The long awaited publication of the Department of Health's
Information Strategy 'The Power of Information: Putting all of us
in control of the health and care information we need', whilst
welcome, has provoked debate and mixed reactions across the health,
social care and IT sectors.
The document paints a rather pretty picture of an integrated
health and social care system that shares information through the
use of modern technologies, to improve service planning, delivery
and quality. Placing patient access to information about their own
care at its heart, it also outlines plans to provide such access
via a single website portal provided by the Government, with GP
records expected to be available to patients by 2015. The
availability of high-quality of information from healthcare
organisations such as the NHS Commissioning Board, the Care Quality
Commission, Monitor and the Department of Health itself is also
described as key to improving patient experience.
A drive towards reducing the use of paper records over the
coming years makes Electronic Patient Records a necessity along
with a change in the culture and mindset of healthcare
professionals and bodies, and this is clearly communicated
throughout the strategy. It places responsibility for recording,
presenting and using information upon health professionals, and the
revolutionary impact of mobile devices on the working practices of
clinicians is recognised. There is to be a focus on ensuring these
are fast, flexible and portable, with the capture of information
occurring once and at the point of care.
Emphasis is placed on local decision-making, to be underpinned
by a 'route map' for implementing national information standards
for 2013-2018, and of course the usual suspects are common themes
throughout the document; promoting telehealth, improving
productivity and efficiency, the provision of information about the
quality of care to support patient choice, and a real emphasis on
encouraging and utilising patient feedback.
These are all highly commendable aspirations and the Department
of Health's Director General and Managing Director of NHS
Informatics, Katie Davis, certainly delivers in this strategy a
laudible vision that will surely be supported by most
stakeholders.Yet there are many who feel it falls far short of
providing much-needed answers, believing it lacks the leadership,
detail and commitments necessary for effective implementation.
Clearly intending to move on from previous strategies and
initiatives and barely mentioning the National Programme for IT,
the strategy has prompted commentators to claim that there are gaps
around a number of pressing concerns such as the abolition of PCTs,
or the work previously undertaken by soon-to-be-canned programmes
including NHS Connecting for Health, NHS Choices, NHS Online and
Healthspace.
Whilst it may be true that the less-than-punchy 100-page
strategy fails to deliver consistency or clear steps and actions,
the document does state that it is not intended to 'reinvent
large-scale information systems or set down detailed mechanisms for
delivery' and promises that more detailed implementation plans are
on their way. One suspects that those who feel shortchanged by this
may well have been the ones to complain had it been more
prescriptive and dictatorial.
With very little mention of financial commitments, there is also
concern over the funding and development of infrastructure to
support this strategy. Yet one is to remember that this is an
information strategy, not an IT strategy. Yes, it reads more like a
vision than a strategy, but considering the complexities of health
informatics on a national scale and the chequered history of
government-led NHS IT initiatives, it would have been unwise for
Davis to attempt to cover technology and provide detailed
implementation plans in an already long-winded initial information
strategy. The emphasis placed on local decision-making demonstrates
the lessons learned from past top-down IT initiatives and it is
certainly sensible for Davis to be taking it one step at a time at
this stage.
With organisations now anxious to get on with realising Davis'
vision, what's now needed in the forthcoming implementation plans
are specific financial commitments, a call to action so that Trusts
can get on with developing and implementing their own strategies,
and focused guidance on how to improve infrastructure to facilitate
the delivery of this strategy. The dialogue generated by the
publication of the Information Strategy will serve to better inform
these plans ensuring that, when eventually delivered, they are
robust, workable and future-proof.