation into healthcare?

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My noble friend is right. One of the key recommendations is that by automating routine analyses such as radiology, diagnoses and pathology and routinely bringing in AI to sequence bed management, we will reduce the burden on clinicians so that they are able to see more patients. The review makes specific recommendations to help the workforce become more digital ready, which means increasing capacity and capability, and building the right environment. That is exactly what we have embedded into the NHS people plan and all that we are working on through NHSX.

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My Lords, I declare my interests as set out in the register. Robotic process automation—RPA—is an emerging software technology that can undertake repetitive tasks in place of human workers. Many industries are seeing the benefits of using this technology and thus releasing people to do more value-added work. I believe that it has been used in a small number of NHS trusts. Can the Minister say whether there are any plans to deploy this technology more widely across the health service?

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The noble Lord is right to say that technologies such as this offer the most potential to reduce repetitive work and transform how our healthcare is delivered. This is what we are focusing on to ensure that we can give health and care staff the ability to spend more time delivering personalised care in medicine while also ensuring that we improve systems to make them more efficient and productive.