News in brief
Fifth of patients have records access: NHS England has reported a big jump in the proportion of patients who are able to access their GP records online, according to eHealth Insider (EHI). The present government came to power promising to give patients access to their medical records by 2015; a pledge that was subsequently changed to access their GP records and then access to a subset of them by this date. The latest “framework” for NHS IT, ‘Personalised Health and Care 2020’ (PHaC2020), re-expands this promise, saying that “in 2015, all citizens will have online access to their GP records and will be able to view copies of that data through apps and digital platforms of their choice.” PHaC2020 adds that individuals will be able to see more of their records – and add to them – by 2018. However, progress on the first part of the commitment has been slow. EHI reported this summer that the most up to date figures available from NHS England at the time indicated that around 3% of patients in England could access their record. However the latest figures to be published by the commissioning board, which run to the end of September 2014, indicate that 21% of patients are now registered with a practice that offers access to records online. At the same time, the number of patients registered with practices that enable them to book appointments and repeat prescriptions online has jumped to 91% and 88%; probably because these services were included within the new GP contract.
A&E units ‘creaking under pressure’: Sir Bruce Keogh says ambulance services in some parts of the country are struggling and Accident & Emergency (A&E) units are stretched, according to the BBC. However he insists that forward planning and the injection of extra funding should help the NHS cope better than in previous winters. The government has released an extra £300m bringing the total winter pot to £700m – 75% more than last year. Sir Bruce made the comments at a conference at the King’s Fund. Speaking at the same meeting, Dr Clifford Mann, president of the College of Emergency Medicine, said that the system was facing huge demand pressures but was “working pretty well”. It comes as Gloucestershire’s Hospitals Trust has declared a major incident, faced with no beds for up to 60 patients. People are being told to only go to A&E if they have no other option. Dr Mann raised the possibility that the NHS 111 helpline could be adding to the pressures on A&Es.
Ambulance targets: Plan for longer times in England revealed: Target times for ambulances to reach some seriously ill patients could be lengthened, the BBC has learned. A leaked NHS document includes plans to change the response time for some Red 2 patients – those with “serious but not the most life-threatening” conditions – from eight to 19 minutes in England. It said the plans had been backed by health secretary Jeremy Hunt, subject to approval by ambulance trust bosses. The government said no decisions had been made. Labour has demanded answers, and rejected suggestions from ambulance chiefs that it was told about the plan to change response times and raised no objections. “We have never given any support for this plan. When raised in passing, [shadow health secretary Andy] Burnham explicitly warned of the need for caution and consultation as he repeated today,” a Labour spokesperson told BBC political correspondent Carole Walker. “The evidence needed to be produced first and it hasn’t been. Instead, ministers are forcing it through from January, in the middle of a crisis, without proper planning,” the spokesperson added.
NHS England names 100K genome centres: NHS England has named the 11 centres across the country that will drive efforts to sequence 100,000 genomes by 2017, linking genomic data to electronic patient data to spur medical research, reports eHealth Insider. The genome centres, each led by an NHS trust, each have an established track record of “excellence in genomic services”, according to NHS England. The 100K Genome project involves collecting and decoding 100,000 human genomes – complete sets of people’s genes – and linking the results with a national database of electronic patient records to enable scientists and doctors to understand more about specific conditions. Ten centres, spread out across different regions, have been designated for genomic work on both cancer and rare diseases. The NHS 100K genome centres include: East of England, led by Cambridge University Hospitals NHS Foundation Trust, South London, led by Guy’s and St Thomas’ NHS Foundation Trust and North West Coast, led by Liverpool Women’s NHS Foundation Trust. NHS England has said the project could improve the prediction and prevention of disease, enable new and more precise diagnostic tests, and allow personalisation of drugs and other treatments to specific genetic variants.
