The Sisyphean task of interoperability should be the NHS’s biggest tech priority

Standards and clear leadership are needed to make progress in this crucial area, according to Tom Russell of techUK

Credit: Pikrepo

The recent period of policy purgatory known as purdah left some of the most pressing issues related to digital health and healthtech without much direction. 

Now into a new decade, there is a renewed spirit to address some of the challenges and opportunities that health and social care will face in 2020. 

For the newly elected techUK Health and Social Care Council, the sector’s first and foremost technology priority is making meaningful progress on interoperability. 

This challenging topic covers the broad themes of mandating and setting standards in order to facilitate the seamless flow of data across and between organisations. The challenge is how to reconcile the current reality regarding siloed data and proprietary software, with the opportunity to broaden the marketplace for suppliers, offering greater choice for providers and driving competition. 

In terms of its ubiquity, it is the Sisyphean task of the health IT industry and one of the primary questions is that who is ultimately accountable for it centrally within the NHS in England. 

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Understanding this point is crucial, and although the emergence of NHSX as the leading tech unit seemed to settle this question, much is still to be done before it can claim success on its stated missions regarding interoperability. 

Defining an open ‘Digital Health Technology Standard’ is key, and the first draft is scheduled to be published in early 2020. This standard will play a complex role as both a carrot and stick for suppliers, simplifying their route to market when meeting it and creating an additional barrier for those that do not. 

Matthew Gould, the NHSX CEO, has spoken at length on interoperability, and NHSX is currently appointing a director of standards and interoperability to take the reins directly. 

Where this leaves NHS Digital is a matter for discussion, especially given their recent publication of the FHIR UK Core standards. The organisation’s role has historically been an important one, but with the tectonic plates shifting it is unclear what role it will play long term. 

Looking to help facilitate this ongoing dialogue, techUK is a founding member of the healthcare community group INTEROPen, who has been leading the charge in bringing suppliers to the table. 

The next steps must be industry-led and supported, if standards are to be agreed and implemented uniformly across the system. As part of a range of planned events over the year, techUK hosted a roundtable on interoperability to bring together the industry ecosystem in an attempt to assess the current state of play and harness the existing expertise and a workshop on local spend controls with NHSX.

Think local
Closely following on the list of priorities is an increased focus on regional engagement across the whole of the UK. Aligned with the new government’s plans to increase economic activity, improve productivity and localise decision-making, digital health is going local. Critical to this in England is the role of the nascent Integrated Care Systems (ICSs). 

NHSX’s Digital Health Technology Standard will play a complex role as both a carrot and stick for suppliers, simplifying their route to market when meeting it and creating an additional barrier for those that do not

As per the NHS’s Long Term Plan, all Sustainability and Transformation Partnerships are scheduled to become ICSs by April 2021 and they will represent the future system architecture for care delivery across their population footprint. For industry, this means a new focal point for engagement, and as accountability flows more from the centre to these ICSs, it is imperative that industry pivots its focus towards the regions. 

The council also recognises the importance of continuing our work to put “the UK into techUK”. Our ongoing campaign to foster a broader ecosystem and maintain our successful engagement across the devolved health administrations in Scotland, Northern Ireland and Wales will be essential to the programme in 2020 and beyond. 

The opportunities here are largely around tapping into the momentum behind the government’s “levelling up” agenda to help foster more digital health hubs across the country. By bringing together academia, life sciences, the NHS and industry more broadly to collaborate on new technologies, the potential for developing world-leading clusters outside of London and the South East is astounding.  

2020 is shaping up to be the year where the foundations for future success are lain down and proper planning and engagement now is imperative for the NHS to achieve its ambitious targets for digitisation and improved outcomes set out in the Long Term Plan.


Sam Trendall

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