News in brief
Hunt: Patients to access entire record online by 2018: Jeremy Hunt has formally announced that patients will be able to access their entire medical record online by 2018, reported Health Service Journal (subscription required). Speaking at the Health and Care Innovation Expo in Manchester, the health secretary said the electronic records will be “read and write”, meaning patients will be able to add comments and correct errors in their records. However, Hunt admitted the NHS has “not won the public trust” in its use of patient data. GP records are already available online to many patients, but the health secretary said all patients would be able to access their primary care records by next year. All healthcare interactions will be available by 2018. He said that the move will empower and inform patients about the quality of care being provided. He added: “When patients start accessing their medical records they start thinking about their healthcare in a different way… when you have shared access you have shared endeavour.” Hunt also expanded on the idea of “intelligent transparency” that he introduced in speeches in June and July, while calling for a shake-up of NHS hours and ways of working, reported DigitalHealth.net. He said the first stage of this would involve publishing and sharing data, while the second would focus on making sure that the NHS learns from it. The third and final stage would be taking all that information and putting it into the hands of patients. “That’s the most exciting part of all,” he said.
Call to app developers to transform NHS services: The NHS is being urged to adopt a 21st century technology model using apps to benefit patients, reported Yahoo News. Life sciences minister, George Freeman called for the NHS to embrace innovation and adopt new technology to help lead the way in giving more personalised care. Speaking at the Health and Care Innovation Expo, Freeman said simple-to-use apps could help transform services and “empower” people into taking more responsibility for their health. The apps could help patients manage diabetes or stop smoking, and may also relate to mental health. Mental disorders are the largest cause of disability in the UK, affecting one in four people during their life with an estimated cost to the economy of £105bn per year. A call for developers has gone out from NHS England to receive a share of funding to develop new apps. Freeman said: “Nearly 6.5m patients can already book appointments and order repeat prescriptions online and three million patients are registered for online access to GP records. But we need to continue to encourage patients to use new technologies to better manage their health, care and treatment.”
Patient barcodes included among NHS England paperless aims: NHS England is pushing forward with plans to implement new governance measures for digital maturity next year that will require healthcare bodies and organisations to end ‘unnecessary use’ of paper in favour of new solutions like barcodes for patients, drugs and equipment, reported Government Computing. With clinical commissioning groups (CCGs) required by next April to set out their respective plans to eradicate using paper to support health and care services by 2020. Tim Kelsey, NHS England’s national director for patients and information said organisations in England had to curb their reliance on paper as a means of ensuring more efficient operations. “As well as saving precious resources, technology can dramatically reduce errors. Urgent action is a moral imperative where paper is the currency of clinical practice,” he said in a speech delivered at the Health and Care Innovation Expo. By November 2015, CCGs and care providers will be required to complete a self-assessment process benchmarking their use of digital technology and paper free records. This will in turn inform a digital maturity index detailing efforts in the NHS to make effective use of technology and setting out where improvements are needed.
Handbook ‘to define interoperability’: An interoperability handbook and procurement guide has been released to help clinical commissioning groups (CCGs) write their digital roadmaps and healthcare providers achieve the vision of interoperable patient records, reported DigitalHealth.net. Inderjit Singh, NHS England’s head of enterprise architecture, said at the Health and Care Innovation Expo in Manchester, that the interoperability handbook will support CCGs in preparing their plans for going paperless by 2020, which need to be submitted by next April. Singh said these roadmaps will define and articulate where CCGs want to get to and a new “digital maturity index” will define where they are now. The handbook is intended to help them get between these two places. It will reiterate the “interoperability strategy” that was first released as part of one of the National Information Board’s workstreams. These are taking forward the latest NHS IT framework, “Personalised Health and Care 2020”, which was itself issued to support the “Five Year Forward View” plan to save the NHS £22bn by 2020-21. The handbook will give options for how to achieve the interoperability strategy’s ultimate aims and outline the standards, policy and guidance organisations should be looking to consider when planning their digital journeys. Singh said the handbook will help to define what is meant by interoperability as it is “an overused and overly technical word”.
