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2015 was certainly not a quiet year in the world of NHS IT. From an unsurprising further delay of Care.data to a disastrous start to NHS 24's IT system, the NHS struggled with large IT programmes. Paired with the news that NHS England’s digital chief Tim Kelsey is leaving the NHS, it's safe to say that NHS technology has had a turbulent year.
But momentum is beginning to picking up as the NHS prepares to go paper-free at the point of care by 2020. With clinical commissioning groups in charge of leading the agenda, and determined to get this right, 2016 may prove a story of success rather than another NHS IT failure.
Here are some of Computer Weekly’s top NHS IT stories of 2015.
When NHS England’s director of patients and information Tim Kelsey announced he was leaving the NHS to set up shop in Australia, many were surprised to see him go.
Kelsey, who has been responsible for overseeing the NHS IT strategy, is best known for running the controversial Care.data programme and being a vocal – and sometimes controversial – supporter of moving NHS IT into the 21st century.
His move to Australia will see him take up a job with Telstra Health, the very same company which bought Dr Foster Intelligence, a health informatics company co-founded by Kelsey himself, in March 2015.
Kelsey’s departure has raised questions over the future of the Care.data programme, which has proved an enormous challenge, critisised by the public and privacy campaigners.
The stop and start saga of the controversial care.data programme continued in September 2015, when the four pilot sites – which began trialling the programme in June 2015 – were asked to put the project on hold – the fourth delay to the programme since its conception.
The controversial programme – which aims to extract anonymised patient data, from GP surgeries to a central database held by the Health and Social Care Information Centre – has come to a halt once again, as the NHS works on creating an opt-out and consent model for it.
Health secretary has asked the Care Quality Comission to undertake a review of the standards of security for patients’ confidential data across the NHS, and the national guardian for health and care, Fiona Caldicott, will provide the guidance on the opt-out model, due to be published in January 2016.
Cambridge University Hospitals NHS Foundation Trust’s implementation of its £200m e-Hospital programme was seen as one of the biggest achievements among NHS trusts last year, but Computer Weekly reported in September 2015 that the programme has not gone exactly to plan.
Both its CEO and CFO have resigned while the trust is in the midst of an investigation into its finances and the e-Hospital programme. Cambridge is now suffering from a £20.6m deficit, with £8.6m due to the IT project.
The Care Quality Commission has also criticised the trust. It said the introduction of the Epic electronic patient record system, one part of its e-Hospital programme, had affected the trust’s ability to report and act on data collected on the system; and that medicines were not always prescribed correctly, due to the system’s limitations.
In a bid to move forward with the paperless NHS agenda, in September 2015 NHS England told clinical commissioning groups (CCGs) they would have to submit roadmaps on how to achieve a paper-free NHS by April 2016.
While CCGs are in charge of delivering on this, the plans include everyone in their local health economy from hospitals and GP practices to community, mental health, ambulance and social care services.
CCGs will be held accountable for a series of milestones, which included an October 2015 deadline for discharge summaries for acute or day care patients to be completed and sent to GPs electronically. By 2016, this will include patients discharged into social care services.
NHS England has also developed a digital maturity index which will measure each NHS trust’s “readiness” to go paperless at the point of care.
NHS 24, the special Scottish health board which delivers telephone and advice services, went live with a new IT system in October 2015, but a few weeks into November it was forced to suspend the system on the grounds of patient safety.
The system was already two years behind schedule, with costs spiraling from £75.8m to £117m, and was heavily critisised in a report by the Audit General for Scotland shortly before going live.
NHS 24 chief executive Ian Chrichton said the plan is to continue to develop the system offline and attempt another launch in early 2016.
After a trip to the US in October 2015, health secretary Jeremy Hunt announced that he had asked a US professor, Robert Wachter – the interim chairman of the Department of Medicine at the University of California, San Francisco – to undertake a review of the digital future of the NHS.
Wachter – author of The Digital Doctor, which looks critically at the rise of healthcare IT systems in the US – will review the NHS’s digital systems to keep it from “falling into elephant traps” while it steps up its game to going digital.
The review will be similar to the 2013 Berwick review on clinical safety in the NHS, and Wachter will produce a report to government in the summer of 2016.
IT problems and poor information governance place patient care at risk at the Southwark Primary Care Trust, (now Southwark Clinical Commissioning Group), an employment tribunal heard after a whistleblower came forward about the issues.
Bernie Rochford became aware of problems with the IT systems used to record patients’ details in 2011 and alerted senior managers. She claims she was bullied out of her job after raising the concerns and in May 2015, and brought a claim to an employment tribunal for constructive dismissal after blowing the whistle on IT and information governance problems. The NHS trust has since denied the allegations of bullying.
According to evidence heard by the employment tribunal, the trust – which was responsible for providing continuing care services to patients – had no clear idea how many patients were on its books, where all the patients were or whether they were alive or dead.
After nearly a year’s delay, the NHS e-referral system went live in June 2015, but the system had to be suspended temporarily two days after launch.
The system was deployed despite having 33 unresolved issues with the online software, and a warning that it was going live without following correct government digital guidelines. After a performance review, the system was withdrawn from service.
However, the system for booking NHS hospital appointments went back online shortly after.
Despite asking for up to £5.5bn for NHS technology in its bid to raise chancellor George Osborne ahead of the autumn spending review, NHS England seemed very happy with the £1bn it got.
Exactly how the money will be spent is yet to be determined, but it will help the NHS deliver a fully integrated health and social care system and an interoperable patient record, available at the point of care by the end of 2020.
Osborne also announced £250m in funding for the 100,000 Genomes Project, which aims to introduce whole genome sequencing technology in the NHS and sequence 100,000 genomes by 2017.
The Health and Social Care Information Centre launched a five-year plan on how to make the NHS a world leader in the development and use of health and social care apps by 2020.
The plan includes the implementation of a common digital platform for integrated care, using apps and technology such as wearables. Underpinning this will be a common technology architecture that supports organisations across health and social care.
The use of health apps is a big part of the NHS’s drive to going digital, as set out in NHS England’s Personalised Health and Care 2020 framework, which was published in 2014.