AI-generated documents ‘biggest bet’ to improving NHS productivity, ex-director of transformation says

By on 21/09/2023 | Updated on 21/09/2023
Dr Tim Ferris speaking at Public Service Data Live in London. Photo by Tom Hampson

Countless lives could be saved if the UK were to adopt artificial intelligence (AI) that can automatically generate documents and so allow nurses and clinicians to focus on patient care, the NHS England’s outgoing national director of transformation told Global Government Forum.

Speaking on his last day in the role to an audience at Public Service Data Live in London on 14 September, Dr Tim Ferris said that the UK prime minister’s “biggest bet” for improving productivity across the national health service was to lift the burden of documentation from healthcare workers.

“I am absolutely convinced, and I’ve seen it for myself, that documentation issues… [are] a huge drag on the productivity of the service, like a 20%, 30%, 40% drag,” Ferris said.

The innovation that stood the greatest chance of making a difference over the next ten years, he said, is what is known as “ambient documentation”, an AI-based approach already used in industries such as aviation.

“When an airline pilot leaves a plane, everything that she did, from entering the plane until the leaving plane, is documented. She documents nothing because the environment around her has been built to do the documentation. She just does. That is possible in healthcare. And I’ve seen it, and it is stunning,” Ferris explained.

He cautioned that using AI to generate documentation would mean “a big change in workflows” and that trust in how such documentation was produced would need attention.   

“Our voice interactions, which become stored in bits and bytes, are going to… generate massive data. We’re going to have to develop workflows that give us confidence that [as soon as] the voice part is sorted, it’s immediately deleted. Then, you’ve got a large language model taking what is essentially a transcript and turning that into the kind of structured documentation you need. That is all doable.”

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Demands on the horizon

Ferris started as NHS England’s national director of transformation during the COVID-19 pandemic in May 2021. Recounting key moments and lessons from his time at the service, he said he had been surprised to learn that “the frontline [of the NHS] wasn’t digitised”. He stressed that digital transformation and workforce expansion are both essential if the NHS is to meet its capacity challenges in the coming decades.

“We actually don’t have access to some of the really critical pieces of data that are necessary to manage the delivery of healthcare and conduct research over the next few years,” he warned.

“You look at those numbers that need to be hired to provide healthcare services for the next 25 years. That is a big challenge, and a significant increase in the workforce. It’s impossible to imagine that data and technology won’t be needed in addition to that workforce to deliver the ever-increasing demands in healthcare.”

Ferris highlighted information governance (IG) as another critical piece of the puzzle to improving outcomes. He described the ‘national’ in ‘National Health Service’ as “an interesting description of what is extraordinarily autonomous and siloed organisations – literally hundreds and hundreds of them – each with their own information governance [IG] leads”.

“If the decision-making was clear, if the rules were clear, then I don’t suppose that would pose a problem,” he said, adding: “Because IG rules have lots of ambiguity to them, and you have a thousand-plus people making decisions, what you end up with are inconsistent decisions throughout the NHS, and therefore patchy access to technologies that you’re trying to adopt to get access and implement it.”

Reflecting on the lessons of the pandemic, Ferris praised the “narrow vertical” that facilitated the delivery of the UK’s vaccination rollout, from the top of government down to local vaccination centres.

“When we are all aligned around what it is we need to do, data can do amazing things for the health of the population,” he said.

He concluded that though the UK still had huge potential to transform care through better use of its data assets, aversion to change within government held equal potential to undo progress and put lives at risk.

“[In government], when we sit in rooms and we assess the risks of change, sometimes those conversations turn into catastrophization. What I am most focused on is that the status quo is not okay. In fact, the risks of the status quo are significantly greater than the risks of change,” he said. “We’re making progress, but we have a long way to go.”

More information: Public Service Data Live

About Jack Aldane

Jack is a British journalist, cartoonist and podcaster. He graduated from Heythrop College London in 2009 with a BA in philosophy, before living and working in China for three years as a freelance reporter. After training in financial journalism at City University from 2013 to 2014, Jack worked at Bloomberg and Thomson Reuters before moving into editing magazines on global trade and development finance. Shortly after editing opinion writing for UnHerd, he joined the independent think tank ResPublica, where he led a media campaign to change the health and safety requirements around asbestos in UK public buildings. As host and producer of The Booking Club podcast – a conversation series featuring prominent authors and commentators at their favourite restaurants – Jack continues to engage today’s most distinguished thinkers on the biggest problems pertaining to ideology and power in the 21st century. He joined Global Government Forum as its Senior Staff Writer and Community Co-ordinator in 2021.

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