Mental health apps given prize fund: A £650,000 prize fund to develop new mental health apps for the NHS has been announced by life sciences minister George Freeman. Speaking at the Health and Care Innovation Expo, Freeman said that mental health disorders were the “single largest cause of disability in the UK”, affecting one in four people, and costing £105 billion a year. He argued that it was therefore essential for new, digital services to be developed for those living with mental health issues, reported DigitalHealth.net. The fund will be handled by NHS England. Freeman also re-announced plans to create an “endorsement” model for NHS apps, which he said would “ensure that patients and professionals can identify which digital health apps are safe and effective to use.” The plans, which were initially billed as a “kitemark” for health apps, were first announced in November 2014, as part of the “Personalised Health and Care 2020” IT framework for the NHS. The development of the endorsement model has been taken forward by the National Institute for Health and Social Care Excellence, Public Health England, and the Health and Social Care Information Centre. Freeman told the Expo that the work should be piloted this month, and rolled-out in 2016.
NHS can be the home of the Innovation Revolution: The NHS has the opportunity to become the “go-to place for innovations”. That is the view of Sir Bruce Keogh, NHS England’s national medical director, who this week refuted any suggestion that the health service is slow to embrace or develop innovations, but did concede that it is often too slow to exploit them. Sir Bruce was speaking during a panel debate at the Health and Care Innovation Expo which included a discussion around the NHS Innovation Accelerator programme. Around 140 innovators applied for the scheme, with the 17 chosen so far announced in July. Keogh said: “There’s been a lot of debate about our NHS, but one of the things often levelled at us is why we are so slow to embrace innovations. I don’t accept the argument that we don’t develop innovations, but I do accept that we are often too slow to exploit them. We have an opportunity in our NHS to be the go-to place in innovations.”
HSCIC launches cyber security service for health and care: The Health and Social Care Information Centre (HSCIC) has set up a cyber security service to manage risks to data in health and care, reported Computer Weekly. The care computing emergency response team (CareCERT) aims to enhance cyber resilience across health and social care. The CareCERT service will begin launching functionality in a phased approach from autumn this year, with the full go live in January 2016. Funded by the Cabinet Office’s national cyber security programme, CareCERT will provide incident response expertise for managing cyber security incidents and be a central source of security intelligence. It will also provide best practice and guidance for organisations, as well as supporting the analysis of emerging and future threats. Rob Shaw, HSCIC director of operations and assurance services said he hoped that CareCERT will be a “valuable resource for the health and social care sector, providing best practice guidance to support organisations to keep their information safe and secure”.
Inquiry launched after HIV clinic reveals hundreds of patients’ identities: Health secretary, Jeremy Hunt, has ordered an inquiry into how the NHS handles confidential medical information after the “completely unacceptable” breach of the privacy of hundreds of HIV patients, reported The Guardian. The 56 Dean Street clinic in London apologised this week after sending a newsletter which disclosed the names and email addresses of about 780 recipients. The newsletter is intended for people using its HIV and other sexual health services, and gives details of treatments and support. Hunt said the Care Quality Commission would conduct what he called a thorough and independent review of the effectiveness of existing data security measures in the NHS and recommend changes. It will also look into how the NHS can beef up its security against cyber-attacks and reduce the risk of staff inadvertently disclosing sensitive information. Hunt said the inquiry was vital to ensure patients could be confident that the health service will properly safeguard details of their health and treatment records. “The truth is that we will throw this all away if we lose the public’s trust in our ability to look after their personal data securely,” he said.
