NHS Tech Plan vision: Quarter of providers have no EPR

NHSX, the unit for digital and technology for health and care in England, has launched this week a document outlining the draft vision for transforming the use of technology across the system, as the country looks to provide ‘more joined up’, personalised and proactive services.

Following the publication of last year’s long term plan, it acknowledges the discrepancy between the “promise of technology” and the reality, as a quarter of providers have no electronic patient record and a third of social care organisations still run on paper.

“Visionary talk about AI and data will sound hollow to nurses who have to wait fifteen minutes to log on to their computers; in hospitals where patient data is stored in paper files at the end of the patients’ beds, where doctors cannot access GP records or test results without phone calls and faxes, and where the social care workforce have to rely on inconsistent paper records or faxed information when a patient is discharged into their care,” it reads.

The paper was made public a day before NHSX chief executive Matthew Gould confirmed on Twitter that the agency had appointed Sonia Patel as national chief information officer for health and care. Patel, who is currently the joint CIO for the London North West Healthcare and the Hillingdon Hospitals trusts, will be succeeding Will Smart, who is now with DXC Technology.

WHY IT MATTERS

“If we can get this right, there is huge potential to improve outcomes, the experience of patients, people in care, and staff, and productivity. The opportunities to improve health and care are almost endless,” NHSX states in the document.

But there are many hurdles in the way, starting from “varying levels of confidence and expertise”, “hundreds” of systems that do not talk to each other, and little scaling of innovative solutions.

“The barriers to adoption at scale are too high,” NHSX admits.

And it’s not only about the NHS; there are over 18,500 organisations in the social care sector, employing around 1.5 million people. But the integration between the NHS and social care is significantly lacking. According to a digital maturity assessment from 2017, at the time, less than 10% of people and carers could digitally access or update care records.

To address these issues and more, NHSX has set out five missions:

  • Reducing burden on staff;
  • Giving citizens access to tools and services that allow them to actively participate in their care;
  • Ensuring information can be accessed by those authorised whenever and wherever needed;
  • Improving safety; and
  • Increasing productivity.

To deliver them, the agency says it plans to work with stakeholders to set and support the adoption of standards enabling interoperability and integration between health and care, provide ‘targeted’ funding and further clarity on who pays for what, and more.

“The NHS is too big and unwieldy for unitary tech solutions to be the answer, the social care sector is similarly also too diverse. Equally, letting a thousand flowers bloom has led to the current situation, where literally thousands of different systems cannot speak to each other,” the paper reads.  

“The only way that tech can work in a system as huge as the NHS (which has a bigger GDP than Hungary) is for the centre to set clear, open standards, and enforce them. Local providers can make their own choices, and as long as what they do and buy is compliant with the standards then everything will slot together and systems will be able to communicate.”

Additional activities will also see NHSX set a model of “what good looks like”, which providers will be able to refer back to. The criteria will also be part of NHS’ improvement methodology and the inspections of the regulator of health and adult social care services, the Care Quality Commission.

Others will look at improving the sharing best practice, identifying ways to “better” support frontline staff and setting up a “small strategic commercial function” supporting the relationships between providers and tech vendors.

THE LARGER PICTURE

Since the launch of NHSX, there has been a lot of confusion around the future of NHS Digital.

NHSX’s new vision says it will set out a “more detailed breakdown” of the roles of each agency over the coming months. But it states that NHSX will continue to be the “guiding mind on the digital transformation of health and care” (vision, strategy), and NHS Digital the delivery organisation.

ON THE RECORD

In a statement shared on Twitter, NHS Digital said: “We welcome Matthew Gould’s NHSX vision for the role digital technology has to play both in the NHS and social care. We look forward to working with NHSX to deliver the technology platforms, services and solutions that will be needed to make that vision a concrete reality for everyone who works in health and social care, and for the people they care for.”

More information about the new vision for the tech plan can be found here. 

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