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The Health and Care Innovation Expo 2015 returned to Manchester in September and witnessed an array of speakers from across the sector sharing their experiences, plans and goals for transformation in the NHS.
Tim Kelsey, the national director for patients and information, who is leaving the organisation to take up a new post in Australia by the end of the year, confirmed that NHS England will be launching an endorsement programme for apps, with an ‘NHS kitemark’. He said: “There are approximately 97,000 health apps. Who knows how many of those are safe or not? The NHS now needs to encourage people to use digital services and that is why we are launching the endorsement programme.”
Health Secretary Jeremy Hunt aligned his opportunity to speak with the thought expressed earlier in the day by Beverley Bryant, director of technology at NHS England. His keynote was directed at digital engagement, arguing that use of technology for healthcare had not kept pace with innovation in other areas of life such as the use of smartphones and the internet.
In the UK, it is reported that 84 per cent of the population use the internet, while 59 per cent use a smartphone. Contrastingly, and of worry to Hunt and the Department of Health, only two per cent have had any degree of digital interaction with the NHS. This is despite the promotion of apps, of which Hunt has encouraged smartphone users to familiarise with. These can allow patients to routinely check NHS advice, services and medical records. Hunt has stated an ambition to have a quarter of smartphone users, equalling 15 per cent of all NHS patients, using apps by the end of the next financial year.
Claiming that patients should exploit technology more to help better manage their own care, Hunt issued his belief that by 2016, all patients in the UK should all be able to securely access their GP electronic records online in full. Access to medical records would lead to a profound change in culture in a way that is transformative for people with complex or long-term conditions.
Hunt said: “I also want patients not just to be able to read their medical record on their smartphone but to add to it, whether by recording their own comments or by plugging in their own wearable devices to it.”
Hunt continued to he say that, by the end of 2018, all doctors and nurses will be able to access the most up-to-date information across GP surgeries, ambulance services and A&E departments, no matter where a patient is in England. By 2020 this will include the social care system as well.
He said: “Powerful patients need to know about the quality of healthcare being provided, but they also need to be able to harness the many innovations now becoming possible. To most of us it feels like there has been more change in the way we book taxis, shop, bank or store photos than the way we access healthcare. Yet for every single one of us healthcare is more important than all of those things.
“Experience from other countries suggests that opening up access to your own medical record leads to a profound change in culture in a way that is transformative for people with complex or long term conditions.”
Hunt has also taken several opportunities to reassure the public that their personal medical data is being held securely. Amid recent cyber hacking cases, most notably telecoms company TalkTalk, which revealed that nearly 157,000 customers had their data breached, such reassurances need more weight behind them.
Acknowledging that the NHS ‘has not yet won the public’s trust in an area that is vital for the future of patient care’, Hunt announced several measures to increase security of confidential medical information. These include a review of standards of data security for patients’ confidential data across the NHS to be carried out by the Care Quality Commission (CQC). The CQC is to have significant input from National Data Guardian for health and care, Dame Fiona Caldicott, with the work expected to be completed in January with recommendations on how the new guidelines can be assured through CQC inspections and NHS England commissioning processes.
As released in the ‘Accessing and sharing health records and patient confidentiality’ report in October, the NHS is introducing Summary Care Records – electronic health records of essential patient data – to enable healthcare staff across the country to provide immediate care and treatment. NHS England and the Health and Social Care Information Centre will also introduce the care.data programme, a national collection of anonymous patient data to enable population-level analysis of health trends.
As part of his bid to carry the NHS into the modern age of digital engagement, Hunt has said that he wants to ‘change the face of modern medicine beyond recognition’. He said: “These changes are being driven by technology and by our ability to use data differently. And although healthcare has lagged behind the travel, retail and banking sectors in embracing what is possible, we are now on the cusp of changes in modern healthcare that will be as profound for humanity as the invention of the internet.”
At the end of October, Hunt also revealed that Robert Wachter will lead a review into the digital future of the NHS. Wachter, chief of hospital medicine and chief of medical service at the University of California San Francisco and author of The Digital Doctor, has previously examined the rise of healthcare IT systems in the US. It is due to report next summer.
Hunt has commented that the review will be similar to the review on clinical safety in the NHS, which was undertaken by Don Berwick in 2013.
A Digital Health Intelligence NHS IT Leadership Survey has discovered that 67 per cent of NHS IT leaders believe the healthcare service can reach the NHS’s ‘paperless’ targets by 2020.
It surveyed members of the Health CIO Network and CCIO Leaders Network in August 2015 and found that 67 per cent of respondents were ‘quite confident’ or ‘extremely confident’ that the NHS could significantly reduce paper and reach paperless targets by 2020, with only 14 per cent saying they were ‘not at all confident’ or ‘not very confident’ of achieving the target. The idea of a ‘paperless’ NHS was first introduced by Hunt in 2013.
However, only 28 per cent said they were confident that patients would have this read/write access to their records, with 53 per cent saying they were not confident. The survey also asked respondents of their top three IT priorities, with 73 per cent saying ‘moving to paperless working’, 68 per cent saying ‘improving quality of services’ and 67 per cent saying ‘supporting new models of care’.
Meanwhile, management consultancy firm McKinsey has warned that the NHS needs to spend an additional £7.2 billion to £8.3 billion on digital technology over the next five years in order to achieve necessary savings. The McKinsey Report, which is dated April 2014, claims that the background to its work is the NHS’ need to close the gap between essentially flat fund funding and rising costs and demand that could reach £30 billion by 2020-21.
Through the ‘Five Year Forward View’, NHS England has argued that £22 billion could be found through investment in prevention and new ways of working. The report contends that savings of between £3.2 and £3.9 billion can be found in the acute sector by investing in electronic health records and in systems to improve quality. Further savings could be found in productivity improvements resulting from investment in community, mental health and primary care services, integrated working, and digital channels for patient access and monitoring.
The report believes that the NHS will need to provide an investment of £5 billion to £5.2 billion to secure the savings, and further estimates that it would need to spend £2.3 billion to £3 billion on training, adoption and running costs. This takes the total bill from £7.3 billion to £8.2 billion.
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