NHSmail SMS funding extended for GPs: NHS England has extended central funding of email-to-SMS services for primary care organisations using NHSmail, after the Department of Health (DH) caused an outcry by announcing plans to cut funding from next March. Dr Paul Cundy, joint chairman of the British Medical Association and Royal College of GPs’ joint IT committee, told eHealth Insider (EHI) he hopes the six-month extension will provide a chance for “heads to be cracked together at the DH” and secure permanent funding of SMS services for primary care. A full business case prepared in July for the transition from the current NHSmail service to its replacement revealed plans to move SMS service costs onto local providers, stating that funding would “cease to be a central concern” from 31st March 2015. “After this health and care organisations must procure and fund their own service.” The document said the preferred model for the provision of SMS services, the G-Cloud framework, will create a market of competing suppliers for local NHS organisations. Cundy told EHI at the time that the plans “will go down like a lead balloon” with GPs as they have had so much dumped on them, and the idea that they have to pay could be “the final straw.” However, NHS England has now agreed to support a replacement SMS service for primary care organisations that use the current version of NHSmail until 30th September.
Caldicott calls for care.data clarification: An independent oversight panel led by the National Data Guardian, Dame Fiona Caldicott, does not anticipate the need for any changes to the principles of NHS England’s controversial care.data scheme, despite calling for answers to a number of outstanding questions about its implementation, according to Government Computing. In the findings of a report sent to the care.data Programme Board looking at the proposed ‘pathfinder’ testing of the scheme, the Independent Information Governance Oversight Panel (IIGOP) concluded that it would be “reasonable” to proceed with selective trials once clarifications were given concerning 27 questions about privacy and the wider scope of the programme. According to NHS England, care.data is intended to bring together what it calls coded medical details held by GPs with hospital data stored with the Health and Social Care Information Centre. It is hoped that combining these data sets will allow commissioners to better understand how to treat diseases and deal with emerging patterns and trends in healthcare. Implementing care.data has continued to prove controversial with pressure groups and patient groups, which have raised concerns over the confidentiality implications of sharing highly personal data concerning medical and mental health histories – leading to the project being delayed from earlier this year to an as yet unspecified launch date.
NHS England online GP services support questioned: Dr Neil Bhatia, a GP and data protection lead at Oaklands Practice in Hampshire, has warned that NHS England must do more to support surgeries across the UK in expanding digital services available to patients to protect user confidence, reports Government Computing. With surgeries expected to begin offering online appointment booking and patient records from April next year, Bhatia claimed that – based on his experiences – GPs were largely being left to their own devices to ensure systems are implemented in time. He added that with individual surgeries all largely adopting personalised approaches to introduce online services within the deadline set by NHS England, GPs were being given little central support to ensure they are not overwhelmed by demand as their new systems go live. “Surgeries have just been told to do this, but certainly my practice hasn’t heard from NHS England about how it may be working,” he said. NHS England has maintained it is committed to providing support and guidance to GPs in order to help overcome potential challenges in implementing expanded digital services, having recently released its interactive Patient Online Support and Resources Guide. Under the plan, every patient is expected to be granted online access to their GP records via approved apps and digital platforms from next year, with wider access to all records held by hospitals, mental health and social care services by 2018.
Northumbria issues framework tender: Northumbria Healthcare NHS Foundation Trust has issued an invitation to tender for a framework agreement for the provision of an integrated electronic health record system worth between £6m and £200m over four years. The framework agreement is intended for NHS bodies across the United Kingdom, and is divided into three lots: electronic prescribing and medicines administration system; ward information management system; and A&E. Tenders may be submitted for one or more lots. eHealth Insider reports the trust was awarded funding for the projects in the first round of NHS England’s technology fund. It received £411,000 for an observations system and £539,000 for an e-prescribing and medicines administration system.
IBM to replace McKesson as NHS electronic staff record supplier: The Department of Health (DH) is set to award a contract worth up to £400m for the NHS electronic staff record (ESR) to IBM, reports ComputerWorld. Subject to contract signatures, IBM will take over from McKesson in the summer of 2015 for five years and nine months. IBM will responsible for maintaining and improving the system, for example by improving the user interface and integrating with NHS Mail. The ESR holds records on 1.4million NHS staff and its main functions are payroll, pensions, core HR, recruitment, finance, e-learning, management reporting, integrated identity management and manager and employee service.
