Big Science and Big Data Impact Assessment: Locating the Efficiency Bundle
In this seminar produced for NHS Wales, Dr Patricia Oakley sets out the scale of the challenge facing the NHS as the baby boomer generation ages, with “peak death” projected for 2044, and asks what governments and health boards need to do in the meantime to keep care affordable and effective.
he traces three waves of state investment. The first, Big Science, covers the past decade’s advances: genomic medicine, proton beam radiotherapy, stem cell research at the Crick Institute, and progress in prosthetics and regeneration.
The second wave, now arriving, brings new technologies into everyday practice — 3D-printed implants and personalised tablets, and genomic profiling that allows treatments to be tailored to the individual patient. The third and newest wave is Big Data: the “data lake” projects (such as the one underway in NHS Wales) that pool genomic, epidemiological, prescribing and cohort-study data, so that predictive analytics can support clinicians making decisions on the ground.
The purpose of all this investment is efficiency, but so far the gains have mostly landed in the acute (hospital) sector. Her central case is that the real opportunity lies in shifting care into the community: home-based care, hospital-at-home, rapid diagnostic centres on the high street, and a reimagining of district nursing, GP practices and specialist services around local, community-centred models.
She closes by turning to the practical consequence of all this: a complex, multi-agency change management challenge over the next decade (2024–2034) in rethinking the roles of district nurses, specialist nurses, GPs, consultants, physician assistants and support staff, so that the workforce is ready for the demand this ageing population will bring.