CCGs given ultimatum over ‘paperless’ progress: Clinical commissioning groups (CCGs) face having their plans for 2016-17 rejected if they do not show progress in meeting standards set out in new digital guidance, an NHS England director has told Health Service Journal (subscription required). The guidance, published this week, is designed to help local health economies create “roadmaps” setting out how they intend to provide “paper free” care at the point of delivery by 2020. NHS organisations that do not roll out universal digital care records by 2020 face having their funding to provide care removed, NHS England’s national director for patients and information Tim Kelsey has said. Performance on the use of digital care records will be assessed against national data quality standards, which will form part of the Care Quality Commission’s inspection regime from April. CCGs will lead on creating the roadmaps, but it is up to them whether they work individually or collaborate with other organisations to identify the footprint their plans will cover. Local commissioners will need to inform NHS England the footprint their roadmap will cover by November. The data standards will be announced next month, while the roadmaps will need to be completed by April 2016.
Upgraded NHS Spine communications hub saves £20m in first year, says HSCIC: The NHS Spine – the health service’s communications hub that connects key IT services – has saved more than £20m in its first year, according to the Health and Social Care Information Centre (HSCIC). One year after the upgrade of the infrastructure behind the NHS Spine platform, the running costs of the system – which is used in all NHS organisations and handles up to 1,800 electronic transactions per second – have been cut by £21m compared to the previous version, reported Computer Weekly. The Spine is available around the clock and transfers around 400 million messages per month. It has reduced system response times by almost 90%, resulting in 750 saved hours across the NHS every day, according to the HSCIC. HSCIC’s director of operations and assurance services Rob Shaw said that, although the Spine has improved significantly, there remains work to be done. “We have deliberately designed the system to be flexible and adaptable to the needs of individual care organisations, which means it best meets the needs of NHS staff with new systems; improved speed and functionality,” Shaw said.
London to roll-out eRedbook: A handful of London trusts are about to start trialling the eRedbook child health record, ahead of a capital-wide roll-out over the next couple of years, DigitalHealth.net reports. Three or four London trusts will test the electronic version of the “Red Book” given to all new parents, in which immunisations, tests, and key developmental milestones are recorded. The eRedbook was accredited by the Royal College of Paediatrics and Child Health in November last year, and was strongly supported by health secretary, Jeremy Hunt, as part of his call for an overhaul of NHS working practices. Kenny Gibson, NHS England’s head of early years, immunisation and military health, said: “What we want is a secure platform for screening, immunisation and health checks that parents can own and be proud of. We would also like to add apps that provide information and support.” The intention is that all 32 boroughs of London and all clinical commissioning groups will use the eRedbook, with roll-out starting next year and continuing into 2017 and 2018.
Christie NHS Foundation Trust deploys Tableau software to better patient care: The Christie NHS Foundation Trust, one of the largest cancer treatment centres across Europe, is using Tableau business analytics software in order to improve data delivery and develop patient care, reported Integrated Care Today. The trust is reportedly now home to an online portal for its medical staff, which can be used to access key information. Another healthcare centre using Tableu is the Claire House Children’s Hospice, which uses its software to help obtain and understand its data. Daniel Tibble, head of business intelligence and software development at the Christie NHS Foundation Trust, said: “It’s about putting data in the hands of the decision makers when they need it. A lot of our dashboards centre on vital patient-care delivery, so anything we can offer that makes that faster and better directly contributes to better medical care.”
Peterborough latest to Evolve records: Peterborough and Stamford Hospitals NHS Foundation Trust is planning to have fully implemented Kainos’ Evolve electronic document management system by this autumn, reported DigitalHealth.net. The trust received £792,000 from NHS England’s ‘Safer Hospital, Safer Wards: Technology Fund’ to support the installation as part of a drive to cut the use of paper records. A spokesperson confirmed: “The electronic document management system will be fully implemented by the end of the year; however we are aiming for an autumn completion.” The board papers said that staff are currently taking part in training sessions for the system and that some members of a staff who are more mobile, such as therapists, will have access to the system on iPads. In June this year both Poole Hospital NHS Foundation Trust and The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust went live with the system.
