Royal Colleges publish shared action plan to adopt AI in the support of early diagnosis

The Royal College of Pathologists and The Royal College of Radiologists have published a joint report on the role of artificial intelligence (AI) in the NHS.

The joint briefing, Embracing AI to support the NHS in delivering early diagnoses, follows a roundtable meeting held at 10 Downing Street in October 2023 chaired by both colleges. It sets out a shared plan of action for government, the NHS, medical royal colleges and the diagnostic workforce, to secure the benefits of diagnostic AI for patients.

As technology-centric specialties, radiology and pathology are at the forefront of the AI revolution which holds great potential to tackle bottlenecks at the diagnosis stage, leading to better health outcomes and shorter waiting lists.

The report welcomes the Government and NHS England’s (NHSE) action to date to implement AI in diagnostics, however progress will rely on investment, planning, and the provision of modern IT systems in the NHS. The expansion of digital pathology will also be essential if AI in this specialty is to make a significant contribution to delivering earlier diagnoses.

The report makes a series of recommendations:

Government should:

Develop a plan for the robust validation of AI algorithms, which must include the provision of Secure Data Environments (SDEs). Funding will be needed to both deliver the infrastructure and to enable the collection of the necessary data.
Implement the Hewitt Review’s recommendations for the recruitment and retention of Digital, Data and Technology (DDaT) staff into the NHS.
Support NHS pathology services to become fully digitised. An estimate of £200-£300 million over five years would be required to reach the goal of full digitalisation.

NHS England should:

Simplify and standardise information governance processes to speed up the rate of implementation of AI.
Continue existing work to establish expert teams to assist individual NHS organisations to implement Ai applications.
Set up audit processes to collect real world data on AI applications to assess their long-term health effects.
Expand the NHS Digital Academy to ensure all clinicians have access to AI training.
Develop a work programme to predict how healthcare professionals’ ways of working will change with the widespread adoption of AI. Medical Royal Colleges and healthcare think tanks should be closely involved with this work.

Medical Royal Colleges should:

Develop clinical guidelines as new AI tools come into use within the NHS, setting out best practice for implementation and shaping clinical pathways.
Support the regulation of AI by developing robust audit processes for AI tools.
Work with regulatory bodies to assess the value of promising AI tools and identify evidence gaps.

However, workforce will be a limiting factor to the roll out of AI in the NHS

There is a 24% vacancy rate among cellular pathologists and an estimated 22% are predicted to retire within the next five years.
In radiology, there is a consultant workforce shortfall of 29%.

This shortage of staff is contributing to delays to patients receiving their diagnosis and starting treatment.

Dr Bernie Croal, President of the Royal College of Pathologists, said:

`Artificial intelligence has the potential to transform the diagnostic landscape, improving health outcomes and shortening waiting lists. While the advent of AI in pathology is very exciting, and the NHS could be a world leader in the development and use of AI in pathology, a great deal of work is required to get to the point where AI is fully developed and used safely in the NHS. Investment in the pathology workforce, digital pathology, joined up functional IT systems, which facilitate information sharing across organisations, as well as training for pathologists to understand and use AI, will all need to be put in place.’

Dr Katharine Halliday – President, Royal College of Radiologists said:

`Rapid developments in AI have huge potential to improve patient care and maximise diagnostic capacity. Radiologists are at the forefront of these innovations but there is much work to do to make sure the NHS is ready to capitalise on them – with a 29% shortfall in radiology consultants in the UK this will be a challenge. Nevertheless the opportunity is too good to miss, these are exciting times and I hope this report spurs on the action required for us to make them most of them.”