The United Kingdom's health secretary, Jeremy Hunt, has announced new plans for a multi-million-pound package to fast-track expansion of digital technology across the UK National Health Service (NHS).
Implications | The new digital health package has been drawn up by the UK Department of Health (DH) in response to a review by the National Advisory Group on Health Information Technology in England. Twelve NHS organisations will be selected as "global exemplars" to deliver pioneering digital approaches, and universities will host a new "NHS digital academy" for training of NHS professionals in key digital healthcare skills. New digital services for patients will include GP registration, access to records, and medical advice all in one place via tablet/smartphone. |
Outlook | The Wachter report, on which the project is based, recommends that lessons be learned from the previous National Programme for Information Technology (NPfIT), which was launched in 2002 but shut down in 2011, having failed to achieve many of its original goals. The DH stated that the new services will become available from the end of 2017, and are intended to facilitate patient access to NHS services via mobile devices such as smartphones, and increase the use of the growing range of online NHS services available. The move also coincides with a "transparency drive" to provide information on local quality of care, and a new online triage service for the NHS 111 non-emergency telephone line service. |
The UK Department of Health (DH) has announced a plan to fast-track the expansion of a digital heath technology programme throughout the National Health Service (NHS), in response to a review conducted by the National Advisory Group on Health Information Technology in England, chaired by US clinician Bob Wachter, and entitled "Making IT work: harnessing the power of health information technology to improve care in England". The full original review may be accessed here, and the UK government's release regarding the new package is available here. The primary aim of the initial stage of the programme is to "fast-track digital excellence and improve the digital skills of the NHS workforce".
Global exemplar organisations, and a new NHS digital academy
A key part of the initial stage of the plan is to establish 12 "global exemplars" at specific NHS sites, which will be expected to deliver "pioneering approaches to digital services" in partnership with international organisations of their choice, followed by dissemination of best practice throughout the NHS at a later date. Concurrently with this, a university-based "NHS digital academy" will be established, to centralise training of NHS staff in digital healthcare technology skills.
The 12 initial exemplar organisations will be:
- City Hospitals Sunderland NHS Foundation Trust
- Royal Liverpool and Broadgreen University Hospitals NHS Trust
- Salford Royal Hospitals NHS Trust
- Wirral University Teaching Hospital NHS Foundation Trust
- University Hospitals Birmingham NHS Foundation Trust
- Luton and Dunstable University Hospital NHS Trust
- West Suffolk NHS Foundation Trust
- Royal Free London NHS Foundation Trust
- Oxford University Hospitals NHS Foundation Trust
- Taunton and Somerset NHS Foundation Trust
- University Hospitals Bristol NHS Foundation Trust
- University Hospitals Southampton NHS Foundation Trust
These trusts will receive up to GBP10 million each (USD13.4 million) for the initial development of new approaches to digital medical services, alongside staff training and implementation by new chief clinical information officers. This will be expanded to include a further 20 trusts, which will become national exemplars, with intensive training support from the NHS digital academy, and funding of up to GBP5 million each to improve the application of digital technology within their organisation.
New digital facilities for patients
New digital services are planned that will allow patients one-stop access to GP registration, healthcare records, and medical advice via their tablet or smartphone. These measures include:
- Expansion of the NHS 111 service – In consultation with leading clinicians, the existing NHS 111 non-emergency telephone line service will be expanded to include a new "online triage" service for non-serious health problems, where patients enter symptoms online and receive tailored advice or a call-back from a healthcare professional. The scheme will be piloted to optimise patient outcomes.
- Health apps – NHS England intends to launch a library of NHS-assessed apps, and advice on wearable devices, to influence the selection of reputable and effective products for patient health monitoring and improvement.
- Relaunch of NHS Choices as NHS.UK – The NHS Choices website will be relaunched as NHS.UK, with an expanded range of services, including online GP registration, appointment viewing/booking, and prescription ordering/tracking.
- Access to health records – Inspired by the "blue button" app in the United States, an app will be available on NHS.UK for secure downloading of personal health records by patients, allowing instant access to information such as prescriptions and test results.
- Transparency information – The DH plans to release improved data on performance of local NHS services on the revamped MyNHS website, available here. This is part of a declared DH "transparency drive". Information on dementia, diabetes, and learning disability services are currently available on the site, and maternity, cancer, and mental health data will follow later this year. There are plans for the site to include maps, graphs, and tools for analysis of service performance over time.
Rollout of these patient services is expected by the end of 2017.
Outlook and implications
This initiative is an expansion of one announced in February (see United Kingdom: 9 February 2016: UK health secretary announces USD6-bil. investment in NHS digital plan). However, the drive for digital technology throughout the NHS is not a new one, and the Wachter report urges caution at the planning stage, stating that "it is better to get digitisation right than to do it quickly."
In this context, the report highlights the UK's previous National Programme for Information Technology (NPfIT), an ambitious GBP12.4-billion project launched under Tony Blair's labour government in 2002, but which was eventually shut down in 2011, having failed to achieve many of its original goals. It was intended to implement single centralised electronic care records for patients throughout NHS England, connecting 30,000 GPs and 300 hospitals, and providing secure and audited access to records by health professionals. Following a close scrutiny of the successes and failures within the scheme, the Wachter report concludes that the focus of the NPfIT rested too heavily on the technology itself, rather than service change for patients, and that insufficient consideration was given to clinician/NHS executive engagement. It also cites criticisms of the scheme at the time from NHS staff, of it being "rushed", losing its focus over time, and having a general lack of sufficient technology support during the implementation stage.
It is clear that the DH is keen to distance this project from the NPfIT, and to learn lessons from the experience. Although the new project does have some of the same aims (including centralisation of patient records and online access), the emphasis is quite different. The health secretary said, "Bob Wachter's excellent review made it clear that digitisation is as much about people as it is technology, and that this is a real opportunity to improve patient care for the long term." It will be interesting to see where the new developments align themselves with NHS services, which are currently financially stretched, and it is to be hoped that, as the report recommends, the focus is on the provision of improved patient services, rather than a simple focus on the technology itself.