Personalised health and care 2020: Was it worth the wait?

This week saw the long-awaited National Information Board (NIB) framework launch  ‘Personalised health and care 2020: a framework for action’ which sets out the core and immediate priorities for digital health in the NHS.

This long-awaited document – which terms itself a framework rather than a strategy or a plan –outlines how the better use of data and technology can improve health, transform the quality and reduce the cost of health and care services.

Such improvements can give patients and citizens more control over their health and wellbeing, empower carers, reduce the administrative burden for care professionals, and support the development of new medicines and treatments.

We know all that of course, and the document does acknowledge that the NHS is not as advanced with its use of technology as it could be.

To address this, the NIB sets out a series of proposals that aim to:

• Enable individuals to make the right health and care choices through care record access and accredited apps;
• Give care professionals and carers access to all the data, information and knowledge they need with real-time digital information by 2020 for all NHS-funded services, and comprehensive outcomes data;
• Make the quality of care transparent by publishing comparative information on all publicly funded health and care services, including the results of treatment and what patients and carers say;
• Build and sustain public trust by ensuring citizens are confident about sharing their data to improve care and health outcomes;
• Bring forward life-saving treatments and support innovation and growth by making England a leading digital health economy, particularly in light of breakthroughs in genomic science to combat long-term conditions including cancer, mental health services and tackling infectious diseases;
• Support care professionals to make the best use of data and technology by ensuring the workforce has the knowledge and skills to embrace the opportunities of information;
• Assure best value for taxpayers by seeing that current and future investments in technology reduce the cost and improve the value of health services.

In addition to the proposals, the framework also sets out some key deadlines and announcements:

• The 2020 deadline for digital records across NHS is a “hard stop” that must be met by care providers, according to Tim Kelsey
• All patients will be able to view and comment on their full GP record by 2018, and NHS England is to pilot digital care accounts holding patient records and personal budgets
• The NIB is to drive adoption of mobile technology that enables professional, patient and carer collaboration
• Dame Fiona Caldicott appointed National Data Guardian for health and care to safeguard patient information
• The HSCIC is to outline a plan to open up NHS infrastructure such as N3 and summary care records (SCRs) to accredited providers and service users by the end of 2015
• NHS England’s Digital Maturity Index is to be used as part of inspection and training accreditation
• Interoperability standards guidance to be published in 2015, with local roadmaps in 2016
• The adoption of semantic web technology is supported in a bid to improve the use of less structured information
• The GS1 standard – used for unique identification of people and assets – is to be used from 2016.

The NIB commits to reporting annually on progress against these proposals, and will consult widely to see if they remain appropriate priorities. In addition, roadmaps on who will do what are to follow in the coming months, as is an evidence base of what works in the UK and internationally.

This latter move sees technology aligning itself even more closely with a clinical worldview that places a high value on evidence. It will be interesting to see if this proves an obstacle to more innovative solutions.

One of the key themes running throughout the document is that of collaboration, something that is talked about widely in the NHS but rarely happens. That said the framework encourages technology entrepreneurs to recognise the NIB’s commitment to open collaboration and embrace a future in which “they provide services that are open to others, in this way encouraging yet further innovation”. This may prove challenging, especially if NHS purchasers expect suppliers to give everything away in the name of ‘innovation’.

Another element that has been picked up by the national press, are the plans to ‘kitemark’ apps for consumption, but it is not clear which – if any – apps will be provided centrally. Let a thousand flowers bloom, perhaps?

Standards and interoperability are also mentioned, like the old aunt and uncle who have been to every family gathering for the past 10 years but have only just been noticed.

“We will be tight on standards and definitions, and clear on expectations regarding interoperability, but we will support local decision-making on systems, programmes, interfaces and applications,” it states.

National applications will remain the ‘electronic glue’ enabling different parts of the health service to work together. Locally devised approaches will be supported, subject to meeting certain standards. Details will be welcome here.

And crucially, the proposals are to be delivered within existing financial resources. However the document does mention an as-yet-unpublished McKinsey study for NHS England that suggests that digital investments deployed as part of transformational change can deliver significant savings.

Subtle hints aside, the document does appear to give some more detail on the direction of travel for the UK healthcare technology market. Dates and owning organisations are made clear. But setting direction is one thing; with finances pushed, keeping the course may prove a mighty challenge.

Useful links
Personalised health and care 2020: Using data and technology to transform outcomes for patients and citizens
https://www.gov.uk/government/publications/personalised-health-and-care-2020

Animated slides which explain what Personalised Health and Care 2020 means for patients and citizens
https://www.gov.uk/government/news/introducing-personalised-health-and-care-2020-a-framework-for-action

EHealth Insider coverage (PHaC 2020 tag)
http://ehi.co.uk/tag_search.cfm?tag_name=PHaC2020&tag_type=Article