The must-read stories and debate in health policy and leadership.

Keep calm and carry on prepping

The NHS will continue its no-deal Brexit preparations despite ministers standing down cross-government planning for crashing out of the EU.

Although the pan-government no-deal preparations — code-named Operation Yellowhammer — are being paused, NHS EU exit strategic commander Keith Willett told NHS leaders preparations would continue because the UK could leave without a deal at the end of January.

A short letter sent to local system leaders, published on the NHS England website on 30 October but dated for the day before, said: “If ratification has not happened by 31 January 2020 the legal default is that the UK will leave the EU without a deal.

“This means that preparations for a no deal outcome must continue, adjusted to the new timescales. The current daily EU Exit SitRep [data on medical and other supply levels] therefore will be paused from today (Tuesday) until we approach the next no deal date.”

With around just 50 working days to go before the next no-deal ‘cliff-edge’, this would appear a sensible strategy, albeit far from ideal given the resources the preparations are sucking out the system at both local and national level.

The danger of the system being completely overwhelmed will, of course, only increase as winter progresses. But the NHS can only play the hand it has been dealt, so keep calm and carry on prepping.

Robot revolution?

According to NHSX, artificial intelligence can make a big difference to healthcare but that doesn’t mean the process of introducing AI to the NHS is straightforward and there is understandably a lot of public scepticism over its reliability.

NHSX’s report — titled Artificial Intelligence, How to get it right and published earlier this week — revealed half of developers are not seeking ethical approval before they start producing AI systems for healthcare.

The lack of clarity on ethics surrounding AI development was blamed on a “lack of awareness” among developers. A third of AI developers who took part in an NHSX survey said they were not developing within the Department of Health and Social Care’s code of conduct, or weren’t sure whether they were. 

NHSX has now pledged to ensure expectations of compliance with the code is made clear in all funding applications.

But that’s not the only thing hindering the rise of AI. The report noted the “complex governance framework” around AI tech could limit innovation and even compromise patient safety. It added “regulatory pain points” in the development pathway could also deter innovators.

It is hoped the new national AI Lab, announced by the DHSC in August, will help overcome these “pain points” and encourage the spread of “good” innovation.

However, while it is essential the process for introducing AI in healthcare is finetuned, focus also needs to be turned towards informing patients of how tech is used in the NHS.

Research by the Royal Society of the Arts, Manufactures and Commerce, commissioned by the NHS as part of its wider AI report, found patients are “highly worried” about “losing the emotional judgement” of doctors and nurses if automation is used more widely across the health system.

It also stressed the public and patients need to be involved in research so patient need for new technologies is identified correctly.