‘Patient-centred, inclusive, and impactful’: Introducing the NHS AI Lab’s Ethics Initiative

The NHS Constitution is founded on the principle of equality in both access to healthcare and outcomes for all. It sets out our social duty to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.

As the NHS AI Lab seeks to accelerate the adoption of AI across health and care, we need to be mindful about the risk that these technologies could exacerbate existing health inequalities. We are aware that diagnostic algorithms, for example, can have different accuracy rates for different demographic groups. In practice this means that a dermatological app could fail to identify malignant skin lesions for ethnic minorities with darker skin if it has primarily been trained on images of fair skin. To address this kind of bias, we need strong ethical and regulatory guidance in place and to evaluate the impact of technology at every stage of its development, pre- and post-deployment.

The NHS AI Lab is well-positioned to make a difference to the ethical assurance of AI, given our role in supporting all aspects of the AI life cycle. From working with innovators as they define the purpose of their products to guiding health and care professionals as they deploy these technologies to assist them in providing care, we want to take a leading role in ensuring that AI technology is fair and empowering.

The AI Ethics Initiative, as part of the NHS AI Lab, will invest in research and trial practical interventions that complement and strengthen existing efforts to validate, evaluate, and regulate AI-driven technologies. We will collaborate with academia, the third sector, and other public bodies, to consider pressing challenges, such as how we incentivise innovators to design products that meet the health needs of marginalised communities or what processes we can put in place to address algorithmic bias so that AI technologies are accurate for all patients. This work will help us shape our key programmes, including the AI in Health and Care Award Award, AI Imaging, and AI Skunkworks.

Our focus will be on how to counter the inequalities that may arise from the ways that AI technologies are developed and deployed in health and care. We believe these inequalities aren’t inevitable, and that if they are proactively addressed we can realise the potential of AI for all users of health and care services.

We are inspired by the philosophy of “Nothing about us without us”, which comes from the disability rights movement, and conveys the need to directly involve patients and the public in the process of adopting AI within health and care. Our intention is to be patient-centred, inclusive, and impactful as we strive to integrate ethics into the AI life cycle, and we will support projects that can demonstrate these values.

Patient-centred

As set out in the NHS Constitution, the patient or service user is central to everything that NHS and care services do, and as we accelerate AI-driven technology, we will do so in response to the needs and preferences of those in our care.

Inclusive

We will seek to involve the public in the development and deployment of AI wherever possible, particularly people from marginalised communities to ensure that their specific health needs are taken into account.

Impactful

We are committed to collaborating with partners and grantees on defining and setting expectations for how research or interventions will make an impact at the onset of projects, and allocating time and resources to integrate learning as part of the NHS AI Lab’s programmes of work.

The AI Ethics Initiative is getting off the ground with three initial projects:

• Optimising AI to improve the health and care outcomes of minority ethnic communities, through a joint research call with the Health Foundation
• Facilitating early-stage exploration of algorithmic risks, in partnership with the Ada Lovelace Institute
• Empowering healthcare professionals to make the most of AI, in partnership with Health Education England

If you’d like to learn more about these projects, please visit our Ethics Initiative web page.

If you would like to learn more about our approach to AI ethics and our projects, please join the AI Ethics Initiative launch event at 12.30pm on 10 March. If you would like to contact us about the Initiative please email ailab@nhsx.nhs.uk