NHS England is developing an NHS Technology Strategy and Roadmap, setting a national direction for NHS IT.
NHS England has published its Business Plan for 2013-14 – 2015-16 called 'Putting Patients First', which explains how it will deliver its mandate from the government.
One of the plan’s key targets in relation to IT is to have 95% of trusts using the NHS Number as the prime identifier in clinical correspondence by January 2015.
'Putting Patients First' says NHS England will “set the direction for NHS technology and informatics so that commissioners, providers and suppliers can make informed investment decisions.
“In co-production with key strategic partners and in consultation with stakeholders, we will develop and publish an evidence-based NHS Technology Strategy and Roadmap.”
Other developments outlined in the plan include an integrated business intelligence tool, which will “provide the robust information needed for evidence based, insightful decision making for all parts of NHS England."
It will also develop a linked package of shared-decision making aids so that people can make choices in collaboartion with clinicians about their treatment.
The plan says that health and care data is one of England’s greatest public assets and "putting it to work" is key to improving patient outcomes.
To harness this, NHS England is developing the care.data programme, which will provide timely data linked across the different components of the patient journey and the outcomes resulting from treatment.
The programme recently got approval from the General Practice Extraction Service Independent Advisory Group to proceed to extraction.
The plan says that 75% of GP practices will be providing a full extract to care.data by September this year.
Three-quarters of hospital trusts will be providing patient level prescribing data to care.data by December 2015.
The plan also says that mental health trust providers will all complete the mental health minimum data set, and will publish regular information on key indicators in 2013-2014
“Through 2013-14 commissioners must use sanctions if not satisfied over the completeness and quality of a provider’s data on the Secondary Uses Service,” it adds.
'Putting Patients First' pledges that all NHS patients will be able to leave feedback in real time on any service by 2015.
“A deeper understanding of how users of NHS services view aspects of the care they receive is essential to make services better,” the plan says.
The Friends and Family Test will be introduced for 100% of acute hospital inpatients and Accident and emergency patients from April 2013 and for women who have used maternity services from October 2013. The aim is that 30% of trusts improve their scores by 2014-15.
© 2013 EHealth Media.
The elephant in the corner of the room ???personal opinion 107 weeks ago
All this talk about the NHS Number reignites (in my mind) the debacle over identity cards AGAIN!!!
I am still of the opinion that before treatment is given, the person should prove who they are. Let's face it, everyone in the "mainstream" of society always carries some sort if identification with them; be that a driving license, bank card etc. It is only those on the fringes who do not. However, I don't necessarily see this as a problem for this very small minority. Do as they do in other countries - provide emergency, life-saving treatment only unless you can prove who you are.
Would you expect Tesco to give you food if you could not provide them with evidence that can pay for it? Remember, a debit/credit card is only a form of promissory note. The actual money changes hands long after you leave the shop.
For those of you who are old enough, in the early days of the NHS, your doctor would not see you unless you showed them your registration card which proved that you were registered with him. Your NHS card had printed on it that you were obliged to present it before treatment (and still does I think).
As you can probably gather, this is an emotive subject for me. Time to get off the soap box...
Dangerously Closewishfulthinker 106 weeks ago
We are getting dangerously close to suggesting that we should identify patients who are NOT entitled to treatment ie "those on the fringes of society". Like a tattoo on the wrist maybe? Your fringe may be my mainstream.
Tattoo?personal opinion 106 weeks ago
I still maintain that there must be ways we could make sure that only those who are entitled to NHS treatment actually get it. Not only that, but positive identification will help to make sure that the the data end up in the correct electronic record.
re: The elephant in the corner of the roommrtablet 107 weeks ago
Thank you Mr personal opinion -
You can't talk to someone about your electricity bill without going through an identity check. Meanwhile you can clock tens of thousands of pounds worth of NHS treatment signing in as Del Trotter.
Oddly enough (although it's otherwise the usual Westminster spin) - the pledge to bill non-EU nationals for NHS treatment might just precipitate a reality check at Richmond House. On the other hand if flushing 20 billion on NPfIT didn't ....
Strategy, what strategy?!?HealthCTO 107 weeks ago
NPfIT was the last strategy you had...and it was a badly flawed one even then. In the past 3-5 years, the blather about an IT strategy for the NHS has been non-stop and now we have a new effort at crafting one. Is Sir David going to make sure one is delivered? Really?
Does anyone in the halls of power (DoH and CB) even know what a properly defined strategy is? And if so, do they have intestinal fortitude to craft one and put it out there? Or will their strategy remain to do as little as possible to keep from rocking the boat and losing my job?
Strategy requires vision and leadership. Uh-oh, now we know what the real problem is...
