Jason Gordon

Closing the NHS Funding Gap: Review of HealthInsights seminar

Jason recently attended a HealthInsights seminar in London where many of the sharpest NHS minds gathered to discuss the importance of interoperability and how it will help save billions.

It’s not exactly breaking news that the NHS have a funding gap of £30bn to close by 2020. But the way in which they plan to achieve this is interesting.

One word: Interoperability.

I recently attended a HealthInsights  seminar in London where many of the sharpest NHS minds gathered to discuss the importance of interoperability and how it will help save billions.

Interoperability refers to the ability of two or more information systems to share, communicate and co-operate. Accurate and easily accessed health data expedites speedy and appropriate care, which can have a life-influencing impact on patients. But information needs to be accessible by every health and social care provider who comes in contact with the patient. 

Consider what happens when a patient from Kent arrives at an Aberdeen hospital unconscious. The availability of shared health data could be critical to the patient’s survival.

Humans will always be the most effective interface with a patient for gathering information but the sheer scale of data which the NHS handles across the UK, means digital technology is the only viable option. 

Kingsley Manning, Chair of HSCIC, stressed that there has to be a practical solution to the sharing of data and that timelines are key. He describes the  sharing of data on referrals as ‘a disgrace’ as staff await a 2nd class letter arriving. Quality of data is also crucial. According to Manning, the error rate in primary data across the NHS is 20% - a worrying statistic.

As data solutions are sought, patient experience must remain at the centre.
What are the patient’s needs and how can clinical professionals meet them?  When care is shared across departments and organisations, at local and national levels, they need to be able to communicate effectively. If a local authority has one system and the health trust cannot communicate with it how effective will transfer of care be?

Paul Rice, Head of Technology Strategy NHS England, highlighted that if the NHS is to become paper free at the point of care, the EHR (Electronic Health Records) must be viewed as an interaction method - not a digital typewriter.
Commissioning boards must confirm a footprint, get assessed and articulate their roadmap. It’s not only important to have a system but also to focus on the measurement and management of this system. PAS (Patient Administration Systems) play a key part in local digital roadmaps, and they must be interoperable.

As they develop their digital roadmaps, CCGs need to start with the end in mind - to implement EPRs into single accounts that cover the full care remit;  mental health, community care trust, social care etc. The goal is to increase patient safety and efficiency and this needs to be the driving force as interoperability progresses.

Finding the right technology seems to be a problem.There is no ‘one size fits all’ solution and software vendors are a little bit behind the curve on this. Having said that, it’s recognised that there needs to be greater commercial incentive for companies to work with and innovate for the NHS. 

There is a growing sense of frustration amongst NHS stakeholders with regards to the sharing of information, with many pain points identified at this seminar. 

Should patient data be shared locally or nationally? Should this be dictated centrally (as it would in the corporate world) or should Trusts/Commissioning Groups maintain their autonomy? What does the NHS do with legacy systems that don’t communicate?  What is the key driver for interoperability - to improve care or save money? This of course is the million dollar question, of which the answer should be the former, but in reality is probably the latter.

One thing is apparent, clear direction needs to be given centrally, particularly with regards to procurement, if the CCG’s are to appropriately develop and deploy their digital roadmaps.

Of course it’s vital that accessibility is woven into the roadmap from the ground up. Accessibility of patient health information is key for the NHS going forward and reasonable accommodation for the 1 in 5 adults who currently can’t or don’t access the internet needs to be built in. There are solutions:  assistive technology like screen readers, magnifiers and translation software can help solve many of the problems, particularly for people with disabilities.

A final word? Professor Michael Thick - Chief Medical officer & Chief Clinical Information Officer, stressed that it’s not just technology which can save the NHS money - we all have a part to play. To make lasting savings the NHS must move from Illness to Wellness where citizens have co-responsibility for their health, and accordingly have choices and responsibilities. There’s a lesson for all of us right there.


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