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It’s never a quiet year in NHS IT, and 2018 was no exception. The NHS celebrated its 70th birthday, and received the gift of £20bn a year by 2023.
Unfortunately, nothing comes for free, especially not for staff at NHS Digital, who were told to reapply for their jobs and were at risk of being made redundant.
Despite the upheaval, NHS technology made huge strides during the year, with the NHS finally launching its front door to the health service in the form of an app, and its Citizen ID verification platform went live.
New health secretary Matt Hancock also joined the ranks and quickly set out ambitious plans for the NHS in his tech vision, promising to mandate national open standards for the health service and tech suppliers and to build a health and caretech ecosystem.
Here are Computer Weekly’s top 10 NHS IT stories of 2018.
Prime minister Theresa May’s summer of musical chairs in the form of a new cabinet reshuffle saw long-standing health secretary Jeremy Hunt replaced by DCMS secretary Matt Hancock, and it wasn’t long before he started to make significant plans to overhaul NHS technology.
Hancock’s NHS tech vision includes several proposals on how the NHS will become the “most advanced health and care system in the world”, through modern technology architecture, a focus on user needs, privacy and security, interoperability and inclusion. In an exclusive interview with Computer Weekly, he said “the time is ripe now to bring about this tech revolution in healthcare”, and promised to help all parts of the NHS to improve their use of technology.
One of the more sensitive news of the year was NHS Digital’s plans for a restructure. The organisation needed to change its shape and size in order to cope with funding and demands, but unfortunately this meant most staff had to reapply for their jobs, and many would face redundancy.
Computer Weekly understands there will be more changes to come over the next two years. As part of the “organisational change”, each part of NHS Digital will come up with its own proposal for change, looking at its size, budget, current skills, skills needed and its size.
As a birthday present to itself, the NHS launched its new “digital front door” in October. The front door, in the form of an app, aims to give patients access to a range of NHS services, including being able to book appointments, view their medical records, order repeat prescriptions, select their data-sharing preferences, organ donation preferences, end-of-life care preferences and access NHS 111 online’s symptom checker and triage service.
Although in pilot phase, the app is now gradually being rolled out to all GP practices across England, and will soon be available to everyone.
4. NHS to pilot ID verification platform this spring
The NHS has been hard at work building its own platform for ID verification instead of using the Gov.uk Verify platform created by the Government Digital Service. The platform aims to allow patients to securely access online health records and services.
This spring, it began piloting the identity verification system, which will eventually become the standard way of proving people are who they say they are when accessing NHS services, including those via the app. The Citizen ID platform will also use an “offline couching identity service” where the patient’s clinician can generate a “token of trust” for a patient to be able to access their medical records online. There are currently a number of NHS services in the pipeline to use citizen identity services.
Despite making huge strides in some ways, the NHS is still failing to deliver “basic IT”, if we are to believe NHS England’s national director for operation and information, Matthew Swindells.
He said too many people across the NHS “consider it a success if they can keep their emails under control”, adding that it’s “not the sort of transformation change the NHS needs”. His comments came as it has became clear that many trusts around the country don’t even know how many beds they have, or “how many patients are lying in them”.
As a response to national data guardian for health and care Fiona Caldicott’s recommendation of an eight-point consent model that would allow patients to make an informed decision on whether or not they want their data to be shared, following the Care.data scandal, the NHS launched a national data opt-out tool in May.
The online tool lets patients decide if they want to give the NHS access for just their individual care, or allow their data to be shared for research and planning purposes.
The aim is to make it easier for patients to get information on what it means to not share their data and to improve trust and confidence in the health and social care system.
Another part of the NHS to get an overhaul is the GP IT framework. In August, NHS Digital issued a prior information notice for a £450m framework to replace the current GP Systems of Choice (GPSoC) framework.
The new framework aims to pave the way towards “supporting modularisation in the future and segments the requirements in a way that should make it easier for suppliers to provide discrete capabilities, as well as providing buyers with more choice”.
It wouldn’t have been a year of NHS IT without a data scandal. In June, it was discovered that 150,000 patients who had opted out of having their information shared for purposes other than their direct care, did not have their objection sent to NHS Digital.
The data breach was caused by a coding error in one of the most popular GP IT systems, TPP’s SystmOne. As a result, the patients accidentally had their data shared by NHS Digital for use in clinical audit research between March 2015 and June 2018.
More than a year after the 2017 WannaCry cyber attack, which crippled the NHS, the health service is still feeling the effects. In October, the Department for Health and Social Care estimated that the immediate costs of the attack was £92m – £19m in lost output and £73m to restore affected data and systems.
The department will also spend about £275m on additional security measures by 2021.
As a birthday present to the NHS, the prime minister gifted the health service with an extra £20bn a year by 2023. The aim, she said, is to build a health service around the “needs of the patient”, with an increased focus on technology.
The money will come in part from an increase in taxes, but also from what the government referred to as the “Brexit dividend” – money the UK will save by leaving the EU.
Theresa May also touted technology as one of the key building blocks in the transformation of the NHS, enabling safer, more accurate and faster care, and earlier diagnosis.