The Department of Health’s long-awaited Information Strategy is finally here. It sets out an ambitious ten-year framework for public health, health care, and social care information. Will the strategy transform health and social care information as we know it today?
Information is the cornerstone of an effectively functioning health and social care system. It must also support service users, and public accountability to demonstrate that taxpayers’ money is well spent. While the NHS is data-rich, this information doesn’t always serve the needs of its users well. A strategy that makes NHS information more fit-for-purpose in meeting the increasingly complex health and social care needs of its users is long overdue.
The Information Strategy makes strides in this direction. Putting more information in the hands of patients and increasing transparency of information about the quality and outcomes of services, has enormous benefits in terms of enabling people to take control of their health and make decisions about it. The government’s proposal for a single, trusted portal for information, alongside a diversity of information providers, will also facilitate this. The aim of giving patients access to their GP records by 2015 will be challenging, as Dame Fiona Caldicott, chair of the National Information Governance Board, has warned. But it is the right way forward for a modern, caring and empowering NHS.
Enabling greater use of better data by clinicians to improve the quality of care is of paramount importance, especially when the NHS has to do more with less. Clinical audit data is trusted by clinicians but its use in the NHS has been unnecessarily tardy. The strategy’s push on this is very welcome. Setting data standards gets the priority it deserves as data quality and consistency are all-important if data is to have any value. But will the NHS Commissioning Board have the skills and capacity for this highly specialised role? It is crucial that compliance with data standards is monitored, but the Care Quality Commission may not be best placed to take this on in full given the significant challenges it already faces. Publication of regular data quality bulletins for all providers – including non-NHS – by the Information Centre, with the Commission using its leverage with providers where compliance appears weak, may be more pragmatic.
Given how over-ambitious IT projects such as the National Programme for IT (NPfIT) can go over-budget and under-deliver, the strategy does well to steer clear of this way forward. The goal of linking health and social care records is the right one and is vital for facilitating integrated care to meet the needs of older people and those with chronic conditions. But implementation of this nationally will require new investment locally in IT systems and supporting infrastructure and services, for which no extra funding is available. At a time of unprecedented financial constraint for the NHS, some commissioners and providers will find it challenging to invest in developing information systems rather than frontline services.
Health and social care data are at very different stages of development. While there are some outstanding local examples of record linkage across services, the landscape varies, with many tortoises for every hare. The technical challenges will be particularly acute for social care. As the strategy acknowledges, local authorities lack the capacity and skills in using information other than for administrative purposes and many social care providers lack electronic care records. This is a big mountain to climb on skimpy rations, and progress is likely to be patchy, incremental and determined by local buy-in.
The strategy says relatively little about the availability, timing and quality of information on the quality of care delivered by non-NHS providers, and its comparability with NHS data. With the policy of ‘any qualified provider’, both commissioners and patients need this information to make informed choices.
Will the strategy lead to a transformation in health and social care information? Unlikely in the short to medium-term. But the strategy makes the most of available information and takes its development in the right direction.