The Department of Health has shelved plans for a massive expansion of its personal health record project, HealthSpace.
HealthSpace was conceived as a way to allow people to access and eventually add to a version of their Summary Care Records. But like the national SCR project, it has suffered from lengthy delays.
An £80m-plus business case, that was due to be submitted to the Treasury, now appears to have been kicked into the long grass. Most of the team working on HealthSpace has been stood down and released for other work, with just a skeleton crew retained.
Last year’s Health Informatics Review outlined a wide-ranging role for HealthSpace, but the DH has now done a U-turn and demanded more evidence of the site’s value to patients before pushing ahead with further expansion.
Plans for HealthSpace were based on making it a hub for transactional services, so patients could book nurse or GP appointment, manage long-term conditions, order repeat prescriptions or medication reviews and complete pre-registration assessments online.
Other planned services included access to letters and test results and access to data sent through telehealth devices.
Low take-up of the services currently offered by HealthSpace has done little to promote the portal’s cause.
Figures released to GP Dr Neil Bhatia under the Freedom of Information Act show that out of more than 250,000 records created, just 812 people had activated an advanced HealthSpace account and only 437 had accessed their SCR.
A survey conducted last year as part of the SCR independent evaluation found 60% of patients at a walk-in centre did not want a HealthSpace and 10% were uncertain.
The percentage of those not wanting a HealthSpace account rose to 87% for patients with low levels of health literacy.
The evaluation by University College London recommended that the DH focus on optimising the use of HealthSpace in specific, clearly defined scenarios such as in self care for one or two chronic conditions, before attempting to offer it to NHS patients more generally.
In a statement issued to EHI Primary Care, the DH said "HealthSpace has entered a phase of evaluating patient experience of its services and assessing what extra offerings should be made available in the future.
“Pilots of the HealthSpace Communicator function, which enables secure communication between clinicians and patients, are beginning to run at sites across England.”
The statement added: “These aim to establish its value for both patients and clinicians in different care settings on how best to develop the service. HealthSpace should be based on what patients want, rather than an expectation of what they need.
“This period of time is crucial to developing the future directions for the service and involves a redistribution of current resources, including staff, so that efforts are directed appropriately.”
An outline business case worth £80m to £90m – one source puts the figure at £98m – had been developed by CfH, which was to have been submitted to the Treasury earlier this year.
However, the DH is understood to have spiked the business case, seeking more evidence for the value of HealthSpace, which has not received the backing of Christine Connelly, director general of informatics.
Dr Neil Bacon, founder of the doctors’ website doctors.net and the patient website iwantgreatcare.org, said he was unsurprised that the DH had shelved its plans.
“I think this is their way of quietly getting rid of it,” he told EHI Primary Care. “In the commercial world, if a solution with more than 250,000 potential users had only been used by 400 people it would already have been put out of its misery.”
Dr Bacon said he believed there was a clear and growing demand for patients to manage their own health records but that innovative, entrepreneurial solutions rather than government-led solutions would meet that demand.
He said “trusted brand names” in the UK were already working on solutions which might tie in with the worldwide personal health record services such as Google Health and Microsoft HealthVault.
John Coulthard, head of Microsoft’s UK health team, said: “The innovation in the health space – not HealthSpace – is going to come from a number of organisations, many of which are outside government, such as social care, charities and the commercial sector.”
Dr Paul Hodkgin, founder of Patient Opinion, said he was also not surprised that future plans for HealthSpace were on hold.
He said: “It’s one of those obvious ideas that is incredibly difficult to implement and there are interesting alternatives to these monolithic solutions.”
However, Dr Amir Hannan, a GP who has pioneered patient access to records and a member of the HealthSpace Reference Panel, said he remained optimistic about the future of patient access to records in the UK.
He told EHI Primary Care: “Patients need to be able to see the information that’s stored on them and I believe there is a lot of support for that nationally.”