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The NHS is failing to deliver 'basic IT', says Matthew Swindells

NHS England’s national director for operations and information calls for the NHS to get to grips with data, and says it won’t be able to deliver an integrated health and care system without getting the basics right

The NHS’s failure to “get the basics right” is stopping the NHS from running efficiently, and more must be done to ensure data quality and output across the health service, says NHS England’s national director for operation and information, Matthew Swindells.

Speaking at UK e-Health Week, Swindells criticised the NHS as a whole for not doing enough to drive a much needed digital transformation across the health service.

He said too many people across the NHS “consider it a success if they can keep their emails under control”, adding it’s “not the sort of transformation change the NHS needs”.

The NHS has faced unprecedented pressure over the last year, particularly around A&E performance, bed capacity and funding.  

Swindells said that although the NHS needs to be focused on that, there is also an opportunity going forward “of an NHS which is personalised, data led and fast to deploy new innovation”.

He said NHS England’s 10-year plan is a vision for an integrated health and care system that brings everything together, and that the NHS has an opportunity to use the resources available to deliver this.

The approach NHS bosses are taking is focused on regional health population management, considering the patient being treated rather than the individual organisations.

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Regions have banded together to submit sustainability and transformation plans (STPs) on how to deliver integrated health and care across their areas, and local digital exemplars are working on shared health record projects.

However, Swindells added that if the NHS wants to get the backing to move forward with an integrated health and care system, “we need to be better at doing ‘today’ than we are”.

“We are investing millions of pounds in technology, yet we’ve got six organisations that still can’t tell us what their waiting lists are. It’s not acceptable,” he said. Barts Health NHS Trust, for instance, hasn’t submitted a referral to treatment report to NHS England for nearly four years.

“We walk around most hospitals and we’ve not known how many beds we have and how many patients are lying in them,” said Swindells. “We need to at the very least get the data that we capture back out. If we can’t do the basics, me going cap in hand to the treasury for another £10bn to sort IT out just sounds like fool’s money.” 

He highlighted e-rostering as another example of failing to use data properly, saying most hospitals use an e-rostering system, which he described as a “glorified spreadsheet” and “expensive pieces of technology that are not enabling better rostering: not enabling the matching of staffing to clinical need, not enabling staff to be flexible about when they work and therefore making more available”. 

“We have to make this stuff work well,” said Swindells. “Our failure to deliver competent, bog-standard IT is stopping us from running an efficient NHS, and we have to get that right.”

NHS 111

NHS England is in the process of building and rolling out its online NHS 111 service, allowing people to check their symptoms and receive a call back from a nurse or an out-of-hours GP. 

Swindells said the vision is that if someone uses the NHS 111 service and then needs a prescription, instead of having to book an appointment with a GP to get one, they will come away from using the service with a prescription ready to go.  

In September 2017, health secretary Jeremy Hunt announced that, by the end of 2018, patients would get access to a range of NHS services through mobile apps, or online. 

This includes accessing their own medical records, NHS 111 services, being able to order repeat prescriptions, updating their personal preferences – such as organ donation and data sharing – and support for long-term conditions. 

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