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Following the continuous increase in the use of mobile technology – smartphones, tablets and apps – the importance of mobile technology has never been more important. Speaking at the e-Health Week in March, Secretary of State for Health Jeremy Hunt reinstated that government spend on technology funding has not been cut, more that it would be victim to a ‘staged rollout’. Claims had been made that only £43 million of the initial £240 million originally promised in the technology fund would be allocated to the successful applicants. When the fund was first announced, NHS England said that the £240m would be split over three years, with two-thirds of the money (£160m) being available in 2014/15 and the final third (£80m) being available in 2015/16. Now the split will be of £20m and £23m respectively.
However, Hunt insisted that IT and technology remained vital components of the NHS. This is clear in practice, as doctors and practitioners are now being equipped with the technologies that enable them to access instant services and the important information required to deliver immediate care, no matter where they are. This is particularly evident for community health where practitioners work within patients homes rather than hospitals.
This level of immediate care has a knock‑on effect on the overall level of care that the NHS can offer. Being able to use the right equipment in the right way enables quick care and better decision making. Additionally, using a mobile app to capture information once and then make it consistently available can vastly improve their experience of healthcare.
The key is ensuring that all staff are trained thoroughly, not necessarily quickly. In recent weeks, BT spent a day at Humber NHS Foundation Trust to demonstrate how the day would operate before and after the use of mobile working. Healthcare staff were given access to real-time patient information while on the move without needing to return to the office to access records.
Beverley Bryant, Director of Strategic Systems and Technology at NHS England, said: “We are committed to a digital strategy to help transform health services through technology and put patients in control of their care and welcome the latest investment in the Integrated Digital Care fund which will help to digitise and integrate patient information across health and social care, enabling safer, more joined up services.”
One of the concerns that mobile technology proposes is the disintegration of one to one contact between practitioner and patient. However, despite initial unease, mobile technology can be proven to provide productivity gains and improve workflow – thus promoting interaction. But how is digital technology funding being accessed and encouraged?
The Integrated Digital Care Fund
Jeremy Hunt and NHS England Medical Director Professor Sir Bruce Keogh launched the Safer Hospitals, Safer Wards Technology Fund in May 2013 to support NHS providers in moving from paper-based systems for patient notes and prescriptions to integrated electronic care records along with the development of e-prescribing and e-referral systems. To reflect the key priority of enabling information flow across care settings, the fund has now been renamed the Integrated Digital Care fund.
NHS England is responsible for the delivery, administration and governance of the fund to facilitate the widespread adoption of modern, safe standards of electronic record-keeping. Digital systems have the potential to benefit patients and clinicians by enabling safer, more joined up care through the sharing of comprehensive clinical information. This can lead to reduced prescription errors, improve clinical decision-making and support patients to interact with their own health record.
The Safer Hospitals, Safer Wards Technology Fund was open to NHS Trusts to support the rapid progression from paper-based clinical record-keeping to integrated digital care records (IDCRs). The initial wave approved 213 projects from digital clinical records to electronic prescribing and medicines management totalling over £195m.
Applications for the Integrated Digital Care Fund closed on 14 July 2014. In total, 226 applications were received and 47 organisations have been awarded funding totalling over £44 million. In the second round, integrated digital records remained a priority but with an emphasis on supporting information flows across organisational boundaries. Consequently, the eligibility criteria was widened to include local authorities. E
The latest round
It was revealed in March how health and social care providers across the country will have access to £78 million this year to invest in technology and help them move from paper-based clinical records to integrated digital care records. If the cuts that Hunt dismissed turn out to be false then NHS Trusts and local authorities will use £43 million of Integrated Digital Care funding to put in place electronic information systems which make sharing information between care settings easier and ensure that patients only tell their story once.
Approval has also been granted for the second tranche of the Nursing Technology Fund which makes £35 million available to Trusts, health charities and community health providers to spend on digital services that will support nurses, midwives and healthcare assistants in their work and help them release time to care.
Adrian Byrne, Director of Information Management and Technology at University Hospital Southampton NHS Foundation Trust and successful applicant of the Integrated Digital Care Fund said: “We’re delighted to be the recipient of an award that will allow us to advance paperless working by implementing an electronic document management system. It will also greatly assist us in cutting down costs by moving out of an existing shared library facility currently holding around one million patient records.”
Awards have gone to a range of organisations including Marie Curie Cancer Care – awarded £1million for their Connected Nursing project to enable mobile access to digital care records, digital capture of clinical data at point-of-care; Milton Keynes Hospital NHS Foundation Trust – awarded £646,000 for their Paperless Nurse Observations project to allow nurses, midwives and care staff to capture vital signs and Early Warning Scores at the bedside in real-time; Devon Partnership NHS Trust – awarded £204,000 for their Video Consultations for Nursing Staff project to equip patients and develop proper therapeutic environments for remote consultations in a community mental health care setting.
Speaking of the Nursing Technology Fund Jane Cummings, Chief Nursing Officer for England, added: “The Nursing Technology Fund has supported nurses, midwives and care staff to carry out valuable and innovative work, and will continue to empower staff to deliver safer, more effective and more efficient care.”
Case study: University Hospital Southampton
University Hospital Southampton has, over many years, developed the concept of a digital care record that is now used by all staff. It has become a core part of their everyday routine and usage is standardised across the organisation – there are no separate disconnected ward-level systems. Integration within South West Hampshire means that shared case notes are used across the whole locality. This gives clinicians access to a complete view of patients’ information as and when they need it, helping to reduce unnecessary delays and improve decision-making. They also have single click-through context sensitive access to the wider Hampshire Health Record.
Co-ordinate My Care
The ‘Co-ordinate My Care’ scheme lets terminally ill patients in London define how and where their care is delivered. A single digital care record integrated across health and social care gives GPs, ambulance service, NHS 111, the local authority and social services access to these wishes as and when they need them. It has led to a sharp increase in the number of people ending their life in a place of their choosing, boosted patient satisfaction and reduced costs. Plans are underway to extend the scheme to other parts of the country and long-term conditions such as diabetes and mental illness.