A view to the future; the NHS at 70 and beyond

Would you rather be treated by a fallible human or a compassionless robot? Healthwatch explores people’s views on the NHS at 70 and beyond

In the 70^th much celebrated year of the NHS, Healthwatch is turning its attention to the future, asking the public some big questions about what they want health and care in England to look like. Every year our Healthwatch network engages with around half a million people, helping them to find services and working hard to understand their experiences of care. From this wealth of insight and feedback, it is very clear that things are already changing rapidly in how health and social care services help us to live our lives.

People’s health and care needs are very different to previous generations, their relationships with doctors, nurses and other health professionals are changing and technology is revolutionising the types of treatments available and how we interact with services – but with this comes some big practical and ethical questions.

Using these three themes Healthwatch is launching a national conversation to find out more about what people want and expect from hospitals, GPs and care services in the coming decades. We want people to look beyond the well-documented challenges of the here and now and help us set some clear goals for the NHS and social care sector to aim for.

The perceived impact of technology

To kick things off, we polled 2,000 people to find out more about what impact people think technology will have on the way the NHS operates in 20 to 30 years’ time. We found that:

• Almost four in five people (78% net ‘likely’) expect that technology monitoring people’s lifestyles will be commonplace and will be used to inform treatment options, with a fifth (20%) stating that they think it is very likely.
• Two thirds (67% net ‘likely’) think it is likely to some extent that artificial intelligence (AI) will be used to diagnose conditions. Only three per cent of people thought it was very unlikely.
• Some people were more sceptical about the pace of change, with one in 10 (12% net ‘unlikely’) stating that they think the NHS will still be using fax in three decades’ time.

Yet just because people think technology will be widely used, this doesn’t necessarily mean they are yet comfortable with the idea. For example, two thirds (70% net ‘likely’) think the use of robots in surgery will be commonplace but, when given a simple choice:

• two thirds (66%) said they would rather be treated by a human doctor who is more likely to make a mistake but offers compassion;
• one in three people (34%) said they would rather be treated by a robot doctor that rarely makes a mistake but lacks compassion;
• over 65s were the least likely to choose AI – 72% choose the human doctor.

The route to NHS efficiency savings?

People are also uncertain about technology being the route to making huge efficiency savings in the NHS. We asked people to rank one to 10 – in order of importance – a range of ways health and care services can ensure they meet future demand. Respondents ranked the increased use of technology to help people self-manage conditions at ninth. This was significantly lower than things such as a greater focus on prevention which was ranked fourth and improved screening for early warning signs of disease – ranked second.

So, whilst there is a clear expectation that technology will change the way things work, there needs to be much greater engagement with people about how and why. This will be vital when the health sector and patients come to try and solve some of the big ethical dilemmas created by things like personalised medicine, wearable technology and artificial intelligence.

With these changes happening fast, Healthwatch is calling on people to share their thoughts to help shape the debate. People can get in touch via www.healthwatch.co.uk/nhs-100 or on social media using #NHS100.

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