Labour attacks NHS England’s Christmas ‘news blackout’: Labour has criticised NHS bosses’ decision not to publish key performance data over the festive period, describing the move as a news blackout, reports The Guardian. NHS England has decided to not publish its usual weekly datasets covering issues such as patient waiting times in A&E after Friday 19th December, until the 9th January 2015 due to the holiday break. “It is highly unsatisfactory to have this news blackout over the crucial Christmas period. People can’t be kept in the dark,” said Andy Burnham, the shadow health secretary. NHS England’s decision follows last week’s performance data, which showed that record numbers of patients had not been treated in A&E inside the four-hour maximum waiting. The Telegraph also reported on the Labour party’s concerns of enforcing a “news blackout” on data that covers the number of patients attending A&E departments, patients waiting too long to be seen, numbers kept on trolleys for up to and over 12 hours, ambulances queued outside hospitals, vehicles diverted to other A&E departments, bed capacity and cancelled operations.
Accenture and BT to battle for NHS email contract: The NHS has shortlisted BT and Accenture, down from five bidders, for the delivery of its email system reports Computer Weekly. The NHSmail contract is as a secure email service and is the only NHS email system accredited to “Government Official Sensitive” status approved by the Department of Health. A spokesperson for the Health and Social Care Information Centre said: “Evaluation of bids is complete and BT and Accenture have now been invited to participate in an extended clarification period with the other suppliers having been notified that they were unsuccessful.” The successful bid is expect to be announced in February 2015. The government procurement framework includes: Secure eMail; Secure eMail Gateway; Mobile Device Management; White Pages and Directory Service; Business Partner Secure eMail; and eMail router. The NHS hopes most of its organisations will join the new mail service, but individual trusts will be able to choose whether or not to join.
West Suffolk NHS Foundation Trust selects Stalis to enable a quality-assured data migration: West Suffolk NHS Foundation Trust has commissioned Stalis to provide its migration tools and services to support a safe and timely project migrating data from its existing iEXPRESS PAS to Cerner Millennium, reports Building Better Healthcare. Based on Stalis’ robust and secure CareXML platform, the project will include the migration of PAS, A&E, Alerts and RTT data from the existing iEXPRESS system into Cerner Millennium. Data will also be migrated from other legacy systems including Medifusion and EPRO. Stalis will provide a secure and accessible historic archive of non-migrated data, meaning minimal data transfer, which will further mitigate risks and timescales. Stalis will also provide data quality assessment and strategies for cleansing as well as trial load and Go Live support. Andrew Meiner, managing director at Stalis, said: “Our extensive expertise and experience in healthcare means we provide NHS organisations with confidence that their staff are working from the best and most complete information, whether they are clinicians making decisions about patient care, managers monitoring performance against contracts, or service improvement managers investing in reorganisation and change management.”
Basildon and Thurrock NHS digitises half a million patient records: Basildon and Thurrock University Hospitals NHS Foundation Trust has finished digitising 446,000 patient records, reports ComputerWorldUK. The milestone marked the end of a four-year implementation project, with the trust scanning its final batch of records into a Fortrus electronic medical record (EMR) system this week. The scheme cost £7m to implement but the trust expects it to save £2.6m a year in reduced operating costs and improved efficiencies. Since 2010 a team of 35 has scanned records into the EMR system using equipment from Kodak and IBML. In that time they have moved 68 million pages of patients’ records from an aircraft hangar-sized warehouse to a 34-terabyte database on a computer little bigger than a fridge freezer. The trust said the system will improve patient safety by ensuring medical records, including test results, appointment times and medical histories, are available to staff at any time. A group of clinicians helped to configure the system, led by Ian Linehan, a retired consultant colorectal surgeon. He said: “Most NHS systems are bought in and inflicted on us [clinicians]. But this time we were asked what we wanted first. And that was one place to log into to find out information about a specific patient.”
NHS ‘fails to keep pace’ with mobile savvy patients: The NHS is failing to keep pace with increasingly mobile savvy patients, according to a new study conducted by digital healthcare agency Integrated Change. The study found that, despite a 118% increase in mobile visits to hospital websites, just 43% of these websites are mobile optimised. This means that less than half of NHS hospitals are presenting their content in a way that smartphone users can navigate and easily access. Integrated Change founder and development director Scott Hague told Pan European Networks: “It’s apparent that patients are incredibly receptive to mobile technology. And the NHS has some brilliant web resources for users and plenty of content for those looking for accurate healthcare information. The sheer volume and quality of what’s available freely to users is certainly something to boast about.” In addition to assessing data surrounding trusts and their mobile offerings, the study interviewed 100 private orthopaedic patients and found almost half would find it useful to be able to make appointments via mobile and access certain information specific to their appointments and treatment.
