Can the Topol Review deliver the digital transformation the NHS needs?

The Topol Review: Preparing the healthcare workforce to deliver the digital future was commissioned to explore how to prepare the healthcare workforce, through education and training, to deliver the digital future. What does it say and what does it mean for primary care?

The NHS is undergoing a period of rapid technological change and advancement. Led by cardiologist, geneticist and digital medicine researcher Dr Eric Topol, the Topol Review was commissioned to explore how the healthcare workforce can be prepared, through education and training, to become better able to manage in this technologically advanced and digitally-driven environment. It’s not just about apps, although they will play an important role, the report also tackles some of the current defining trends including genomics, artificial intelligence, digital medicine and robotics.

In undertaking the review, Dr Topol appointed a review board and three expert advisory panels to support him. The report was produced by Health Education England, the national body responsible for skilling up the health service. It was launched at an impressive event, which was captured for this film:


The Topol Review is based on three fundamental principles:

  1. Patients need to be included as partners and informed about health technologies, with a particular focus on vulnerable/marginalised groups to ensure equitable access.
  2. The healthcare workforce needs expertise and guidance to evaluate new technologies, using processes grounded in real-world evidence.
  3. The gift of time: wherever possible, the adoption of new technologies should enable staff to gain more time to care, promoting deeper interaction with patients.

Technologies which the review believes will transform healthcare include genomics, digital medicine, artificial intelligence (AI) and robotics. At a practice level, the review envisages the greater adoption of technologies like speech recognition, AI-informed decision support tools and – perhaps inevitably – a greater use of apps to drive personalised healthcare.

In embracing the potential for new technology, there is a clear need to up-skill employees says Topol. In addressing the acknowledged skills gap, the review recommends that the NHS will establishes new education programmes in digital healthcare technologies, including specialist masters degrees and apprenticeships. In the future this specialist workforce will need to be supported to learn and develop new skills, including the commissioning of digital technologies and their application in GP practices.


Despite the aspirations of the report, initial response was muted although Harry Evans, a researcher at the influential The King’s Fund, struck an optimistic note, saying the review, “makes a number of welcome recommendations to create a digitally-savvy workforce with the knowledge and flexibility to embrace emerging technologies.”

Responding to the report’s findings, Professor Derek Alderson, president of the Royal College of Surgeons, said, “With so much technological change on the horizon, it is clear that the skills we equip our NHS workforce with, as well as the way we train them, will need to undergo a transformation too.”

While welcoming the report, NHS Employers chief executive Danny Mortimer urged caution saying, “The deployment of technology will, of course, require significant resource and investment and we would repeat that this needs to be properly funded by government and not left to, already stretched, individual NHS trusts to dig even deeper to fund.”

The review itself concludes with the statement that, ‘The greatest challenge is the culture shift in learning and innovation, with a willingness to embrace technology for system-wide improvement.’ Many would argue that the key issue is not the willingness of the NHS to adopt technology, it’s more a question of whether the NHS is able to adequately fund and support staff to do so. Regardless of the thousands of words written on the subject of technology and its potential, it’s money that will do the talking.

You can download a copy of the Topol Review here.

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