Author: James Clark
The UK’s Department for Health and Social Care (“DHSC”) has published a major strategy document (‘Data saves lives: reshaping health and social care with data’) outlining the government’s plans for the regulation and use of data in healthcare.
In this post, we look at some of the most interesting proposals outlined in the strategy and consider what they might mean for the future regulation of data and technology in UK healthcare.
Secure Data Environments
The NHS will step up its investment in and use of ‘secure data environments’ (sometimes referred to as ‘trusted research environments’). In simple terms, these are specially designated, secure servers on which a third party researcher’s access to health data can be properly controlled and monitored. These will become the default route for NHS organisations to provide access to their de-identified data for research and analysis. This creates opportunities for providers of secure data platforms and the privacy enhancing technologies on which these platforms depend. It also highlights the need for companies working with the NHS to increase their own familiarisation with, and investment in, secure data environments.
Secure data environments are a hot topic in data circles. For example, they also emerge in the EU’s new Data Governance Act, in the form of its creation of ‘data intermediation services’ – i.e., services that provide a secure environment in which companies or individuals can share data.
Fair Terms for Data Partnerships
The strategy also contains proposals for the data sharing agreements that NHS bodies use when providing access to health data. Supposedly responding to public concerns about data sharing partnerships with the private sector, the Government will:
- Require data sharing arrangements to embody 5 core principles (for example, any use of NHS data not available in the public domain must have an explicit aim to improve the health, welfare or care of patients in the NHS, or the operation of the NHS, and any data sharing arrangement must be transparently and clearly communicated to the public).
- Develop commercial principles to ensure that partnerships for access to data contain appropriate contractual safeguards. This will lead to a review and likely update of NHS Digital’s template data sharing and data access agreements by December 2023.
Consequently, those organisations accessing NHS datasets are likely to see changes in the contractual terms on which that access is provided, and greater scrutiny of the overall arrangement to ensure adherence with principles designed to encourage public trust and confidence in such arrangements.
Trust and Transparency
On a similar theme, the strategy contains a range of other proposals designed to improve the public’s trust in the use of health data.
Alongside the investment in secure data environments, the Government also publicly commits to increase investment in a wider range of privacy enhancing technologies (or ‘PETs’), such as homomorphic encryption (a technology that allows functions to be performed on encrypted data without ever having to decrypt it) and synthetic data (artificially manufactured data which strongly mimics real-world data, but without the privacy consequences). The ICO has written supportively about some of these technologies in its updated draft guidance on anonymisation, and consequently there seems to be a concerted push towards the adoption of technical solutions to privacy concerns in an ever more data-dependent world.
The Government also plans to further improve transparency and understanding around how it uses health data (public confusion surrounding changes to the National Data-Opt Out regime in 2021 is admitted as an example of the sort of failing the Government wants to avoid in the future). Developments on this front will include a ‘Data Pact’ (a high-level charter outlining core guarantees towards the public in terms of fair use of health data) and an online hub, with a transparency statement explaining how publicly held health and care data is used in practice.
Improving Access to Health Data
Alongside the focus on public trust and transparency, the strategy is also concerned with promoting greater access to health data in the public interest. This is a theme that has been prominent internationally following the Covid pandemic – a renewed understanding of the importance of health data for research and development purposes, leading to a demand to break down unnecessary barriers to accessing and combining datasets for these purposes.
The Government plans to do this partly through major investment in (of up to £200 million) in NHS data infrastructure to make research-ready data available to researchers. DHSC envisages a ‘vibrant hub of genomics, imaging, pathology, and citizen generated data, where AI-enabled tools and technologies can be deployed’.
On the legislative front, it’s likely that this part of the strategy will also be supported by the Government’s impending Data Reform Bill, which amongst other things, is making changes to the research provisions of UK data protection law to, for example, provide a clearer definition of scientific research, a broader form of consent where used as a lawful basis for research, and a more concrete privacy notice exemption where data is repurposed for scientific research purposes. All of these changes are expressly intended to promote greater use of personal data, including health data, for responsible research purposes.
There are strong parallels here with the EU’s proposals for a European Health Data Space, which will promote access to electronic health data for secondary purposes.
Encouraging AI Innovation
No data strategy in 2022 would be complete without consideration of Artificial Intelligence (AI). On this front, DHSC:
- Commits to working with the Office of AI (OAI) on its developing plans for the regulation of AI in the United Kingdom. The OAI’s White Paper on the governance and regulation of AI is expected imminently and will be closely scrutinised as the UK’s response to the EU’s draft AI Act. The health sector is one of the most sensitive and important in an AI context and the NHS’ work on this will be led by a newly created NHS AI Lab.
- Will develop unified standards for the efficacy and safety testing of AI systems, working with the Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Clinical Excellence (NICE). Safety standards that can be used by development teams building AI systems are an important part of the regulatory framework for safe AI, and this is likely to be a welcome step.
- Will, through the NHS AI Lab, develop a methodology for evaluating the AI safety of market-authorised products in healthcare.
In summary, the strategy contains an ambitious set of proposals that are intended to cement the UK’s position as a world leader in healthcare informatics and data-driven health research. Notably, they are clearly designed to balance and reconcile competing demands for greater access to and use of health data, with the protection of trust, privacy and security in that data.