News in brief
Tech fund 2 money may return – Hunt: Nearly £200m slashed from NHS England’s technology fund may be reinstated in future as part of a “staged roll-out”, health secretary Jeremy Hunt has said. Hunt made the claim at London’s e-Health Week conference, where he stated the government’s commitment to funding innovation in health IT despite the drastic cut. When asked by eHealth Insider to comment on the cuts to the ‘Integrated Digital Care Technology Fund’, Hunt said: “What we’ve actually done with the tech fund is stage the roll-out rather than cut it in absolute terms.” The second round of the fund was launched in May last year to help fund the development of integrated digital care records and other IT projects, and received more than 226 bids from NHS organisations and local authorities.
NHS Code4Health programme will improve digital literacy for clinicians: National director for patients and information at NHS England, Tim Kelsey, launched the NHS Code4Health programme at UK e-Health Week. NHS Code4Health will provide doctors, nurses and care staff with specialist training and support to create and deliver their own IT programmes and products to increase their involvement in the development of online tools that will directly lead to improved care. NHS staff can apply for programmes including ‘App in a day’ which takes delegates through the entire process of App development from design to delivery in just one learning session. Beyond the training, the aim of the programme is to bring together like-minded individuals and organisations of all sizes to form communities where they can share ideas, insight and tools on how to improve healthcare through the adoption of technology. Tim Kelsey, national director for patients and information said: “Finding the best innovations in health and social care and spreading them to every corner of the system is crucial to ensuring services evolve to meet the changing needs of patients.” Code4Health is a key part of the National Information Board’s Framework for Action, Personalised Health and Care 2020.
Focus on targets in NHS poses threat to patient care, says think tank: A “targets and terror” approach to ensure large hospital A&E departments in England treat, admit or discharge 95% of patients within four hours may undermine their care, a former senior NHS official told the Guardian. Senior managers in hospitals are so busy collecting information on how they are doing each week to satisfy regulators, NHS bosses, health commissioners and politicians that they are not sorting problems on their own frontline, Edwards and two co-authors claim in a briefing paper. Major A&Es have not hit the 95% mark since summer 2013 despite all the attention paid to weekly figures in recent months, they say. But emphasis on the four-hour measure distorts the picture of how big hospitals are doing in the face of a 12% increase in attendances at their A&E units and a 27% increase in emergency admissions in a decade. The A&E rise is “entirely in line with what would be expected based on population growth”, according to the paper, which warned that 17,000 extra hospital beds could be needed by 2022 unless more could be done to treat people outside hospital.
Election won’t stop 5YFV – Stevens: The “success or failure” of the new models of care outlined in the NHS ‘Five Year Forward View’ depend on the contribution of healthcare IT, NHS England chief executive Simon Stevens announced at UK e-Health Week. “Getting technology and information right over the next five years is going to be essential for the transformation that we need,” said Stevens. His Five Year Forward View, published last autumn, sets out a plan to improve public health and introduce new, efficient service models to try and bridge the gap between flat funding and rising demand by 2020-21, reported eHealth Insider. This gap, known as the Nicholson Challenge after his predecessor, who first warned about it in 2008, could reach £30 billion without action. Stevens reflected earlier speeches when he outlined four trends that technology is bringing to healthcare: greater use of data highlighting the need for more transparency; the personalisation of care, such as targeted cancer therapies; the need for a more anticipatory care model; and the transfer of power to patients rather than healthcare professionals.
NHS England to launch care.data standards testing within weeks: NHS England expects over the next few weeks to begin the testing of standards required to address concerns that have delayed the launch of its controversial care.data scheme, reported Government Computing. Tim Kelsey, NHS England’s national director for patients and information, said the outcome of these tests would be used by National Data Guardian Dame Fiona Caldicott to determine if the organisation has ensured extra legislative safeguards were in place to address concerns she previously raised over the programme. Aimed to link up primary care and hospital information, the launch of the programme was delayed from last year due to criticisms of NHS England’s attempts to explain the implications to patients of how their personal information would be collected and shared between different organisations.
EPRs ‘could prompt med neg claims’: The growing use of electronic patient records (EPRs) could encourage a culture of “electronic ambulance chasing” as people hunt for evidence of medical negligence, according to new research. The paper from the University of Birmingham, published in the British Journal of General Practice, said that the “uncompromising documentation of events” in EPRs may lead to a corresponding rise in the likelihood of lawsuits against clinicians and hospitals, reported eHealth Insider. Tom Marshall, the paper’s author and professor of public health and primary care at the university, said that while patients or lawyers requesting electronic records is a common part of the litigation process, the growing use of EPRs could reverse the normal process for negligence lawsuits. “Previously, a patient who has experienced an adverse event first decided to take legal action and then, having initiated legal action, might request their medical records. Now, because it is much easier to search electronic than paper records, a patient who has experienced an adverse event could first request their medical records and then initiate legal action.” Marshall said that to demonstrate medical negligence, a claimant must show that the doctor failed to meet the required standard of care, with electronic records required to be disclosed to claimants on request.
