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Innovative technologies such as genomics, digital medicine, artificial intelligence (AI) and robotics are likely to transform how patient care is delivered through the NHS, but both future medical students and existing clinical staff will need extensive extra training to take advantage of this potential, according to the newly-published Topol Review.
The review project was led by cardiologist, geneticist and digital medicine researcher Eric Topol, who is executive vice-president and professor of molecular medicine at the Scripps Research Institute.
Topol assembled a review board and three expert advisory panels to product the in-depth report, which contains a number of recommendations to support the aims of the NHS Long-Term Plan and the workforce implementation plan, which, it is hoped, will ensure a sustainable health service for decades to come.
It explores how technological developments will change the roles of clinicians; what the implications of these changes are for the skillsets that will be needed by clinicians; and the consequences of this for their education, training and development.
“Ultimately, embracing and implementing these technologies – including genomics – throughout the NHS, while clearly representing a challenge, is likely to prevent diseases and their complications, and produce an overall improvement in health outcomes,” wrote Topol in his introduction to the review.
“We are at a unique juncture in the history of medicine, with the convergence of genomics, biosensors, the electronic patient record and smartphone apps, all superimposed on a digital infrastructure, with artificial intelligence to make sense of the overwhelming amount of data created.
“This remarkably powerful set of information technologies provides the capacity to understand, from a medical standpoint, the uniqueness of each individual – and the promise to deliver healthcare on a far more rational, efficient and tailored basis.”
The report recommends that NHS organisations foster a new culture of learning by adopting multi-professional collaborative approaches; introducing more workplace learning infrastructure; developing proactive, rather than reactive, learning; and giving staff dedicated time for development and learning away from their day-to-day duties.
Acknowledging that delivering the enhanced education needs of the future NHS workforce will be a challenge, the report calls on the NHS and local organisations to support the development of a group of educators who are ready to lead upskilling programmes in the next five years. Organisations should also develop systems to identify and nurture educators within the workforce, it says.
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The report proposes establishing a new NHS Digital Education Programme to oversee the implementation of a national digital education strategy around genomics and digital technologies.
This will play a role in supporting technological specialists within the NHS, addressing and plugging skills gaps through expanded educational programmes, and more flexible and responsive training for specialist technologist roles, which may include engaging with industrial learning organisations through work placements, exchanges or secondments.
To ensure the future NHS workforce is adequately equipped, the review recommends that universities should move immediately to ensure that genomics, data analytics and AI are made prominent elements of the undergraduate curricula for healthcare professionals. Students moving into the system must be given an appropriate level of digital literacy at the outset of their studies, says the report, and this would include ethical and patient safety considerations arising from AI.
Universities also need to begin to offer opportunities for medical students to intercalate in fields such as engineering or computer science, and to encourage graduates in these fields to consider a career in healthcare technology.
In response to the Topol Review, Health Education England has announced it is setting up a programme for 20 digital fellowships in healthcare for clinicians and non-clinicians to incorporate digital health expertise into their careers and pursue training in the area.
The aim is to support those taking part in the Topol Programme to develop the digital capabilities that will lead them down the path towards chief clinical information officer (CCIO) or chief information officer (CIO) posts in the health industry. Applications for this will open later this year.