News in brief
Government hopeful on patient access target: The government is optimistic about meeting its April deadline for patient access to online records, despite January figures revealing that thousands of practices were yet to offer the service, reported eHealth Insider. Health secretary Jeremy Hunt has pledged that all patients who want it will have online access to their GP record by 31 March 2015. The latest official figures, from the Health and Social Care Information Centre, show that at the start of 2015, around one third of practices (2,500) had switched on the necessary functionality. NHS England director of strategic systems and technology Beverley Bryant said the latest preliminary figures suggest around 90% of practices are offering patients access to summary information held in their medical record. “At this stage we’re optimistic about meeting the target of having 95% of practices providing online appointment bookings, ordering of repeating prescriptions and access to summary information by March 31,” she said.
Dr Foster Intelligence sold to Australian telecoms giant: Dr Foster Intelligence has been bought by an Australian telecoms giant, Health Service Journal (HSJ, subscription required) has revealed. The health informatics company, which was formed through a joint venture with the Department of Health in 2006, has been acquired by Telstra Health, a provider of electronic health solutions which is a division of the Australian telecoms company, Telstra. Dr Foster co-founder, Roger Taylor, said the acquisition would give it “global reach”. The price Telstra paid for Dr Foster is undisclosed, but HSJ understands the Department of Health has broken even on the initial £12m investment it paid for a 50% share of the company in 2006. The acquisition builds on an existing partnership between the companies, with Telstra holding exclusive rights to provide Dr Foster’s products in Australia since December 2013. Shane Solomon, Telstra Health’s management director said the company was “delighted” to acquire Dr Foster.
NHS problems ‘at their worst since 1990s’: Services in the NHS in England are deteriorating in a way not seen since the early 1990s, according to a leading health think tank. The King’s Fund review said waiting times for A&E, cancer care and routine operations had all started getting worse, while deficits were growing, reported the BBC. It said such drops in performance had not been seen for 20 years. However the think tank acknowledged the NHS had done as well as could be expected, given the financial climate. Professor John Appleby, chief economist at The King’s Fund, which specialises in health care policy, said: “The next government will inherit a health service that has run out of money and is operating at the very edge of its limits. There is now a real risk that patient care will deteriorate as service and financial pressures become overwhelming.” He said in terms of how standards were slipping – not how low they had reached – the situation was the worst it had been since the “early 1990s”.
International focus on Scotland’s integration plans: Scottish health secretary Shona Robison said Scotland was leading the way among global health services through its plans to integrate health and social care services, during a speech to the 15th International Conference for Integrated Care. Delivering the keynote speech of the three-day conference in Edinburgh, the health secretary said she was proud that Scotland had been chosen to host the conference just days before all Scottish local authority and NHS partnerships put their integrated plans in place. Robison said the Scottish Government’s “bold approach” to the integration of health and social care has been recognised internationally and that Scotland has “a lot to offer” other countries in terms of learning and sharing best practice.
NHS Number still not ‘universally’ used as the patient identifier – Kelsey: The NHS Number has still not been universally adopted by health providers as a consistent unique patient identifier, despite featuring in national planning guidance and contracting documentation for over a decade, reported National Health Executive. This is according to a board paper that Tim Kelsey, national director for patients and information, will present at NHS England’s board meeting this week. Kelsey has asked the board to approve the priority list of digital standards and confirm the organisation’s intention to use “all available commissioning levers in 2015-16 to help secure comprehensive adoption of digital standards by the publicly funded NHS and care sector”. NHS England has said the use of the NHS number as a primary identifier is “is essential to the provision of safe, seamless care”, as is progress towards systems and processes that allow the safe and timely sharing of information. To do this, the 2015-16 planning guidance stated that the NHS number will be used as the primary identifier in all settings when sharing information. However, this was supposed to have already been the case since the ‘Everyone Counts: Planning for Patients 2013-14’ expectations. To enforce it, commissioners will now be able, under new powers proposed through the NHS Standard Contract for 2015-16, to “withhold funding from providers unless these conditions are met”.