Have you read this strategy document?wishfulthinker 107 weeks ago
I cannot express how disappointing I found this document. Written entirely in Big 6 Consultancy-speak, it is anodyne and completely lacking in clear goals and imperatives. It reads like a collection of slogans copied from the doors of police cars.
There is nothing in it I can see about openness and the need to protect whistleblowers. The needs of mental health patients are mentioned, but nothing about patients with learning and physical disabilities, nothing about respecting the dignity of elderly patients or catering properly for their complex needs. Nothing about proper joined-up care across primary, secondary and community providers. Utter dribble.
Missing a pointAdeByrne 107 weeks ago
It doesn't matter whether a patient has an NHS number or not. The key thing is do you need to work on them before you know it, and the answer to that is yes. Book them into PAS/A&E, send samples for tests, send patients to X-ray and theatre. You need to create a record in the hospital systems that will hang together on interfacing and that requires a number, but not the NHS number. That, though important, in many cases will come later in the episode.
re: Missing a pointmrtablet 107 weeks ago
>The key thing is do you need to work on them before you know it<
Erm.. one of main benefits claimed for the 'big NHS database' is that you get to see the patient's records from St Elsewhere and their GP potentially in an emergency. Now you're booking theatres etc without having seen those records i.e. you are not sure about the patients identity - or do you have a peek at a few Joe McDonalds' shared care records - just in case the one you have under your care is him?
Let's have this conversation - but can we please stop pretending that real time NHS number use isn't a precondition of all the interconnected wonders we are being promised under this new strategy.
PDSin arduis fidelis 107 weeks ago
Surely PAS/A&E/EPR systems have a requirement to be spine compliant and sync with the PDS when a patient is booked in or a new patient record is created, as this is a requirement for GP systems. If not then that should definitely be a part of the strategy. If they are then in most cases when a patient is booked into PAS/A&E/EPR the NHS number will be available at the time of booking.
Spine Compliance and other 'requiremeents'in arduis fidelis 106 weeks ago
Didn't miss the point about patients arriving in A&E.
Having worked in A&E, theatres, GP surgeries, refugee camps and on ambulances (corner shop, market, haulage firm and factory) I know only too well that if the arriving patient is unconscious or incoherent it does not therefore mean that their identity is unknowable!
If they arrive in those conditions unescorted and/or carrying no reliable form of identification that would be a fair assumption to make, but that in my experience is not the case for every unconscious/incoherent patient that comes through an A&Es doors - drivers licence for RTAs, medalert tags for diabetics, etc
Spine Compliance and other 'requiremeents'wishfulthinker 106 weeks ago
You can make spine compliance a requirement for new systems if you like, but how many years if not decades do you imagine it would take for all existing PAS/A&E/EPR systems to be retired and replaced by new compliant systems? So why don't we have a nationally funded programme to rip and replace with standard systems.....oh dear we seem to have tried that already. GPs thinking like a corner shop again, whereas by comparison a hospital is more like a factory.
And you still miss the point that in A&E the arriving patient may be unconscious/incoherent/untruthful and their identity therefore unknowable whatever systems we have in place.
Yes true but...AdeByrne 107 weeks ago
It is in everyone's strategy to connect their hospital index to the Spine of course. I think I would be correct in saying that most of them currently batch trace the NHS number however. In the hospital where I work we have a few hundred users of the SCR to check details as a stand alone action.
We would need to get pretty draconian to enforce 100% compliance on this though, as all patients would need to be registered at a GP and have an NHS number, and be prepared to give us the right details.
At the moment we do not create NHS numbers when we do not find a patient, or they are not traced, and there would be a fair degree of chaos if we did. The only ones we create are NN4B which works fine.
Anyone in the country can currently walk into a hospital and get treated, and can refer to themselves as Del Trotter if they like, and till that changes we are where we are.
In addition there would need to be some pretty fundamental design change across many linked systems to make this a true primary identifier and I don't really think that is an ambition. I can see a need for mandatory in many cases and feel that is probably good enough. The term is probably being misused in many cases actually as this may be what people mean when they say "primary".
Any willing providerwishfulthinker 107 weeks ago
Hospitals also have to deal with overseas visitors who have no NHS number but I doubt if many of them pass through GP surgeries.
If this government gets its way, before long we'll be able to use the patient's bank account number as a unique id.
weelllllin arduis fidelis 107 weeks ago
I believe the policy was changed last year around June/July time for Primary care so GPs have to register anyone who wishes (I don't think they even have to ask for proof of residency) so I'm guessing that means no NHS number for some period of time!!!
