The abrupt change in Secretary of State for Health for the UK has overshadowed some recent, and very significant, health-relevant policy developments.
Making the UK a science superpower – will policy moves pay off for health?
Philippa Brice of the PHG Foundation writes:
Firstly, 10 Downing Street announced plans for a new ministerial council to ‘realise and maximise the opportunities’ of scientific and technological breakthroughs and ideas for public good – including tackling societal problems. Curing cancer is one of these aims. The intention is to make the most of UK strengths in science, as demonstrated throughout the pandemic, to ‘cement the UK’s position as a science superpower’.
Supporting high risk, high reward science
The National Science and Technology Council will be chaired by the Prime Minister and will provide strategic direction. This will be supported by a new Office for Science and Technology Strategy based in the Cabinet Office and led by Chief Scientific Adviser Sir Patrick Vallance, who will add National Technology Adviser to his list of responsibilities.
The Office for Science and Technology Strategy will help drive forward Whitehall ambitions to put science and technology at the centre of policy and public services. This includes oversight of national capacity and skills needs and picking the most promising new technologies for the government to prioritise in a deliberate ‘high risk, high reward’ approach. Sir Patrick Vallance said that his new Office would “put science and technology right at the heart of policy-making”.
Earlier this year plans were announced for a new Advanced Research & Invention Agency (ARIA), modelled on the US DARPA, to provide funding and support for rapid research into transformational (and high risk) technologies, to the tune of £800 million. It seems the government feels this did not go nearly far enough and has followed up with plans for highly visible strategic policy oversight. The success of the UK vaccine development is cited as an example of how investment in new technologies can pay dividends for the country. None of these developments are limited to health applications .
Harnessing data for health
Hot on the heels of news of steps to boost the UK’s science superpower status came a draft data strategy for health and care.
Data saves lives: reshaping health and social care with data sets out the vision of the Secretary of State for Health on using data to improve the health and care of the population ‘in a safe, trusted and transparent way’. This is part of the wider Digital Transformation Plan for the NHS, as set out in the 2019 NHS Long Term Plan; NHSX was established to lead digital transformation and fata connectivity across health and social care.
NHSX Chief Executive Matthew Gould commented that the new data strategy would “set out our vision to go further, to learn from the pandemic, to save more lives with data, to use technology to ensure patient privacy is even better protected, and to give patients more control of their health records”.
It addresses three priorities:
Building public understanding of how data is used for innovation, including improving transparency
Making appropriate data sharing the norm and not the exception
Build the technical, legal, regulatory foundations for data sharing
The strategy is unashamedly clear on the imperative to deliver these aims, at scale and at speed, to ‘unleash the unlimited potential of data’, observing: ‘Now is not the time to slow down or pause for breath, when the opportunities are so vast, and the momentum is so great. To the contrary, now is the time to grow our gains’.
Although the data strategy (which is open for consultation) is focused on delivering specific public benefits in health than the wider remits of the science and technology council and strategy office, they both relate to a clear long-term vision at the highest levels of government to make the most of science and foster constructive innovation.
Implications for health
Overall, these policy developments are to be applauded. Science and technology do unquestionably offer us potential solutions to many of our current societal challenges, and efforts to look further ahead, spot the most promising science and make extra support available where it is needed is wise.
The repeated reference to ‘high risk, high reward’ approaches suggests that it is clearly understood that there may be many failures along the way – money will unquestionably be wasted on the development of technologies that do not deliver the desired utility, but the hope is that those that do will provide benefits that more than justify the less successful ventures.
One caveat would be that the NHS does not follow the commercial sector’s approach of ‘failing fast’ – a highly effective approach to rapidly trialling innovations and rejecting those that do not deliver the chosen ends. This is in part due to the potential clinical risks involved.
Closer working with those experienced in this approach could help change a fear of failure culture; the pandemic did illustrate the power of collaborative working driven by shared aims and considerable urgency to deliver extraordinary technological solutions to pressing health needs. However, these fears are not without good reason – not only do innovations for health naturally have to meet the required high standards of safety and efficacy before being put into health service practice, but also the public takes a generally dim view of taxpayer money being expended on apparent failures.
Another potential tricky point is distinguishing between the health and wealth agendas at play in recent developments. Obviously, the aim is to achieve both – improving health services and outcomes as well as other public policy aims whilst simultaneously building on existing UK science strengths to shore up the economic benefits. Both are important, and the two are not incompatible, albeit requiring more cross-sector working.
Unquestionably there are a range of challenges and sensitivities associated with combining a highly valued publicly funded health service with competitive and commercial goals. Public attitudes are critical to successfully navigating these, as recent objections to the General Practice Data for Planning and Research (GPDPR) programme clearly demonstrate. The draft data strategy recognises this, as does the National Genomic Healthcare Strategy, acknowledging the need to both engage with the public and address their concerns, and to ensure that the new measures put in place meet the needs of health professionals and patients.
It would be highly advisable for both the new National Science and Technology Council and Office for Science and Technology Strategy to ensure that they take into account public perspectives as to the best opportunities for innovation to meet policy needs. There is a danger that the urgency of technology ‘push’ (or at times, hype) and policy ‘pull’ can result in failure to address public concerns and values sufficiently early in the research and development process. At the same time, these new bodies have an unparalleled opportunity to foster public support for ambitions to be a science superpower, and to maximise the benefits for citizens. It may be a challenge as great as the technical obstacles to success – but no less worthy of pursuit.
The PHG Foundation is a health policy think tank with a special focus on how genomics and other emerging health technologies can provide more effective, personalised healthcare and deliver improvements in population health.