Code4Health programme “complete waste of time”: The programme, which will allow healthcare professionals to code and design healthcare apps, was unveiled on 4 March 2015, by Tim Kelsey, NHS England’s national director for patients and information. BMA IT lead, Dr Paul Cundy, told Primary Care Today the programme was a “complete waste of time”, as GPs are rushed off their feet and “barely have enough time to breathe” let alone start developing apps. Instead of the programme by NHS England, Dr Cundy said he would like to see the “historic” underfunding of general practice corrected. It is claimed in the last 10 years there has only been a 4% rise in the number of GPs, compared to a 37% increase in hospital doctors and this was because of “ignorance from the powers-that-be about general practice,” said the BMA representative. Chairman of the Family Doctor Association (FDA), Dr Paul Swinyard, said he didn’t really see the “appetite” for any more work in general practice, calling the idea of sitting and building an app “unrealistic”. “Having said that this is not to be a year of rhetoric, the quote ‘The NHS is at its best when it listens hardest. We must leave paper behind in this world’, is pure rhetoric.”
All London CCGs and NHS England join forces on city-wide vision: All 32 London clinical commissioning groups (CCGs) and NHS England’s London arm have set out plans to drive the improvements called for by the NHS Five Year Forward View and the London Health Commission, reported Health Service Journal (subscription required). Every CCG has committed 0.15% of their budgets to create a shared fund to make improvements to healthcare across London. NHS England said this would come to “in the region of £20m”. It is not yet known how much NHS England will contribute. A spokeswoman for NHS England said it was “still defining total investment”. The groups have come up with 13 programmes where improvements could be made, including work to: develop an urgent and emergency care network across the city, address the poorer health outcomes in London for children and young people compared to the rest of the country and address the life expectancy gap for people with severe and lasting mental health issues.
EU ministers back data privacy changes: The European Union has provisionally agreed changes to planned data privacy legislation that will make it easier to share data between health and social care services, reported eHealth Insider. At a meeting of the Council of the European Union this month, ministers endorsed principles to amend its proposed General Data Protection Regulation. According to the new proposals, personal health data could be shared and processed without the explicit consent of the individual in certain circumstances, such as when “necessary for the purposes of preventive or occupational medicine… the provision of health or social care or treatment, or the management of health or social care systems and services on the basis of [EU] law or member state law”. The right to share and process data would also apply when necessary for reasons of public interest and public health. The principles state that the processing of personal health data for public interest “should not result in personal data being processed for other purposes by third parties such as employers, insurance and banking companies”. The NHS Confederation welcomed the changes, saying they “signal an important strategic commitment by ministers to alleviate the burden of data sharing”.
IBM invests to speed Watson adoption in healthcare: IBM has invested an undisclosed amount on Modernizing Medicine, a provider of cloud-based, specialty-specific electronic medical records to speed up adoption of its Watson technology in healthcare, reported Computer Business Review. IBM has not disclosed how much it has invested on the firm, but said that the investment was apart of the $20m Series D funding secured by Modernizing Medicine, raising its overall funding to $49m. Modernizing Medicine has developed the Electronic Medical Assistant system, which is a specialty-specific EMR system to provide specialty-specific billing, revenue and inventory management solutions. Modernizing Medicine will use the funding from IBM and others to speed up expansion of the solution to eight more specialties. The company is planning to further develop its schEMA mobile app which will be powered by Watson supercomputer’s cognitive technology. Leveraging the cognitive computing technology, schEMA mobile app will analyse massive amounts of published, peer-reviewed medical data and healthcare research to help physicians practice enhanced evidence-based medicine.
KLAS says Epic Systems still tops, Cerner catching up: TechTarget reported that Epic Systems still dominates the market for big healthcare system electronic health records (EHR’s) by a wide margin, however Cerner, after its $1.3bn acquisition of Siemens AG’s Soarian EHR unit, is narrowing the gap. According to a new EHR purchasing plans survey from KLAS there is a dramatically consolidated market for acute care EHR systems, with only three other major players challenging Epic and Cerner when hospital officials make buying decisions: Allscripts Healthcare Solutions, Medical Information Technology (MEDITECH), and McKesson. KLAS found that healthcare providers considering new EHR systems from Epic or Cerner, whether as upgrades or replacements, still lean 2-to-1 toward Epic, even though Cerner technically has more market share when Soarian users are added to Cerner’s share.
