Throughout this work we have focused on what the future could be, rather than saying what it definitely will be. By doing this, we are aiming to highlight what needs to happen to make sure innovation can flourish in paediatrics in the future.

Our vision for 2040

In 2040 we hope to see….

• An improved landscape for innovation, with increased capacity for research that is specific to innovation and technology in paediatrics
• Clinicians moving beyond the digital consultations adopted during the 2020 pandemic and using digital health products to better monitor, care for and treat patients
• Technology used in paediatric settings that is designed or adapted for use specifically with children and young people
• Widespread implementation of appropriate guidelines and frameworks that are specific to paediatric care to make technology safe and accessible for all.
• All relevant stakeholders involved in paediatric care, including children and young people, involved in the design, development and integration of different innovations and health technologies relating to their care
• All innovations and technology assessed for accessibility to ensure they will not further isolate underserved populations.
• A workforce with the expertise to utilise new data technologies with confidence and lead projects to address the needs of those working at the coal face of the NHS.

Enablers

In order to achieve our vision, we suggest the following action needs to happen:

Guidelines and regulations

• Clear technology usage guidelines should be established for both healthcare providers and patients. These should include clear information on privacy and confidentiality regarding data storage and use.
• Appropriate legislation and trade agreements with regards to medical devices to ensure the UK has sufficient access to those that have been evaluated as improving health outcomes in paediatric populations.
• Development of guidance on “effectiveness”, to help regulators, commissioners and clinical researchers to evaluate and regulate new technologies.
• Clear moral and ethical responsibilities and expectations by each individual clinician who is building or implementing a new technology into a clinical pathway, is needed. Clinicians could consider a new digital Hippocratic oath[1] or code of conduct.[2]

Research and development

• Increased promotion of scientific research in the UK relating to paediatric healthcare.
• Continued work to digitise and integrate health and care records so that information can be shared quickly and securely between professionals.
• Organisations and healthcare Trusts should have expectations or KPI’s that digital health solutions will be reviewed by each department on an annual basis , so that staff are aware of digital health their patients may be using (that could harm or benefit their patients) so that appropriate advice can be given or so that clinical pathways can be improved, and so that clinical reviews or audits can monitor digital health solutions in pathways.
• Dedicated time in job plans for paediatric innovation and development in every relevant organisation.
• Development of a national database of patient feedback on digital technologies
• Increased focus on capacity building for virtual academic units and networks to support paediatric research, learning from existing practice.[3]
• Expansion of paediatric clinical informatics units such as GOSH drive as a model for multi-disciplinary research data collaboration and rapid development and evaluation of new technology.[4]

Privacy and security

• Development of appropriate policies surrounding privacy and security, to ensure ongoing protection of patient privacy and to maintain public trust. It should always be clearly identifiable where Patient data will be held and who can access the data. Patients should own their own data where possible.
• Clear and mandated national standards for the handling of patient data that meet the General Data Protection Regulations and the 10 standards of the NHS Digital’s Data Security and Protection Toolkit.[5]

Quality and safety

• Adoption of national health data quality standards across institutions, including those already established by NHS England and NHS Digital on interoperability, design, use of data and IT commercial standards within the NHS.[6],[7]
• Establishment of research consortia for different speciality areas to support development of standards and assessment of quality of new technology (building on those already established).[8]
• Development of an apps library developed specifically for paediatric apps to ensure the production and promotion of apps for parents and children that are high quality and credible.
• Partnerships with non-clinical organisations that can offer expertise and impartial, objective support to new technology development.
• Creation of digital health panels in NHS Trusts, shared between hospitals, to assess and provide a report on a new digital technology that could be used in a clinical pathway.
• Expected audit outcomes and clinical evaluations should be built into the pathways of newly introduced digital technologies.
• Introduction of a yellow card system for digital health technologies, with plans for how to stop or recall a technology if concerns arise in the short or long term.

Training and professional development

• Comprehensive training programs of education for existing paediatric staff, covering the governance principles for working with data, the basics of data science, the ethical considerations of new technologies, and how to effectively appraise their appropriateness of use.
• Support the ongoing professional development of the clinical and non-clinical workforce, as well as comprehensive specialist training for those that need it (e.g. in data science, information technology and analytics).[9]
• Look into where pilots could be run for use of VR/AR technology in medical education, for example APLS courses. VR/AR setting-specific properties need to be fully evaluated in order to formulate a broader paediatrics curriculum in the future that incorporates these technologies.
• Creation of identified department leads for digital health to oversee and consider suggested interdepartmental interventions or list the dangers/ benefits to patients of identified digital health solutions.

Funding and investment

• Local investment in existing IT infrastructure and technology to free up healthcare worker time.
• Investment in a faster procurement processes to facilitate the development of new innovation.
• Increased availability of funding for development of paediatric medical technology.
• Investment in VR/AR technology across the NHS to support medical education. This should include collaboration with existing use of VR in the private sector[10] to understand how to design learning platforms that use VR/AR, how it can be used to educate and assess, and how it can be made accessible in an equitable fashion to paediatricians across the UK.