Mobile technology represents future of NHS healthcare, agree former Labour and Conservative health ministers: Smartphones, mobile applications and other new types of information technology will be crucial in enabling better, more personalised healthcare in the NHS in years to come, reported Computing. Those were the views of former secretaries of state for health – Alan Milburn and Stephen Dorrell MP. Both voiced their support for the use of the latest technology in the NHS during a discussion on healthcare priorities for the next government at the UK e-Health Week. “What we need to do is incentivise people to be healthy and kept out of hospital rather than incentivising them to come in,” Milburn said during the discussion hosted by Mike Farrar, former chief executive of the NHS Confederation. Milburn told the audience that it was important for the patient “to be a player on the pitch, rather than a spectator”, before going on to suggest mobile devices and apps represent the best way of achieving that. “Technology is the means to that end. The most exciting things I see anywhere in the world now in healthcare are on this thing,” he said, holding up his smartphone. Stephen Dorrell agreed saying: “The use of modern technology, information technology, allows a change in the relationship between patients and healthcare. It should enable healthcare to be much more effective.”
NHS Choices to broaden audience: The NHS Choices website must expand beyond its current audience of “healthy, wealthy mums” to meet the needs of elderly and poor citizens, NHS England’s head of digital services told eHealth Insider. Helen Rowntree discussed the organisation’s plans to improve NHS Choices as part of the National Information Board’s IT framework at UK e-Health Week. Rowntree said one of the main priorities for NHS Choices was to join up “disparate services” such as prescription ordering, appointment booking and the e-Referral Service replacement for Choose and Book into an integrated platform that can be accessed through the site by June 2015. “There’s a tendency to design digital services in isolation without thinking about what happens when someone turns up to the GP practice to do x and y, and what happens between those visits.” Rowntree said NHS Choices will also host an app store for “high-quality, safe, evidence-based apps that we can say to the users of the website: ‘This is something that we recommend and it’s safe to use’.”
New study links healthcare IT maturity with improved clinical outcomes in NHS: A correlation between the maturity of IT within NHS hospitals and improvements to patient outcomes has been distinguished in a new study from HIMSS UK, reported Digital by Default News. The research, which combines data from 91 NHS hospitals in England together with HIMSS Europe’s proprietary EMRAM capability data (Electronic Medical Record Adoption Model) demonstrates that those hospitals that have a score of EMRAM Stage 4 and above, have a lower Summary Hospital-Level Mortality Indicator (SHMI). John Rayner, director of professional development, HIMSS UK said the findings are a key justification of the investment in healthcare IT going forward: “This report asks us to accept as a general principle that hospitals that are more digitally mature can provide greater levels of patient safety and are more productive than hospitals that have not made investments in technology.”
Charities should be preferred NHS providers, says Andy Burnham: Charities could get 10-year contracts to help deliver NHS services if Labour wins the general election, the shadow health secretary, Andy Burnham, has told voluntary sector leaders, reported the Guardian. Not-for-profit care organisations would be given “a form of preferred provider” status under legislation that a Labour government would introduce to replace parts of the coalition’s 2012 Health and Social Care Act. The move would recognise their contribution to strengthening communities. The announcement came as Burnham sought to allay fears in the voluntary sector that his plan to restore NHS trusts’ preferred provider status for delivery of health services would hit charities as well as private companies. It fleshed out a commitment in Labour’s 10-year plan for health and care, unveiled in January, to give voluntary sector providers “longer and more stable arrangements” than for-profit contractors.
CQC to begin inspections of NHS 111 services: The Care Quality Commission is planning to inspect and rate NHS 111 services based on the model it uses for GP services, it has announced. The regulator said it will begin inspecting NHS 111 services from June, and expects to finish by September next year, with services to be inspected every three years, reported Pulse. It will inspect whether the services are ‘safe, effective, caring, responsive to people’s needs and well-led’, which is based on the model used for GP services. However, it has said that it will rate NHS 111 services according to the six population groups used for GP practice inspections – older people; people with long term conditions; families, children and young people; working age people; vulnerable patients; and people with poor mental health – arguing that providers do not have ongoing responsibilities for their populations in the same way that GP practices do.
Safe staffing app to ‘revolutionise’ NHS nursing rotas: A mobile “app” is set to revolutionise the collection of safe staffing data by drastically reducing the time taken to record and analyse information, according to nurses behind its development. They say it will cut paperwork and help ensure data used to set staffing levels is up to date, reliable and easier to analyse. Their vision is for nurses to use the technology every day to provide real-time information to inform staffing rotas. The official Safer Nursing Care Tool app will be available to all trusts free of charge from April this year, Nursing Times (subscription required) has revealed. The innovation has the backing of the Shelford Group of leading NHS trusts, NHS England and the Health and Social Care Information Centre. The app, designed to run on iPads, is based on the existing Safer Nursing Care Tool – itself developed by senior NHS nurses and the only such tool currently approved by the National Institute for Health and Care Excellence.