NHS launches mental health app library: NHS England has launched an online library of programmes and apps to support people with mental health conditions, reported eHealth Insider. The library, launched this week, contains a list of digital tools endorsed by the NHS for use in clinical practice with an initial focus on depression, anxiety and improving access to psychological therapies. It is available on the NHS Choices website and adds to the site’s existing health apps library, which recommends smartphone and tablet apps on healthy living, health information and several specific conditions. There are five recommended digital tools contained in the library, all of which have demonstrated in trials that they are an effective treatment option in mental health. The tools include online self-help courses based on cognitive behavioural therapy, a live CBT instant messaging service, and an online community message board for people to discuss their experiences.
IBM selected by Department of Health in England to manage NHS Electronic Staff Record system: IBM has announced a contract with the Department of Health to manage and continue transforming the NHS Electronic Staff Record system (ESR), the UK’s most important workforce management tool serving 1.4 million employees, reported News Medical. IBM will help modernise the system by providing increased mobile access and new self-service capabilities making the system more efficient and accessible. IBM Interactive Experience, will design and build a Mobile Ready Portal tailored for many different user types allowing access from PC, Android and iOS devices. The improved interface will give NHS employees easier access to new and existing HR services including mobile, expenses and e-learning. The project will also lay the foundation for future service enhancements including increased central business intelligence reporting using dashboards, alerts and collaboration tools that will help improve performance while helping reduce costs.
NHS to trial innovations in ‘test beds’: NHS England is calling for healthcare innovators from across the world to trial new technologies and digital services at working NHS sites, reported eHealth Insider. Organisations from industry, the voluntary sector or even the NHS itself have until 29 May to apply to the scheme, which allows advances in healthcare to be tested in a clinical setting at one of several ‘test bed’ sites. According to NHS England, the aim is to evaluate the impact of new technologies, such as wearable devices, in the real world rather than in isolation where innovations can be “implemented without rigour and discipline, generating little evidence”. The scheme is part of the NHS Five Year Forward View, a plan for the future of the NHS launched by chief executive Simon Stevens at the end of 2014. Stevens’ said the innovation project is part of an NHS England ambition is to become the “best place on the planet to test new combinations of innovations that produce clear payoffs for patients and taxpayers”.
Adenubi moves from GPSoC to data role: Kemi Adenubi is stepping down as the Health and Social Care Information Centre’s (HSCIC) head of primary care IT to lead work on a replacement for the organisation’s Secondary Uses Service. Adenubi was instrumental in the establishment of the GP Systems of Choice framework contract. She acted as programme director for GPSoC, which was established in 2007 to fund GP IT systems for 75% of practices in England. The HSCIC told eHealth Insider that Adenubi has been appointed as its director for commissioning, finance and data services. “Based within the information and analytics directorate, Kemi will lead on the data services for commissioners and National Tariff System programmes, where she will focus on improving the data flows to NHS commissioners.” Adenubi said that she is “really looking forward to the challenges that this new role presents”.
One Health Alliance recruits technology suppliers to engage NHS: Technology companies across the UK are being given an opportunity for direct dialogue with senior NHS leaders through a series of open discussions being held by the One Health Alliance (OHA). The alliance, a collective of health and care technology suppliers from across the country, is now expanding its membership base, which provides solutions that match the breadth of pressing technology needs facing the NHS and other care organisations. The OHA is inviting companies ranging from small to medium sized enterprises (SMEs) through to multinational technology vendors to register their interest to become new members, which will enable them to have open discussions with those at the helm of NHS policy and delivery. Members attend small and intimate meetings four times each year, where they are joined by guest speakers including senior NHS England figures, chief clinical information officers, chief nurses and other key influencers from across the health and care setting. Companies wishing to join the One Health Alliance should contact Mark Venables directly for an informal discussion at markv@highland-marketing.com or on +44 (0)1877 339922.
