Key points

  • As the NHS emerges from the latest wave of the COVID-19 pandemic, there are hopes that technologies such as automation and artificial intelligence (AI) will be able to help it recover, as well as meet the very significant future demand challenges it was already facing (and which have since grown worse). Drawing on learning from the Health Foundation’s research and programmes, along with YouGov surveys of over 4,000 UK adults and 1,000 NHS staff, this report explores the opportunities for automation and AI in health care and the challenges of deploying them in practice. We find that while these technologies hold huge potential for improving care and supporting the NHS to increase its productivity, in developing and deploying them we must be careful not to squeeze out the human dimension of health care, and must support the health and care workforce to adapt to and shape technological change.
  • The nature of health care constrains the use of automation and AI technologies in important ways. Health care is a service that is fundamentally co-produced between patients and clinicians, making the human, relational dimension critically important to the quality of care. The prospect of health care becoming more impersonal with less human contact was ranked the biggest risk of automation in both our public and NHS staff surveys. Furthermore, many health care tasks require skills and traits that computers cannot yet replicate, while the complexity of many tasks and work environments in health care also poses challenges for automation. Much of what is known about the use of automation is taken from product manufacturing, meaning caution is required in assessing how well ideas and strategies from the wider literature might translate into health care.
  • Given the nature of work in health care is different to many other industries, the impact of these technologies on work will also tend to be different. In many cases, automation and AI technologies will be deployed to support rather than replace workers, potentially improving the quality of work rather than threatening it. Particular opportunities exist for the automation of administrative tasks, freeing up NHS staff to focus on activities where humans add most value – which is especially important at a time when the NHS is struggling with significant demand pressures and longstanding workforce shortages. In other cases, automation and AI can significantly enhance human abilities, such as with information analysis to support decision making, with the dividends accruing through combining human and machine input.
  • Government and NHS leaders have an important role to play in working with and supporting health care workers to respond to the rise of automation and AI, especially those parts of the workforce that may be more heavily impacted. The NHS staff we surveyed were on balance slightly optimistic about the future impact of automation, with more thinking the main impact would be to improve the quality of work rather than to threaten jobs and professional status. Nevertheless, there were occupational differences in these views, highlighting that these technologies may have an uneven impact across the workforce.
  • The benefits of a new technology clearly don’t come from how it performs in isolation, but from fitting it successfully into a live health care setting and redesigning roles and ways of working to derive the benefits of the new functionalities it offers. And the journey from having a viable technology product to successful use in practice is often significant. Teams and organisations will need to consider the ‘human infrastructure’ and processes that need to accompany the technology, and policymakers, organisational leaders and system leaders will need to fund ‘the change’ not just ‘the tech’.
  • Government, working with health care professions and industry, needs to engage proactively with the automation agenda to shape outcomes for the benefit of patients, health care workers and society as a whole. In particular, government and NHS leaders have an important role to play in identifying and articulating NHS needs and priorities, working proactively with researchers and industry to ensure that technologies are developed to meet important health care problems, and supporting the development and adoption of technologies in practice.
  • While new, cutting-edge medical applications of automation and AI often steal the headlines, there are also important quality and efficiency gains to be made through applying these technologies to more routine, everyday tasks such as dealing with letters or appointment scheduling. There is also scope to get more out of existing applications of these technologies. So it is important for the NHS to have strategies in place for doing this, as well as supporting the development of new technologies.
  • Our surveys found public and NHS staff opinion divided on whether automation and AI in health care are a good thing or a bad thing. Majorities said the benefits and risks were finely balanced, and some groups tended to be less positive than others. So government and NHS leaders must engage with the public and NHS workforce to raise awareness and build confidence about technology-enabled care as well as to better understand views about how these technologies should and should not be applied in health care, how we can ensure they serve the needs of all groups, and how important risks should be mitigated. Notably, our surveys also found that those who had already heard about these technologies tended to be more positive about them, so helping to familiarise people with this topic could play an important role in shaping attitudes.
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