In the weeks and months since Keir Starmer’s government took the reins in the UK, promises have been made as to how the National Health Service (NHS) will introduce new technologies and systems to save the body from a slow decline.

Within the first few months of the new UK Health and Social Services Agency Minister Wes Streeting’s tenure, the tone has been set through a mixture of a damning government report that found that the UK’s supposedly world-class health system stands in a state of disrepair with ballooning surgery wait times, a collapse in cardiovascular care and technological distribution.

Initially commissioned under the previous government, the report written by House of Lords member Ara Darzi, has laid out a myriad of failings within the system that will set the agenda for the new government over the next year. Core to that report’s criticisms is the UK’s failing commitment to modernise its hospitals and health systems with the latest medical devices and equipment.

The report itself states: “Over the past 15 years, many sectors of the economy have been radically reshaped by digital technologies. Yet the NHS is in the foothills of digital transformation. The last decade was a missed opportunity to prepare the NHS for the future and to embrace the technologies that would enable a shift in the model from ‘diagnose and treat’ to ‘predict and prevent’ - a shift I called for in high-quality Care for all, more than 15 years ago.

“Some £4.3bn was raided from capital budgets between 2014-2015 and 2018-2019 to cover in-year deficits that were themselves caused by unrealistically low spending settlements.”

The same report found that the UK faced a shortfall of £37bn in capital investment, finding those missing billions would have been invested in the NHS if the country had matched peer countries’ levels of capital investment in the 2010s. It concludes that the amount could have prevented the backlog maintenance and paid for the 40 new hospitals that were previously promised by past governments but do not yet exist. Additionally, it could have rebuilt or refurbished every GP practice in the country.

Following its publication, the UK-centric life sciences field has been clamouring to echo the report's sentiment, calling on the government to drastically up its investment across the medical device space and get newer machines and software rolled out to clinics. However, opinions vary on where to start and in the triage of public spending, what comes first.

Inefficiency and inadequacy

The statement about being in the “foothills of digital transformation” has caused some consternation among the private sector who themselves have been calling on successive UK Governments since the austerity period of the 2010s to drastically up technology funding across the seemingly unendingly beleaguered NHS.

In the over 15 years since the 2008 economic crisis and the period of severe and stinging austerity that followed under the then-Conservative government, public spending on the NHS effectively dried up.

The Darzi report found that the backlog maintenance bill now stands at more than £11.6bn with a lack of capital meaning that there are too many outdated scanners, too little automation, and aged facilities all of which drastically contribute towards an ageing expensive system that leaves little to no room for any form of technological expansion. Additionally, the report found that at least 20% of the UK’s primary care estate predates the founding of the health service in 1948.

Now, many of the findings of the damning report are being echoed by UK life science firms who, while it may be in their own interest to encourage the NHS to buy more advanced technology, have been repeatedly calling for greater investment in the space, arguing that the government has routinely failed to make the connection between a lack of available technology, patient turn-over and staff burnout.

Speaking with Medical Device Network, Philips UK & Ireland managing director Mark Leftwich detailed how before the Darzi report, the company had released its own report that found a similar result.

The Future Health Index UK & Ireland report took feedback from more than 200 healthcare leaders, as described by the study. Results found that nearly all healthcare leaders are facing economic gaps or financial challenges (97%), and 77% have faced delayed, limited, or no investment in medical equipment and technological solutions.

Seven in ten (71%) say that shortages of equipment or staff have led to longer waiting times and delayed access to care.

Leftwich said: “The Darzi report coming out on the back of a Labour government coming into power actually flagged quite some challenges within the NHS, and when you look at our future health index, there's an awful lot of parallels in terms of the same themes coming out over and over again.

“We have been doing our own report now for approximately nine years with about 3,000 people worldwide across 14 countries examining what healthcare leaders think about some of the solutions to healthcare problems. This is the first year ever we have done it in the UK. We asked senior leaders what the main challenges they were seeing were. A big theme is all about staffing.

“The Darzi report showed that it's not just about the numbers of staff but also about the pressures on them and productivity goals. It's about their jobs becoming harder and harder to deliver patient care because they are working, in essence, in estates with technology that has not had investment in a very long time. If you have old equipment to do your job it becomes harder and harder to do that.”

Making up for lost time

Just over a month following the Darzi report, the UK’s newest chancellor of the exchequer Rachael Reeves unveiled the newest financial budget for the entire country. Coming off the back of the searing report, life science stakeholders across the country were awaiting the announcement of increased measures to modernise UK health systems with greater investment.

On 30 October, what was announced by Reeves sent signals of progress through the sector. But for some, it may be too little too late to meet the goals of some of the UK’s past failed commitments to upscale technology across the board and broaden services to communities.

Reeves announced up to £520m ($670m) for a new Life Sciences Innovative Manufacturing Fund. In addition, £22.6bn would be spent in the day-to-day health budget over two years, and there will be a £3.1bn increase to the capital investment budget for the NHS.

A 10.9% average annual rise aimed at addressing a backlog of repairs. According to the chancellor, £1bn will be used for repairs and upgrades while £1.5bn will be used to provide new beds, new surgical hubs, and diagnostic centres.

Away from technological failings, a significant number of the UK’s hospitals and public buildings have been hit with another costly series of repair bills after it was found that they had been built using an older form of concrete known as Reinforced Autoclaved Aerated Concrete (RAAC). This is liable to collapse after a lifespan of approximately 30 years, as a result, this immediate structural issue is liable to take a cut out of some of the money needed to reinforce the body’s technological and staff capacity.

Philips is not the only private sector company that has been running its own research and surveys into what the British medical workforce wants to see in terms of systematic changes.

Primarily focusing on the field of surgery, research by MedTech giant Medtronic concluded that each surgeon loses an average of four hours a week due to inefficient technology. This is equal to more than an entire working month of hours each year. That study, entitled 'State of Surgery in the UK: Technology and Efficiency in Patient Care', found that 79% of UK surgeons feel care would be easier to deliver if technology was improved.

Expanding on the needs of surgeons following the announcement of the October budget, Medtronic's digital technology vice president George Murgatroyd added that the workforce is ultimately being let down by the infrastructure, particularly the digital infrastructure around them.

Murgatroyd said: “If you extrapolate four hours a week across the entire surgical workforce in the NHS, which is around 25,000 surgeons, each of them losing four hours a week equates to losing a potential quarter of a billion pounds. It equates to almost 500 years every single year in wasted time. That is time that we believe is time that we can get back.

“This has been solved in other sectors through digital technology, but we are still facing it. I think the highly dedicated workforce is creaking at the seams with very outdated tech and that is something I think Lord Darzi highlighted in terms of the investment needed to transform the landscape of hospitals.

“The types of things we have been focused on are how can we how can we start automating and providing technologies that do save time. We need to put solutions at people's fingertips to overcome some ludicrous hurdles. For example, a lot of surgeons when they want to review footage of procedures they have performed, still have to resort to using a USB stick and DVD, which is just bonkers in 2024.”

It remains to be seen if this new budget allocation will address some of the many issues underpinning the world's first nationalised health system. As stated in the Darzi report, promises have been made in the past of new hospitals and new community care initiatives that have not materialised and the longer that pattern repeats the more weighted down the NHS will become with outdated technology. Aside from technology, the UK life sciences scene faces further drivers of insecurity, such as a plateauing rate of staff pay, which could threaten to undo much of the progress that investment could bring.