Open source EPR and PAS support now available over two major government frameworks: NHS organisations can save time and money when procuring a range of implementation and support services for open source electronic patient record (EPR) and patient administration system (PAS) software as IMS MAXIMS announced its place on two major procurement frameworks, reported Building Better Healthcare. IMS MAXIMS has been appointed as a supplier on the recently-launched £1.25bn NHS Shared Business Services (NHS SBS) framework and the UK Government’s new G-Cloud 6 marketplace. Both initiatives allow public organisations such as NHS trusts to avoid a full OJEU procurement, a process that consumes significant resources for purchasers. Digital services can be procured ‘off the shelf’, avoiding lock-in to expensive contracts with single suppliers, and encouraging cost-effective, innovative solutions. Shane Tickell, chief executive of IMS MAXIMS, said: “These framework awards represent another significant step in our open source strategy. Making our code available to the NHS aimed to ultimately help implement more-tailored, efficient systems at a far greater pace and far lower cost.”
RCN and IPS call for greater clarity on infection prevention and control: The RCN and the Infection Prevention Society (IPS) have published a joint paper highlighting concerns over the impact of fragmentation with infection prevention and control arrangements within the health service in England, reported Nursing in Practice. The paper points to the complexity that now exists within the health service and the ongoing impact of this. Restructuring of NHS services and the transfer of responsibilities following the Health and Social Care Act 2012 has resulted in the loss of some specialist infection control expertise and a lack of central oversight of the situation as the threat of antimicrobial resistance increases. Rose Gallagher, the RCN’s professional lead on infection prevention and control, said: “Quality commissioning to enable high standards of infection prevention and control is as important as clinical practices when caring for patients.”
Opinion:
GP Neil Paul wonders why an “implementation gap” so often opens up between a simple idea and actually doing it; whether that’s handing out tablet computers, or providing remote access to records and systems.
“One of the local mental health trust consultants complained that the clinical commissioning group had put a CQUIN (quality payment) into a contract, requiring the trust to let a GP know within a day of any changes to a patient’s medication. The idea was to reduce the clinical risk to the GPs; but no one was giving her an up to date list of the patient’s medication from the GP system. She felt this put her at increased clinical risk and she didn’t want to be grilled in coroner’s court about drug errors. Couldn’t we do something about it?
“The other day one of our new salaried docs moaned to me about trying to set-up remote access. He’s really keen to check his results on his days out of the practice so that when he gets in he doesn’t have a huge pile of stuff to do.
“It took me by surprise when I got an account on the University of Liverpool computer system. I logged on from home, filled in some details, and downloaded the latest Citrix client to my Mac from their site. And – hey presto! – I was on their shared desktop using all their apps without any problems on my Mac. It just worked. Which leaves me wondering are university IT departments better than NHS ones?
“Frankly, I can’t see why, if Emis is on a central server accessible on the internet, I can’t just fire up a browser and access it from any device with a security token and/or smartcard. But perhaps that’s a different point. If someone could explain why implementation gap exists to me – it can’t just be PID – let me know.”
Online therapy and technology can turn round tragic suicide numbers
Secure online sessions give greater access to therapy for people with mental health problems, says Sarah Bateup, the clinical lead at Ieso Digital Health.
“The latest Office for National Statistics data, published last month, revealed a 4% increase in suicides – 252 more people killed themselves than in the previous year. These are truly awful figures. But we could have stopped many of them. Suicide is the culmination of a series of triggers or factors that lead to a slide into mental ill health. That means it is preventable in many cases.
“Discretion is vital for bringing down the suicide rate. Men account for more than three quarters of suicides and yet they find it the hardest to seek help, because it is perceived to be “unmasculine” to admit vulnerability or ask for support. Online therapy may not entirely remove the stigma men suffering from mental ill health face but it circumvents it.
“Of course, while the number of suicides represents its most devastating effect, the impact of mental ill health on society goes far deeper. The wider challenge posed by mental illness is huge – it is estimated to cost the UK economy up to £100bn a year thanks to sickness absence, lost productivity and benefit costs. It is a problem that is simply too big to ignore any longer.”
Why wearable technologies offer a prescription for better healthcare
Rob Clark, vice president of business development at Epson Europe, talks about the increased interest in wearable technologies and how they can improve healthcare services.
“One of the key advantages of using wearable technologies is the mobility it allows. Hospitals will be able to switch to wearables that monitor all vital parameters, allowing patients to walk around without attachment to a traditional medical monitor. Furthermore, patients could be given wearables to use before, during and after treatment in order to monitor its effects remotely.
“Healthcare practitioners could monitor a patient’s health remotely, and over time, by accessing the stored data and ‘ring the alarm’ when vital statistics indicate medical intervention is needed.
“According to Credit Suisse, the overall wearables industry is already worth up to $5billion; and with nearly 50,000 health apps developed around the world, and more and more work being done to build new applications, wearables are set to become a powerful tool for innovation in healthcare. ABI Research has also predicted that more than 100 million wearable wireless medical devices will be sold annually by 2016.
“The potential for wearable technology to positively disrupt the healthcare and wellness industries is significant. Only time will tell whether we as a nation are able to put them to good use and curb the pressure that global trends are set to place on our society.”
Blog
Will Simon Stevens get communications right on a five year mission of NHS change, asks Matthew D’Arcy in this week’s blog.