Wishing all our Healthcare Roundup readers a very merry Christmas and all best wishes for 2015.
Opinion
Instead of writing policy and procedure, we in the NHS should learn to listen
Too few healthcare professionals are taught how to listen to patients, Professor Michael Buist writes in the Guardian. Professor Buist, who reflects on personal experiences including the loss of his daughter and his own near death experience in hospital, argues that clinicians not listening or only listening to what they want to hear is a key issue for the patient safety agenda.
“The future of the health and quality agenda rests with our students. We need to teach them to listen and to think,” says Prof Buist, a senior critical care and general medicine practitioner, and chief medical adviser at Patientrack.
“The traditional way we teach our medical students beats the intuition out of them and they have to learn that subsequently on the wards, in clinical departments and in theatre. Many of today’s junior doctors know their discipline well but few have been taught how to listen to the 80-year-old woman in the hospital bed,” he added.
“Students need to be taught much more than a checklist approach to finding out about their patient. Being task-orientated is simply not enough. They need to learn how to listen to the patient. They need to be able to hear the clues the patient gives, the half gaps.
“Interacting with the patient is like dating; healthcare professionals shouldn’t talk over patients and equally they need to provide enough information,” he concluded.
An unstoppable force: Patients will drive the NHS to use their data
Wayne Parslow, UK general manager at MedeAnalytics, reveals how patients have a thirst to be engaged in their health and wellbeing in Building Better Healthcare, and how data is the secret to improving outcomes in the future.
“Michael Seres is a long-term condition patient with a difference – one the NHS can learn a lot from,” said Parslow. “At 12 years old he was diagnosed Crohn’s disease, an incurable bowel condition that has since led him to have 20 major operations, an inability to eat or drink and intestinal failure, before he eventually became the 11th person in the country to undergo a bowel transplant, something that carried a 50% survival rate. He is now in his forties, but from the moment he was diagnosed the key to his remarkable journey was engagement.”
He continued: “Wanting to leave hospital, Michael asked for his test results to be sent to him by text message. He then asked for his doctors to tweet results to him. By some mistake, a secure direct message wasn’t used, with the result that four other surgeons around the world started to pose suggestions and ideas about his results, further contributing to his care. Eventually Michael wanted to avoid the 90-minute journey for his weekly appointment and asked his transplant team to engage him through Skype. They refused. But a surgeon made the Skype call from his home. Five months later the entire hospital embedded Skype in their working practices as a way of engaging with patients.
“We now live in a society where many people use communication devices and wearable technologies everyday and at an exponentially growing rate to monitor their own fitness and health. Patients are already willingly sharing their information. Communicating and genuinely engaging with them on just what can be achieved with their data and with their involvement and use of that data will only fuel this unstoppable force further. This is, as Lord Victor [Adebowale] said, about what data means to people.”
Tackling the scourge of paper-based patient data
In the Information Age, Steve Rudland, the healthcare practice manager (EMEA) at Hyland, says clear focus is required to attack the enormous problem of digitalising paper records in the NHS.
“Across the NHS, many continue to grapple with unstructured data, which often has to be tracked down by staff, leading to delays, errors, cost and lost records. Such access is a prerequisite for informed clinical decisions, where the failure to capture and process data swiftly and accurately could strike at the heart of healthcare provision and lead to increased risk to the patient.
“Healthcare providers who have smooth processes to capture and access all the right data and do not need to constantly ask patients to repeat information, are improving the patient experience. This also increases the likelihood of patients requesting that they are referred to a specific trust.
“Addressing this issue requires a focused approach. The first step is to identify the ways in which information is captured, from paper, diagnostic and digital images and the array of different forms in use.
“For technology professionals, the key is to understand the nature of the unstructured content faced by each department. Too often providers simply replicate existing processes electronically. The aim is not just to automate processes, which may contain errors that would be exacerbate, but to take advantage of further improvement.
“The scale of the challenge faced by organisations, from trusts to clinical commissioning groups, in tackling unstructured patient data is clear. While managers and clinicians charged with resolving this issue may feel that they have been handed an insurmountable task, a successful outcome should lead to improved information handling, cost savings and enhanced patient care.”
Highland Marketing blog
In this week’s blog, Highland Marketing CEO Mark Venables looks back on an important year for the NHS, and asks if 2015 will be the year of the patient?
