The Department of Health has finally unveiled its long-awaited information strategy, setting out the future for...
IT in the NHS after the demise of the troubled National Programme for IT (NPfIT).
Giles Wilmore, senior responsible owner for the strategy, says the plans include a single web portal for health information, the creation of system standards, and encouraging patients to take control of their own health data.
The information strategy has been in gestation for some time, partly due to delays in the government’s controversial health reforms being pushed through Parliament. Now it has been released, the document aims to put informatics at the heart of delivering effective health services.
One key plan is to create a single portal next year for the public to access information on health and social care.
“There is a mass of information on the internet and people don’t necessarily know where to look,” said Wilmore who took over responsibility of the strategy following the departure of former NHS CIO Christine Connolly last year.
“When the current NHS Choices contract comes up for renewal in 2013, we will look to re-procure a new integrated single website offer. We will work with the new agencies to develop tender specs to go out sometime next year," he said.
“It wouldn’t necessarily be all information from the government, but also credible third-party charities and voluntary sectors – respectable information experts. So it would be much more a service where we would provide core information packaged through that website, and linking with those other providers.”
Wilmore said the department won't axe the information on NHS Choices, which gets around 14 million hits a month, but would use it as a portal to access other information: “It’s a very valuable resource and a respected website, which reduces pressure on the NHS.”
The creation of standards will be crucial to health informatics, as the department moves away from the “provide all” systems approach under NPfIT to a “connect all” emphasis, with local commissioning groups procuring their own IT. As such, the department intends to create uniform standards for clinical terminology, coding and interoperability between systems.
Under section nine of the Health and Social Care Bill, the department will have the power to set information standards and make them legally enforceable for the first time. Previously standards were set through the letting large, national contracts under NPfIT.
“But as we move away from that approach we wouldn’t have strong contractual levers if we didn’t set minimum standards centrally,” said Wilmore.
“We are already discussing standards with [IT trade association] Intellect and other trade bodies about how can work together in future to develop standards so we have full interoperability, so system suppliers in the future know the standards they have to meet and when we move to a more devolved system of procuring and upgrading IT in trusts, they will be able to share information appropriately between organisations because they will have fully interoperable systems. We are working with the industry to develop a timetable as to what the crucial standards are and how to embed them," he said.
Setting standards on APIs [application programming interfaces] will also help in encouraging software developers to use information, he said: “We have to be clear about how we allow people to get interfaces between those systems, so we need to develop a roadmap in setting standards.”
Recognising the informatics profession
Another key theme is reinforcing informatics as a profession within the NHS.
“Informaticians in terms of IT specialists, have historically been undervalued and marginalised as ‘the techies’. But actually good information and knowledge systems is the bedrock of any public services. We are keen to promote that and to recognise it, but also encourage other staff to enhance their informatics skills," said Wilmore.
“We are backing the concepts of chief clinical information officers to promote the importance of clinical information being the bedrock of quality care and seeing what we can do to enhance quality of informatics training in curriculum," he said.
“We are not being prescriptive about one model. We learnt from the experience of the history of the national programme that every need will be slightly different. It is more about recognising information services as a key role within organisations, promoting and championing that.”
Wilmore said the focus for electronic patient records is to start with GP records as they are more routinely held electronically and are the primary gateway to the health service for most people - a complete change from the centrally-led approach to patient records embodied in the defunct NPfIT. Patients will be able to access their own health records electronically and book appointments with GPs online by 2015.
The department’s longer-term strategy aims to allow patients and the public to access other records, in areas such as community health, social care and mental health.
“We have no specific timetable [for these areas] as our policy is moving away from the National Programme for IT – we are encouraging trusts and other organisations to develop system which best meet local needs,” he said.
Wilmore said the ambitions of the strategy are already being practiced within pockets of the NHS, but said the challenge will be getting it embedded in the mainstream.
“The biggest challenge is culture and attitude, and I don’t meant that in a pejorative sense. The reality is people are used to working in certain ways. But in other part of society technology is radically transforming the way we access services," he said.
“The blockage is not technology. People need to understand there is an easy and more effective way of accessing those services, and healthcare professionals need to recognise there are benefits for them too. Areas like health by definition involve a lot of face-to-face, consultation, diagnosis. But a lot of things we do don’t require two people to be in the same room together.”