Published by Eleonora Harwich on 26 June 2018
- Our Work
- The Reformer Blog
3 July 2018
Last month, Reform held a panel event on how to make NHS data work for everyone. The event explored: (i) the different ways of defining the value of NHS data and (ii) what constitutes a mutually beneficial public-private partnership between patients, the NHS and industry when there is access to data to create a product. To respect the Chatham House rule Reform has decided to produce as series of three blogs covering the main ideas raised during the event.
Having an open conversation about private sector involvement in the NHS is difficult as the debate is often polarised. The principle of the NHS being a universal healthcare service free at the point of care is not antithetical with the existence of public-private partnerships. NHS organisations should, however, take a more active role in the partnership formation, specifically when these involve access to NHS data to create a product, and understand what their value proposition is (i.e. what they are bringing to the negotiation table/ what makes them attractive). This would allow NHS organisations to have an equal footing in the conversation.
Surveys have shown that people are worried about their healthcare data being used for commercial purposes. However, they would rather share data with the private sector than forgo the health benefits offered by public-private partnerships.
As was highlighted during the event, the NHS does not have the technical expertise to develop all health and care innovation in-house, meaning that partnerships are necessary. However, there is a need for a framework clarifying how the private sector should ethically operate within this area of public service provision. In addition to putting appropriate safeguards in place for how data will be shared with the private sector, there is also a need for (i) greater clarity around the private sector’s commercial models when there is access to NHS data to create a product and (ii) for a framework which truly puts the word ‘partnership’ at centre.
These last two elements are not currently in place. There is a lack of clarity over the commercial models of some private companies operating within the NHS and there is no partnership framework. This means that it is up to Trusts to decide how partnerships will be established with the private sector. As highlighted during the event, the NHS is risking the “chaotic development of random tools and products”. In addition, as there is no single procurement process in the NHS, there is a risk that each individual Trust might enter an unhealthy competition around data.
Part of the value proposition of NHS organisations is the data asset they are stewards of. This is why, as uncomfortable as it may be, it is important to have a conversation around its financial value (as well as the other values discussed in last week’s blog). Without it, the NHS will not have an equal footing at the negotiation table with the private sector and risks undervaluing itself. As highlighted during the event, this could have a long-term impact on the forgone revenue stream that the NHS would have been able to generate.
In addition, some have argued that not accounting for the value of NHS data as an intangible asset would be a mistake. It is denying how the ‘rules of the game’ have changed in contemporary economies: data is a currency. People do not pay with money for services by big tech companies, they pay with data they generate by using those services. Valuing NHS data would help the public sector to not underplay its hand when negotiating with the private and make sure that value is fairly distributed amongst stakeholders in a public-private partnership.
Eleonora Harwich, Director of Research and Head of Digital and Tech Innovation, Reform