Opinion:
Vanguard sites: new models of integration in health and social care
Melanie Henwood asks whether new models of care in the Five Year Forward View will achieve the long sought integration between health and social care.
“While the debate around integration is long-standing, the focus on new care models actually moves things up a gear,” she writes on the Guardian’s social care network this week. Successive governments over at least the last three or four decades have lamented the structural divisions between care and health.
“Recurrent attempts since the 1970s to restructure the machinery of joint working, to create new incentives (and sometimes penalties) for collaboration, and to enable enhanced flexibilities for those eager to innovate, all testify to the continued challenge of fragmentation.
“The latest attempt to achieve better integration and to explore options through the new care models arguably starts from a different standpoint. The central objective is not just closer working, but better integration and coherence around the needs of the patient. This is a qualitative shift in values and objectives.
“The test of the pilot schemes will be if they are able to achieve a better experience for patients and families. Can they offer more integrated, personalised care that enables people to achieve greater independence? Are they able to avoid hospital admission where possible (and timely discharge where not); to have more treatment closer to home rather than visiting consultants in hospitals, and to postpone or avoid permanent residential care? Of course, making better use of resources and achieving savings will also be priorities.”
Devo Manc: five early lessons for the NHS
Bob Hudson, professor in the School of Applied Social Sciences at Durham University, offers five early lessons from the Greater Manchester ‘s devolution plans.
“Clarify the national-local settlement – we are accustomed to the idea of a national health service with across-the-board rights, standards and targets, but there will be little point to the devolution package if regional discretion is effectively curtailed.
“Sort out governance arrangements – we know there is to be a regional strategic health and social care partnership board to oversee developments, alongside a joint commissioning board. Little else is clear.
“Ensure providers are signed up – the parties to the agreement are the regional commissioners. The position of providers is less clear, though they have all attached “letters of support”.
“Engage with the people – the fact that the programme involves some accretion of power by democratically elected councils at the expense of unaccountable NHS bodies has perhaps served to obscure the issue of democratic governance.
“Get the politics right – the NHS is inherently political and it is naive to think these changes can be passed off as somehow technocratic. Powers over the NHS didn’t even figure in Osborne’s wider devolution agreement with Greater Manchester as recently as November 2014, yet only a few weeks afterwards the NHS devo Manc bombshell exploded without warning.”
Calling up a storm
Thomas Meek looks at the troubled history of NHS 111 in the first of a short series of features looking at the major healthcare IT initiatives of the present government in the run up to the general election.
“A “disaster”. A “disgrace”. “Extremely worrying”. “Significantly problematic”. A “total meltdown”. “Chaos threatening patient care”. These are just some of the terms that critics have used to describe the troubled implementation of the NHS 111 telephone service for non-emergency medical issues, since it was formally launched on a national scale in April 2013.
“The idea for a simple, three digit NHS helpline number was a Labour initiative. Towards the end of their time in office, ministers filed plans with Ofcom for a 111 number service to run alongside NHS Direct and 999. At the time, the idea was to run pilots. However, after the coalition came to power, new health secretary Andrew Lansley unexpectedly announced a national roll-out in August 2010.
“National roll-out was completed in April 2013, paving for the way for the closure of NHS Direct in March 2014. Since then, there have been periodic reports of problems, including high abandoned call volumes and long wait times. There have also been persistent reports that the service has actually led to an increase in ambulance call-outs as non-clinical staff opt for an emergency response rather than recommend another option to patients.
“Leading the criticism has been the BMA, which has stated several times over the past two years that NHS 111 is in need of radical change.
“The next immediate hurdle the service has to cross though is the general election on 7 May, although the result shouldn’t have a huge impact on the future of NHS 111 according to IC24’s Lorraine Gray.”
Highland Marketing guest interview
Clinically-led, mobile health technology is crucial for future care, Liverpool NHS CCIO Ian Bailey tells Rob Benson.
