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Holes in the data

Disquiet has been growing in the centre for some time about trusts talking to tech companies about data sharing.

The genesis case was Google Deepmind’s deal with Royal Free London Foundation Trust to share patient data to develop a clinical alert app Streams. That deal was later found to be unlawful. The commercial sense of the arrangement has also been questioned – Google now plans to turn Streams into a global business and Royal Free will see none of that financial benefit.

Google Deepmind and other tech companies have continued to grow their network of data-sharing deals with trusts with little input from the centre. That has made policymakers nervous.

One concern is that trusts are giving away patient data too cheaply but another – growing – concern is these deals might interfere with grander national data-sharing plans.

If a hospital trust signs an exclusive deal to share patient data with an AI company, that creates a gap in the national picture of patients in England. The government views current (and, more importantly, future) national NHS patient data sets as a valuable economic tool to be leveraged to support research and industry. Holes in the data make it less valuable. 

That is why a letter has been sent out to trusts ordering them not to enter exclusive deals to share data with one tech company.

To date, there have been no confirmed cases in the NHS of exclusive data deals, although tech companies have tried. But policymakers are worried enough that they are hoping this missive will see off any future such deals at the pass.  

The detail of the deal

On the face of it, the procurement of a new IT system by Guy’s and St Thomas’ FT is a standard, albeit large, purchase – £175m over 10 years for such a large trust is not out of the ordinary.

What makes it more noteworthy is the successful contractor must include an option to join up two other trusts.

Which ones? Why, neighbour/rival King’s College Hospital FT and embattled specialist Royal Brompton and Harefield FT.

The latter has long been in dispute with national commissioners over the scale of its services. Last year, it went public with proposals to relocate from Chelsea to land owned by GSTT.

A shared IT system is a further indication that this prospect is likely.

Interim chair of KCH Sir Hugh Taylor stressed at his first board meeting that his appointment didn’t automatically mean a merger with GSTT, where he is substantive chair – although it is well-known in senior management circles that this is the current favoured direction of travel.

KCH’s recent chief exec appointment Clive Kay mentioned at the board that he was keen to preserve the brand of King’s, which people opposed to a merger will have welcomed.

A shared electronic patient record system across the two trusts – which already share a pathology service – is more consequential, and points the other way.

It is a real sign of the times that a Shelford Group trust might get merged the way a smaller-brand district general hospital would have been five years ago.