Service numberseohl 107 weeks ago
Service number was used in preference to NHS number on older systems (the conversion of the civilian IT system used that field for service number), but I'd doubt that happened on the latest (how else would lablinks etc work)
NN4BCommunity Driver 107 weeks ago
I thought I saw an ISN in Feb13 that said NN4B would be replaced with a new system in April! As NN4B appears to work that would be par for the course. Meddling where there is no need! Bet that isnt in any new strategy.
I thought so tooin arduis fidelis 107 weeks ago
Although its only during NPFiT years that they started to be given almost immediately after birth. in the early days of C&B new borns were excluded from e-referrals untill they had been allocated an NHS number, which used to be quite some time after leaving hospital.
I don't know about Prisoners, but service personnels NHS numbers become inactive whilst they are serving and their service number is used as an identifier untill they return to civvie life and the NHS, at which point their NHS number becomes live again.
As far as I am aware it has been in discussion for a number of years now to maintain Service personnels NHS numbers in an active state to allow access to services such as C&B, GP2GP, EPS etc
Reaching for my revolver...mrtablet 107 weeks ago
The NHS Number exists to safely identify patients across NHS administrative and system boundaries.
It was introduced in 1996. That it has failed to reach 99.99966% uptake nearly two decades later IMHO stands as an indictment of the entire NHS.
That 95% is still now seen an 'ambitious' goal and any sort of worthwhile endpoint is beyond bathetic.
No NHS Number - no interoperability! Every other last detail of NPfIT [by some miracle] could have come to fruition, but had NHS Number deployment yet failed as it has - nada, nothing : unsafe, unreliable, untrustworthy!
How can you put the 'patient at the centre' if you don't uniquely identify every patient? The fact that the NHS happily trundles along without this yet everyone gets paid and promoted exposes the void at the core of the NHS business model.
Don't pull the trigger...Daniel Defoe 107 weeks ago
We can't "put the patient at the centre" Mr T. Remember, patients have "rights" - http://www.ehi.co.uk/insight/analysis/1085/off-the-record Of
Ofcourse, perhaps things would be different if the NHS was "insurance-based" as in some other countries? Just a thought.
So when are they planning to produce their IT strategy?Mary Hawking 107 weeks ago
The current document is the Business Plan (which, by the way, states the intention - as monopoly commissioner of general practice, to use this to redesign it to fit NHS England objectives) and not the IT Strategy and Roadmap.
When is it expected, and what is everyone supposed to do in the meantime?
Tell us "What" not "how" pleasespotlight 107 weeks ago
I have been reading NHS IT strategies which talk of working with key strategic partners in consultation with stakeholders to deliver benefits to patients, clinicians and managers and help them ... etc etc etc for 20 years now. Marvellous stuff.
I don't remember the original objective of NPfIT but I don't suppose it was to throw 20bn down the drain and create total chaos across the NHS, bringing many hospitals to their knees.
The problem is always that the centre just can't stop itself seeking to control everything and that way of working always fails on programmes of this size. People don't learn because the new leaders always think that it will work now they are in charge.
What we actually need are sensible high level mandated objectives such as patient access to data or the provision of certain data sets and ideally some level of central funding to prime the pumps. That worked so well with the original GP system roll out where the centre paid a proportion of the cost of a new GP system, but the scope of that system was very high level.
What is not needed is another prescriptive method of doing things which can not possible fit all or even most scenarios. What we don't need is restrictive centrally funded frameworks which skew the market and saddle the NHS with mediocre solutions.
Define the high level what and then let us get on with it. Sure there will be some local problems, perhaps even disasters, but at least we wont end up with IT in chaos across the whole of the NHS - again.
A voice of reason...at last!HealthCTO 107 weeks ago
Define goals, set boundaries, align incentives, and then get out of the way! One of the biggest problems with NPfIT and the "new" strategy of CSU's etc. is that there is too much control being expressed from the top (or center or whatever) and no trust in the ability to execute "downstream".
Control is an illusion (e.g., Mid Staffs). Large organizations and systems work best when direction and boundaries are set and the local teams are allowed to make decisions within that context, execute, and be responsible (and held accountable) for their delivery.
Back to the issue of leadership and knowing how to unleash an organization. Oops...THAT problem again.
Some sympathyAdeByrne 107 weeks ago
I do not think the document says that the NHS will "use the NHS number as the primary patient identifier", I think it says we will be using the NHS number as the prime identifier in clinical correspondence. I do not think that generally people will be attempting to make NHS number the primary patient identifier in a systems sense.
I would have sympathy with Spotlight's nervousness that we are drawn into an over-specified view of what is required to be added into what are essentially many finely balanced ecosystems. I hope therefore that what is adopted is more along the lines of an evolution of accreditation standards and sensible data sets.