The Health Foundation: Developing learning health systems in the UK (September 2022)

Summary

Healthcare has, in many ways, always been a form of ‘learning system’. Driven by a diverse community of stakeholders, including health care professionals, patients and the public, a learning health system (LHS) uses internal and external knowledge to continually learn about and improve patient care. However, while LHSs have huge potential to support service transformation and population health, there is a lack of consensus about what an LHS actually is, and how to get started.

This research report from the Health Foundation helps people understand LHSs and how they can be developed. It is the final output of HDR UK’s Better Care Catalyst Programme’s Policy and Insights workstream, which researched the barriers and enablers for implementing LHS approaches in the UK. It also identifies a range of opportunities and actions that can be taken by policymakers and system leaders to advance the LHS agenda across the UK.

Content

Key points

• A learning health system (LHS) is a way of describing a systematic approach to iterative, data-driven improvement. Learning health systems are able to learn from the routine care they deliver, and improve it as a result – as part of ‘business as usual’.
• Research suggests there is a large gap between the promise and practice of LHSs. This is partly due to the lack of a clear definition, vision and evidence base around LHSs, meaning it can be difficult to know where to start or how to make progress.
• This report, part of Health Data Research UK’s (HDR UK’s) Better Care programme, was informed by a literature review, interviews, a survey of more than 100 expert stakeholders and a series of practical case studies, offering real-world examples of LHS approaches already being taken.
• It explores four important areas especially relevant to LHSs: learning from data, harnessing technology, nurturing learning communities and implementing improvements to services. In these areas, targeted action by policymakers and organisational leaders could lead to tangible progress in developing LHSs.
• Amid all the pressures the health and care services are facing, we should be wary about seeing LHSs as a ‘nice to have’. A step change in the health service’s learning and improvement capability is needed if it is to find a sustainable route to recovery and effectively reshape care to meet future health needs.