In a world-first study, an artificial intelligence (AI) model is being trained on a set of NHS data for 57 million people in England, from which personal information has been stripped away. The pilot study is being run by researchers at University College London (UCL) and King’s College London (KCL). The model could transform patient care, identifying individuals where early interventions might improve or save lives.
Foresight, a generative AI model, learns to predict what happens next for patients based on previous events. It’s similar to models like ChatGPT which predict the next word in a sentence based on what it’s seen previously from data across the whole internet.
Foresight is being trained on routinely collected, de-identified NHS data, like hospital admissions and rates of COVID-19 vaccination, to predict potential health outcomes for patient groups across England. This could be events such as hospitalisation, heart attacks or a new diagnosis. Predicting these events early could enable targeted intervention, shifting healthcare much more towards prevention.
Security across a whole spectrum
The pilot study operates entirely within the NHS England Secure Data Environment (SDE), a secure data and research analysis platform, that uniquely enables this groundbreaking work by providing controlled access to de-identified health data from the 57 million people living in England. Access to data at this scale is only made possible through the NHS England SDE, where both the AI model and all patient data remain under strict NHS control.
By including data covering England’s entire population, the model can make unbiased predictions about health outcomes across all demographics and for rare conditions.
The development of the model was supported by the National Institute for Health and Care Research (NIHR) UCLH Biomedical Research Centre (BRC) and the NIHR Maudsley BRC.
Dr Chris Tomlinson, one of the lead researchers from UCL, said,
“AI models are only as good as the data on which they’re trained. So if we want a model that can benefit all patients, with all conditions, then the AI needs to have seen that during training. Using national-scale data allows us to represent the kaleidoscopic diversity of England’s population, particularly for minority groups and rare diseases, which are often excluded from research.”
Through rigorous approval processes, the British Heart Foundation Data Science Centre at Health Data Research UK made it possible for the researchers to access and work in the SDE. The Centre also involved members of the public, who continue to contribute to approving and shaping the research.
Predictions for patients and planning
The researchers believe the model’s predictive power could pinpoint high-risk patient groups, opening up a window of opportunity to intervene to improve and save lives. Due to the diversity and completeness of the training data, the model could also help to highlight and address healthcare inequalities. And the ability to analyse healthcare risks and outcomes on a population level could offer critical support to the NHS when it comes to planning.
Simon Ellershaw, an AI PhD researcher from UCL, said,
“Combining the computing resources needed for AI with NHS data has always been challenging, but thanks to the support of our partners we’ve been able to safely and securely apply state-of-the-art AI methods to NHS data at unprecedented scale.”
The pilot study is an opportunity to test the model in a secure and safe environment, protecting privacy, and all predictions are rigorously tested for accuracy against real-world outcomes. Currently the model is using recent data, from November 2018 to the end of 2023, for a limited number of datasets and made available for COVID-19 research.
Professor Richard Dobson, another lead researcher at KCL, said,
“This pilot is building on previous research that demonstrated Foresight’s ability to predict health trajectories from data from two NHS trusts. To be able to use it in a national setting is very exciting as it will potentially demonstrate more powerful predictions that can inform services nationally and locally. Currently the data in this pilot is broad but shallow, and ultimately we’d like to harness the expertise and AI platforms behind Foresight by including richer sources of information like clinicians’ notes, or results of investigations such as blood tests and scans if they become available.”
Shaping the future
In the future the researchers would like to train the model further on deeper data sources, going back further in time. They’re also exploring how to responsibly expand the scope of the model, which is currently restricted to COVID-related research.
However, the researchers are clear: patients and the public must be at the heart of any guidance developed around the model’s use and predictions, to make sure this research and its applications are in their best interests.
A BHF Data Science Centre public contributor, involved in reviewing and approving this project, said, “As a patient, I’m interested in how this research could help identify linked health conditions, reduce the risk of developing new ones, and support those who face challenges accessing healthcare. It’s important that people know how their health data is being used, so it’s encouraging to see a focus on transparency and making sure AI is used in the NHS in a safe, ethical way with public benefit at its heart.”
Dr Vin Diwakar, National Director of Transformation at NHS England, said, “AI has the potential to transform the way we prevent and treat disease, if trained on large datasets and safely tested. The NHS Secure Data Environment has been fundamental to this pioneering research, shaping a future where earlier treatments and interventions are targeted to those who will benefit, preventing future ill health. This will boost our ability to move quickly towards personalised, preventative care.”
Professor Angela Wood, Associate Director at the BHF Data Science Centre at Health Data Research UK, said, “Harnessing the power of AI with NHS data at this scale represents a huge step forward for health data studies. The Foresight model has the potential to support healthcare professionals to make timely and effective medical decisions for high-risk patients, and to help address health inequalities by ensuring everyone is represented in predictive healthcare. This pioneering work, enabled by the BHF Data Science Centre, demonstrates the UK’s leadership in the trustworthy use of AI to transform lives.”
