This week the long awaited NHS Information Strategy ‘The Power of Information’ was finally published after what was apparently a bit of a scramble to get the final points together.
To those that follow NHS IT closely and have watched the dribs and drabs come out of the Liberating the NHS: An Information Revolution consultation and the report from the independent NHS Future Forum, there is little to be surprised about.
But there were a few points that do stand out:
Don’t mention the Programme
All things National Programme for IT have been almost completely omitted from the strategy. Sure, we wanted this document to be forward looking and to move away from the old model but can we really ignore that it ever happened?! I suppose 18 months ago, when the then DH CIO Christine Connelly said: “We can’t continually be tied to a strategy that was set in place over ten years ago”, she stayed true to her word. But for the new strategy to barely even reflect on a programme that has consumed both NHS IT professionals and IT suppliers alike for the best part of ten years, seemed absurd.
Patient and GP access
The second area that cannot be missed is the hard focus around primary care, the area, which has been applauded for making best use of IT. The headlines around patients being able to book appointments online, being able to access a national portal for choice and email their GP, dominated most of the national papers. The strategy produces few deadlines but sets in stone that all patients should be able to access their records by 2015 (a timescale that has been mentioned several times before).
However, what the strategy doesn’t appear to acknowledge is that although (apparently) patients want this type of access, there are only a pocket of clinicians across the country providing it. In fact, it doesn’t mention that despite at least 50% of GP practices having the technological capability to allow patients access, only around 2% do so. Moreover, it gives little guidance on how to get clinicians on board and realistically it’s unlikely that the DH is going to be able to do this alone. At the very least we are going to need the buy-in of the BMA as well as the Royal Colleges.
Portals, portals a hundred times portals
Portals are consistently mentioned throughout the strategy as being the key to integrated care and joining up systems that have already been deployed. Yet, the strategy appears to lack detail as to where to even start with joining up information across the care pathway. In addition, despite referencing a couple of NHS sites that are using relatively basic portal technology, it failed to mention the opportunities that more ambitious portal solutions could bring in terms of enabling the user to input and extract information to provide a truer picture of patient care.
What is good to see is that the government hasn’t been totally scared off by the programme and recognises that there are still areas where the country can benefit from national direction, for example by ensuring standards are enforceable across the NHS for the first time. The downside to that is it seems, with little national direction comes little funding, and other than a brief mention that trusts that did not receive a PAS under NPfIT would receive ‘some’ money, there was not a lot else.
Now for the hard part
Perhaps the most glaring omission was the lack of any implementation strategy. National director for efficiency and improvement Jim Easton told HSJ it was right not to include implementation detail in the strategy and that: “The strategy is one of the first things which shows how we’re going to see big, serious, important things transacted in the new world.” While the strategy says that implementation plans will follow, the key here is to publish details as soon as possible, rather than creating more uncertainty in the market for another 18 months.
I probably shouldn’t mention it but whatever happened to the technology strategy?!
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