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The government has launched a “bureaucracy busting” strategy for the NHS, aiming to streamline processes, including reducing duplicate data requests.
The strategy sets out a series of plans on how to reduce the amount of paperwork and forms that NHS staff have to deal with, and aims to improve the way data is collected and shared.
It said the Covid-19 pandemic has seen a lot of positive change in harnessing the power of data across the health and social care system, and the government wants to build on that approach.
One of the key priorities is optimising data requests and data sharing. Before the pandemic, NHS organisations spent a significant amount of time fulfilling data requests from bodies such as NHS England and Improvement.
In the Department for Health and Social Care’s (DHSC) call for evidence, on which the strategy is based, respondents said there was a lack of “joined-up thinking between organisatons”, which led to multiple requests for the same data in different formats. When the pandemic hit, many of these requests were suspended.
“Where data collection was vital to the pandemic response, existing powers were used to publish notices requiring health and care bodies to share data to help manage and control the spread of Covid-19 within local systems,” the strategy said.
“This has raised questions about how we can optimise the value of our data through focusing on collecting the most important information and enabling it to be shared widely and used many times, thus minimising time-consuming or duplicative data requests.”
Announcing the strategy, health and social care secretary Matt Hancock said that although rules and regulations have their place, they can also stifle innovation and “damage morale”.
“Learning from the first peak, in July we set up a call for evidence on reducing bureaucracy in the health and social care systems, and I mean the system as a whole,” he said. “We engaged with staff on the front line and spoke with dozens of stakeholder groups.
“The contributions we received have been so vital in lifting that X-ray up to the light, and illuminating those daily irritations that make people’s lives harder – like onerous clearance processes, complicated appraisals and slow discharges. And of course the changes we need to make don’t always have to be big. In the pandemic, we’ve seen that little things can make a big difference, for instance letting doctors and nurses communicate with patients securely over WhatsApp or providing single logins across multiple different computers.”
The strategy also said that when organisations ask for data, it has to be used in a way that maximises benefit to patients, while also reducing the burden on staff. It also called on national and local leaders to “drive systematic change to reduce the drivers of repetitive data requests and build a trusting culture, leading to a reduction in assurance requests”.
During the pandemic, the NHS worked with suppliers Microsoft, Palantir and Google to build the Covid-19 datastore, which is managing data requests. But the work caused controversy, particularly among privacy campaigners.
In the next few months, NHSX will launch and implement a data strategy for health and social care that will “capitalise on the good practice from the response to Covid-19 by building on the permissive approach to data sharing, such as the use of control of patient information (COPI) notices, while protecting the need for patient confidentiality”.
It added: “The strategy will set out a vision on how we can share data effectively and efficiently, for the benefit of better patient outcomes and to reduce burden in the system.”
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The DHSC will also consult on changes to primary and secondary legislation for data collection to be able to continue using the process changes made during Covid-19, while NHSX will work to simplify information governance (IG). In October 2020, NHSX launched an IG online portal, which is home to simplified guidance, as well as a “red tape challenge” to refine existing IG guidance to ensure it is consistent.
“NHSX is convening a new Data Alliance Partnership, bringing together key bodies such as the Care Quality Commission, NHS Business Services Authority, Public Health England and NICE, to agree principles on data collection, sharing and use to minimise the burden of data collection and processing,” the strategy said.
“It will facilitate increased access to data by making aggregate/anonymised data accessible by default, for legitimate purposes and within existing legislation.”
By September 2021, NHSX expects all areas of the country to have a “basic minimum viable shared care record solution”, focused on integrating GPs and NHS trusts providing direct care.
All social care providers are expected to have access to digitised records that are interoperable with shared care records by 2024.
“NHSX will also support the sector by enabling all local areas to access linked health and care data to a standard national specification,” the strategy said. “NHSX will facilitate the exchange of standardised care provider records with the NHS, breaking down the barriers between health and social care.”
This is a far stretch from the “paperless NHS by 2018” target originally promised, and a recent Public Accounts Committee (PAC) report said it was “alarmed at how little progress has been made against current ambitions”.
The PAC report said NHSX is aware there is a long way to go to achieve the new target, and added: “Despite being recognised as essential to managing patient care, there has also been a lack of progress on interoperability (seamless sharing of data).
“Only three out of the 10 standards for interoperability so far identified by NHS Digital were ready by May 2020, and the national bodies are unable to tell us how many are now ready.”
The NHS strategy said NHSX will accelerate the deployment of shared care records, and drive uptake of basic technology in social care. “This includes connectivity, hardware and digital social care record software to deliver immediate productivity and quality gains,” it added.