Provide same-day advice to reduce A&E attendances, GPs told: A directive announced by NHS England will ensure that GPs see or speak to patients seeking urgent advice on the same day that they receive the request. This is one in a long list of “best practice” guidance for GPs that has come out of NHS England’s major review into how urgent care services can be reorganised so that fewer people attend A&E departments and are admitted to hospital in an emergency, reported Pulse. Others include asking GPs to prioritise urgent home visit requests, do morning rounds with patients in community care beds, participate in regular meetings of the local “system resilience group” – the multidisciplinary groups set up to improve urgent care planning locally – and risk-stratify frequent users of mental health support services. The Transforming urgent and emergency care services in England document said that “the overall aim should be that no patient should have to attend A&E as a walk-in because they have been unable to get an urgent appointment with a GP”. The report said: “These may include telephone consultations, e-consultations and walk-in clinics, as well as face-to-face appointments. Channelling patients into a single, rigid process inevitably disadvantages some, can lead to ‘gaming’ of the system and may lead to inappropriate use of emergency departments.”
NHS funding splashed on holidays, games consoles and summer houses: Millions of pounds of NHS funding have been spent on luxury goods such as summer houses, holidays and pedalo boats, under a scheme to give patients “personal health budgets”, reported Pulse. Information obtained under a Freedom of Information Act shows that clinical commissioning groups in England predict a spend of over £120m this year for 4,800 patients on the personal health budgets scheme. Since October last year, all eligible patients have had the right to hold a personal health budget, which allows them to spend NHS cash as they wish. NHS England’s Five Year Forward View has called for a “major expansion” of the scheme. A NHS England spokesperson said: “Personal health budgets are designed to meet identified health needs in ways that give patients more control over the care and support they receive. The spending must be agreed between the individual and the NHS. An independent evaluation of the personal budget pilots – led by the Personal Social Services Research Unit at the University of Kent – found there was a significant improvement in the quality of life and psychological wellbeing of the patients and a reduction in hospital costs.
NHS staff offered Zumba to stay healthy: NHS staff will be offered exercise classes in a bid to keep them fit and in work, NHS England’s chief executive has announced. Simon Stevens outlined his £5m solution for cutting the NHS bill for staff sickness, which currently stands at £2.4bn a year, reported the BBC. He said hospitals can help staff stay well by serving healthy food and running Zumba and yoga classes. He added that GPs should be offered specialist support to avoid burnout. Creating healthy and supportive workplaces was no longer a “nice to have, it’s a must do”, he told the Health and Care Innovation Expo this week. Organisations will be asked to provide staff access to physiotherapy, smoking cessation and weight management services, as well as sports or exercise classes. And they should offer health checks for mental health and musculoskeletal problems – the two biggest causes of sickness absence across the NHS.
Awards
Healthcare IT champion of the year: The voting is now open to find this year’s eHealth Insider Healthcare IT Champion of the Year. Click here to view the shortlisted candidates. Voting closes on Friday 11 September at 4pm. Good luck to all shortlisted individuals. The winner will be announced at the EHI Awards ceremony on Thursday 1 October 2015.
Opinion
Kelsey: Urgent action on a digital NHS is a moral imperative
The online revolution that has transformed so much of the rest of our lives doesn’t support us nearly well enough as patients, citizens or caregivers. The NHS needs to take advantage of new technologies and improve digital record keeping and online services, says Tim Kelsey, national director for patients and information.
“In April, England became the first country in the world to offer citizens the ability to access their GP records online and other digital services in primary care. In the first quarter of this year, more than 3.7 million repeat prescriptions were ordered online. More than 3 million people have registered for record access.
“More than 96% of people registered with a GP now have a summary care record, and more than a third of ambulance services now share that patient information in real time with accident and emergency departments and out of hours services. It means clinicians can treat patients more safely based on knowledge of their medication history and especially allergies and other likely adverse reactions to drugs.
