A digital NHS? An introduction to the digital agenda and plans for implementation

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In recent years, the digital agenda in health care has been the subject of an array of promises and plans, ranging from the Secretary of State’s challenge to the NHS to ‘go paperless’ to the commitment set out in the NHS’s Five Year Forward View to ‘harness the information revolution’. But have expectations been set too high? And is there sufficient clarity about the funding available to achieve this vision?

This report looks at the key commitments made and what we know about progress to date, grouped under three broad themes:

  • interoperable electronic health records
  • patient-focused digital technology
  • secondary use of data, transparency and consent.

It identifies barriers to further progress and opportunities for delivering on the digital agenda.

Key findings

  • Digital technology can transform how patients engage with services, drive improvements in efficiency and care co-ordination, and help people manage their health and wellbeing.
  • For historical reasons, the acute sector is furthest from achieving the goals set out under this agenda, in contrast to general practice where use of digital clinical systems is near-universal. Delivering large-scale digital transformation involves risks for NHS leaders (particularly in acute trusts); they should receive more support and tolerance from regulators and commissioners.
  • To maximise uptake, patients and the public need to be aware of the benefits of digitisation, while being reassured about data security and use.
  • Clinicians and frontline staff must be involved in designing and rolling out new technology.

Policy implications

  • Achieving the digital vision requires more realistic deadlines, given the backdrop of unprecedented financial and operational pressures facing NHS organisations. The government should adopt the Wachter review’s recommendations about extending the timetable to 2023.
  • In doing so, the government needs to take care to preserve the momentum that has been generated towards building local data-sharing arrangements and increasing the uptake of online services for patients.
  • Greater clarity is urgently needed about funding to support this agenda, including when the money already announced will be made available and how it can be accessed.
  • There is a risk that focusing too narrowly on cost savings and ‘going paperless’ could detract from the ultimate aim – to improve outcomes, efficiency and patient experience.

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    Comments

    BRIAN GUMBLEY

    Position
    Director,
    Organisation
    MATM cic MH RECOVERY ORG
    Comment date
    22 September 2016
    When the powers have eventually made up there there minds to finance the NHS properly
    very little can go forward without proper financing of IT why because if staff do not have sufficient access to the right files especially in MH trusts --how can we continually harp on about the digital age of communications when in particular some trusts do not have up to date IT systems --in our trust the fact that assessments are being made on the phone without access to people MH records is to say the least mind boggling --I am not blaming the senior management but the lack of money to equip IT properly is disgraceful

    Jk Singh

    Position
    Commercial Manager,
    Organisation
    G2 Speech
    Comment date
    26 September 2016
    G2 Speech have over 18 years of experience of serving the medical sector. In Holland where we originate, we are providing our services & IT solutions to 98% of hospitals there. On a Worldwide aspect we have nearly completed 700 projects successfully. In the U.K. we have completed successfully over 100 intergrations to EPR, PAS system successfully offering great efficiency gains to the end users. Currently working with 40+ NHS hospitals in the U.K.

    We believe we are the Complete Digital Document Creation Solution provider - Single Solution Platform, Digital Dictation, Speech Recognition, Stuctured Reporting, Analitics and many more services tailored to each user, departments, trusts & hospitals.

    Our Digital platform enhances productivity & return on investments along with the ability to report on usage & identitfy bottlenecks to manage them effectively.

    With a consultative approach we believe that we are the solution provider of choice because of our people, partnerships, innovation and high quality products.

    Our services & products enhance becoming paper free meeting NHS security requirements what ever the work flow process and what ever it is that you are trying to achieve.

    Feel free to contact me for further information

    Cathy Gulliver

    Position
    Clinical Nurse Specialist - Rheumatology,
    Organisation
    Salisbury NHS Foundation Trust
    Comment date
    30 September 2016
    As someone who works at the crux between primary and social care, I welcome the idea of electronic records. If I never have to try and read another doctor's handwriting again or work out which pills Mrs Smith is taking 'its small, pink and oblong' - then I shall be happy.
    BUT I am severely sight impaired. Able to work full time at present until the EPR goes 'live' at the end of October. At present, after that I will be going to work but unable to use my PC. Why? There is a compatibility issue between the EPR and my assistive technology. So my dept is going to be 'down' one full time band 6 nurse until ? when.
    I want to use EPR. I appreciate it is going to be difficult adapting to a new system but I think in five years time we will all wonder how we managed without it.

    Tania

    Position
    Member of the public,
    Organisation
    Citizen
    Comment date
    09 January 2017
    This is a very useful summary, thank you. But as a member of the public and my local PPG, concerns by patients about ‘data security’ mean concerns about the loss of privacy that results in lower standards or more costly care because of perceived risks around privatisation of the NHS and real worries of going down the healthcare route in the US.

    There is universal acknowledgement that the current system is not financially sustainable. And, as a layman /member of the public ‘free at the point of the delivery’ is right to continue. That doesn't mean however that the public wont accept paying a subscription/licensing fee.

    The elderly and low income would be exempt from the fee and the financially viable (and newly labelled JAM) could easily afford the £100pa family fee. And there is no logical reason why prescriptions are free for all at 60 yrs, when the pension age for national insurance is higher.

    The Kings Fund should help progress the financing discussion. There’s lots of excellent free research around, just ask the heads of health care research at Goldman Sachs, Deep Minds (Google), Harvard and McKinsey.

    Una-Jane Winfield

    Position
    Hospital campaigner,
    Organisation
    Save Our Hospitals
    Comment date
    16 February 2017
    Tania,
    Please do NOT take the "free research" from Goldman Sachs, Deep Mind, McKinsey at face value: they only want more consultancy contracts! That is why they always promote fragmentation and the private sector.
    There is no one except the general public, campaigners for the NHS and (sometimes) heads of provider trusts to defend the basic principles of the NHS as a universal service, publicly funded IN ITS ENTIRETY, and provided by publicly run and publicly accountable bodies, not private companies. This is what most people understand (historically) by "NHS".

    Dr Pauline Tang

    Position
    Lecturer - Nursing,
    Organisation
    Cardiff University
    Comment date
    06 March 2017
    Your voice resonates those of the participants in my study. I undertook a qualitative case study on the multi-disciplinary team members’ use of the electronic patient record within one emergency medical assessment unit. The three themes that emerged are: Managing the dynamic context of the ward/unit; Patient safety and Issues with the adoption of the EPR. Clear findings emerged on the usefulness of electronic patient record re: medication safety, bridging the intersection of care, as a vessel for information in the case of patients unable to give their medical histories and facilitating co-production to enhance safe, patient-centred care. It showed how the EPR can mediate the information gaps, between primary and secondary care.

    Alvinowemy

    Organisation
    Alvinowemy
    Comment date
    17 October 2017
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    Alvinowemy

    Organisation
    Alvinowemy
    Comment date
    17 October 2017
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