The National Health Service (NHS) in the UK is a complex organisation made up of hundreds of disparate groups and bodies, meaning attempts at ‘digital transformation’ across the whole are incredibly difficult.
Centrally funded attempts to introduce commonality and shared digital practices have thus far seen catastrophic failures – most notably the £13 billion National Programme for IT, which was scrapped with very little to show for it, and the PR disaster that was care.data.
Currently the digitisation of the NHS is incredibly fragmented, and there have been numerous commitments to speed up progress. The latest being an ambition to make the NHS paperless at point of care by 2020 – which has been allocated £4.2 billion, but has already been dubbed as “likely to fail”.
However, a new group sitting at the heart of NHS England, NHS Digital, is attempting to drive change from the centre with a host of new initiatives, working collaboratively with local authorities and NHS organisations. NHS Digital is responsible for improving information and technology across the health service.
Given the strain that has been seen in the NHS in recent years, with a lack of funding being blamed, it is thought that new approaches to service via the use of digital tools is the best chance of relieving pressure and introducing savings.
But NHS Digital faces as an uphill challenge. It was recently highlighted by a House of Lords Select Committee that there is a “worrying lack of a credible strategy” for digital in the NHS, where Lord Patel, Crossbench Peer and eminent obstetrician, said:
The Department of Health at both the political and official level is failing to think beyond the next few years. There is a shocking lack of long-term strategic planning in the NHS. This short sightedness stems from the political importance of the NHS and the temptation for politicians to reach for short-term fixes not long-term solutions.
We have previously highlighted how NHS Digital believes that change programmes in the past have been ‘too ivory tower’ and how it is working to overhaul the NHS Choices website with more personalised content, with the focus being on helping patients to self-manage their health.
But over the past week or so the group has begun to release details of new services and programmes that it has in play, giving us new insight into some of the work it is putting into action.
GP data hub
It is recognised that better use of data in the health service could do a great deal for improving efficiency and providing better care. However, recent attempts have failed due to poor communication with the public and privacy concerns.
For example, the care.data programme was aimed at extracting anonymised patient data from GPs to a central database, to then help map care provision and provide a new asset for health research. But after a public outcry and numerous campaigns regarding the safety of patient information, NHS England conceded and pulled the plug on the project.
Many argue that the way that the NHS handled the project is a great shame, given the potential benefits that could have been delivered.
However, better use of data is necessary and NHS Digital has announced that one its plans include bringing together statistics in an accessible format to create a new General Practice data hub.
Healthcare professionals, charities, journalists and patients will be able to view a wide range of statistical information on GP practices from across England in one place, once the new data hub is launched.
The first stage of the launch will allow users to view statistics showing the number of patients registered at each practice and the number of people working at each practice. The figures will also show the percentage of people suffering from different health conditions and will measure how well each practice is performing in managing chronic conditions and public health concerns.
The idea is that the hub will allow patients to gain insight into how their practice is performing with other nearby practices. This in theory could help to drive up standards, as GPs compare their data with other GPs in the area.
Dave Roberts, Head of Business and Operational Delivery for NHS Digital, said:
We are delighted that the GP Data Hub will bring together a wide range of NHS Digital GP statistics into an easily accessible format.
We see this as a really great visual tool for professionals and patients who are interested in finding out statistical information about their local GP practices and hope it will encourage more people to engage with what is going on in the primary care sector.
Mental health services
In addition to the new GP data hub, NHS England also announced that it will be funding seven mental health trusts to create new apps that aim to improve care and online access to ‘real-time’ patient records.
This will include, for the first time, all key professionals involved in a patient’s care having access to real-time records – from triage and initial assessment, through to admissions or referrals, as well as transfer between services and follow up care.
The trusts involved also plan to develop remote, mobile and assistive technologies to allow patients to manage their conditions, whilst also enabling family and carers to provide the best possible support.
The trusts will have up to £70 million to invest in these new services – and they are being dubbed as the ‘Global Digital Exemplars for Mental Health’. It’s interesting to note the use of the word ‘exemplars’, given that the Government Digital Service – Whitehall’s central digital function – took the approach of exemplars to drive change across the civil service.
Some examples of what the trusts plan to do, include:
- Mersey Care NHS Foundation Trust is developing an app, with Stanford University, to anticipate and respond to serious self-harm and suicide risks. A prototype has been developed and researchers are preparing a feasibility study to explore the usability of the technology and how the digital platform performs against treatment as usual.
- Worcestershire Health and Care NHS Trust has moved from multiple patient record systems to one system across the organisation. Mobile access to the patient record system will be rolled out to enable staff in the community to access and update a patient’s records. They will also be improving their overall digital infrastructure, including improving wifi access across its estate, and will be developing mobile apps to improve services for patients and carers.
- Northumberland, Tyne and Wear NHS Foundation Trust is looking to deliver digital patient services including online consultations and enabling patients to access their records, complete assessments and provide feedback on-line. The Trust’s digital offering will complement traditional face to face services.
- Oxford Health NHS Foundation Trust will be working in partnership with the University of Oxford to develop an online platform for people experiencing a range of conditions (including post-traumatic stress disorder, depression and anxiety) to receive tried-and-tested psychological therapies on their computer or mobile phone.
Commenting on the announcement, Professor Keith McNeil, NHS Chief Clinical Information Officer, said:
As clinicians, we must embrace technology to help us deliver the best care to our service users, just as it helps us in so many other areas of our lives. Digital technology has the potential to transform people’s experience of mental health services and challenge the unacceptable boundaries between physical and mental health.
I am excited by this investment across a wide range of services and technologies and the opportunity it presents to provide both improved experience and outcomes for service users across the country.
It’s good to see some practical examples emerging from the centre. It’s difficult for NHS Digital to make progress, given the nature of the NHS as an organisation. However, it’s right to focus on collaboration and picking specific areas that will allow it to showcase what is possible. Execution will be key though, and failings will no doubt provide set backs to future support.
Image credit - hand pushing healthcare button on touch screen © pichetw