The analysis, ‘Priorities for an AI in healthcare strategy’, sees the Health Foundation set out six priorities that this strategy should address and some of the key steps to do so, recognising the growing burden on the NHS from escalating demand and significant workforce shortages.

The potential of using AI in healthcare is enormous – supporting the discovery of new drugs, diagnosing illness faster and more accurately, and transforming clinical note taking. However, there are concerns, too. Warning of the risks associated with generative AI, the World Health Organization has called for rigorous oversight to prevent AI systems leading to errors, patient harm, and the erosion of public trust. Accountability when things go wrong is also a key focus, and there are worries, too, that AI could actually exacerbate health inequalities rather than improve access for all.

An effective strategy, argues the analysis, must ensure the use of AI by the health service is not only legal and ethical but also works for the greater social good. The report champions ‘Responsible AI’ as an approach that can provide a framework to ensure that the development of AI is not only trustworthy, designed with ethics in mind, and with risks minimised but also benefits people, society and the planet. It points to countries such as Denmark and Japan, where these concepts are central to their national AI strategies.

The six key priorities that policymakers and healthcare leaders must address are: meaningful public and staff engagement; effective priority setting; fit-for-purpose data and digital infrastructure; high-quality testing and evaluation; clear and consistent regulation; and the right workforce skills and capabilities.

A recent Health Foundation survey found that the public currently have relatively low levels of trust in the use of health data by both government and commercial organisations. Active engagement with the public, patients, carers and staff would help build trust. The paper points to the recent Whitehead Review of Equity in Medical Devices, which recommended that engagement with, and co-design of, AI should involve diverse groups of patients and the public, as well as consider equity, transparency and fairness.

Data and infrastructure

In regard to the NHS’ digital infrastructure being fit for purpose, the paper argues that an effective strategy should set out how processes can be standardised and improved to allow efficient access to high-quality data for the development of AI systems. Such access should be based on a proportionate approach to data security and privacy that effectively balances risk and opportunity, it says.

The NHS Research Secure Data Environment Network, which the Health Foundation says provides secure access to health data for research and development purposes, including AI algorithms – is highlighted as one possibility but somewhat of an unknown, given how new it is; while more radical proposals, such as the creation of a National Data Trust jointly controlled by the NHS and the Government, have also been proposed.

On regulation, an AI in healthcare strategy must introduce a framework that provides clarity and consistency for AI developers and users. Co-ordination of sectoral regulators, whereby all relevant bodies are brought together under an agreed approach that addresses gaps and overlaps, must be a key focus, states the report.

It notes particular concern among clinicians as to where clinical liability sits when algorithms are used in clinical decision-making. International alignment may also come into play here – as the analysis suggests that with many UK-based companies likely to want to sell into EU markets, they may look to meet EU standards by default.

Workforce training

Realising all the benefits that AI in healthcare offers will also rely on healthcare workers possessing the skills, knowledge and capacity to implement and use AI effectively. According to the paper, both clinical and non-clinical NHS staff will need a range of education and training, which, given the pace of change, will be needed throughout careers. Ultimately, states the paper, there needs to be a shared vision for how professions and occupations – as well as new roles – should develop with greater use of AI. Healthcare staff should play a major role in shaping this vision, along with colleagues, employers, trades unions, professional and representative bodies, patients, and the public.

For government and national NHS bodies, addressing the six priorities will require the co-ordination of fragmented initiatives and responsibilities, along with action in a range of areas, says the report. Progress on these priorities, it adds, should deliver several benefits, including:  

• patients and the public will have a voice in decisions about AI design and deployment, be confident that any AI used in the NHS is safe and effective and that the use of health data is secure and trustworthy, and – if it’s deployed well – benefit from AI’s potential to improve care quality and experience;
• staff and healthcare providers will have the skills and capabilities to capitalise on AI, the ability to shape the development of new technologies to ensure AI effectively tackles the challenges they face, and – if it’s deployed well – benefit from AI’s potential to improve job quality and system performance; and
• industry will get a clearer view of what the NHS needs and how to navigate the range of regulations, standards and obligations, and have opportunities for closer collaboration and partnership with the NHS, patients and the public in developing new technologies.

Demand for healthcare is growing rapidly, fuelled by an ageing population and a rise in chronic conditions and multi-morbidity, Against a backdrop of limited workforce resources, the NHS, the analysis concludes, “must do everything to capitalise on the opportunities presented by technology and AI to support staff and improve care quality and productivity. A dedicated strategy is needed to galvanise efforts to harness AI for the benefit of the NHS and ensure the health service remains strong and sustainable for the future.”