“But much more needs to be done. The online revolution that has transformed so much of the rest of our lives does not support us nearly well enough as patients, citizens or caregivers. Hospitals and other providers lag behind general practice in digital record keeping and in patient facing online services.
“Patients are put at risk where paper is the currency of clinical practice. The evidence is clear: electronic prescribing systems that support clinicians to ensure the right medicine is provided to the right person in the right quantity halve medication errors. Yet only 14% of NHS hospital trusts currently deploy these systems.
“Without interoperable digital data, high quality effective local services cannot be delivered. Nor can we achieve a transformation in patient access to new online services and “apps”. Nor will the NHS maximise its opportunity to be a world centre in medical science and research.”
Will NHS.UK be the next GOV.UK?
James Higgott, digital communications manager at The King’s Fund, writes: “When Jon Rouse presented his part of the plans to improve digital services for the health and care sector at the National Information Board meeting in June he focused on just one thing:
“Our number one priority is that we create a single portal. All services [will] start and end with that single portal. Services are developed against consistent standards, with a consistent look and offer, and can be all accessed through that single portal with customers coming in through multiple channels. I haven’t got time to talk about the rest.”
“Currently, only a quarter of NHS acute trust websites are designed to work on mobile devices, even though smartphones are the most important device for internet access. Similarly, 97% of the population may now be able to book GP appointments or access medical records online but if their experience was anything like mine they will have to request a username by phone or post and pick up the confirmation letter in person, the appointment form won’t work on their smartphone and they’ll find that the practice’s computer system has gone down.
“NHS digital teams up and down the country lack the resources to deliver quality digital services. Giving them all hundreds of thousands of pounds to build or procure digital services is not sustainable. Handing this responsibility for digital services to a central body with the necessary expertise and resources could be.
“The challenge facing NHS.UK is complex. For example, building the new online system for selling motor vehicles was essentially a self-contained DVLA project. For NHS.UK to be able to handle appointment bookings and cancellations it will need to integrate with hundreds of NHS trusts, thousands of GP practices and the myriad back-office systems that implies.
“Transform it must. Good-quality digital services, from booking appointments to accessing your personal health record, will improve the patient experience and provide efficiency savings, and right now NHS.UK looks like the best way to achieve this.”
Data presents the health service with vast and diverse opportunities to dramatically improve outcomes for patients
Healthcare leaders agreed that securing the public’s trust in the safety of their medical data and how it will be used to is vital to maximising the opportunities that technology has to offer in improving care.
Commenting at a debate at the Health and Care Innovation Expo conference, leaders reached the following conclusions:
NHS England’s national medical director Professor Sir Bruce Keogh said: “The decision to publish surgeons’ individual outcome data was unpopular at the time but it was the right decision. It has encouraged surgeons to focus on their own results. It has also equipped patients with information that enables them to have meaningful conversations with their surgeons.”
US chief technology officer Susannah Fox said: “I imagine data as a pipeline that we need to open up at every stage: for patients; for clinicians and for the population.”
There was also strong consensus that gaining patients’ confidence in the NHS’s ability to protect confidential medical information and that it would only ever be used to directly improve patient care was key. The group recognised the importance of clear communication and simple methods for patients to use to opt out of sharing their data if that’s what they decide they want to do.
Sir Bruce added: “People need to be able to trust that we’re going to keep their data safe and that we would only share it for the right reasons, which is to improve care.”
David Behan, chief executive of the Care Quality Commission said: “We need to find a way of instilling a level of confidence in people in the data we hold and how that is going to be used.”
Macmillan chief executive Lynda Smith said: “We can’t underestimate the challenges but we also can’t overestimate the benefits that this will bring.”
Blog
The NHS went back to school this week and the first lesson in was health technology, blogs senior communications manager Rob Benson.
