A doubling of spending on information and communication technology will be needed to fund ambitious targets set out in the NHS Information Strategy, according to the Wanless Review on healthcare funding commissioned by The Treasury.
The report’s author, former NatWest Group chief executive, Derek Wanless, and his review team recommend that the money should be found and ring-fenced to ensure that it is not diverted for other purposes.
The recommendations for this largesse, which would see IT spending rise from around 1.5% of total NHS spending to over 3%, have strings attached. Wanless says that stringent standards should be set from the centre to ensure that systems across the UK are fully compatible with one another, and while budgets would be protected, an audit of achievements which flow from the extra spending is recommended.
The extra spending would help to remedy a shortfall identified in the team’s interim report, issued last November, which found that annual NHS IT spending in 2000 was lower than in any other sector of the economy examined and that the UK health service spent a significantly lower proportion of its budget on IT than comparator countries.
Wanless sees well-managed IT as a key factor in boosting health service productivity and a significant part of the upgrading needed to enable UK health services to live up to increasing public expectations and deliver improvements patients and staff want to see.
Responses to the interim report called for priority to be given to the development of electronic records, the integration of electronic communication between primary and secondary health care and social care and for all new investment to be accompanied by staff training.
”The review believes firmly that the health service will need a significant programme of ICT investment to deliver first the infrastructure, then the applications which will secure the delivery of these and other targets,” says the final report.
The review envisages that the new money will cover:
• IT infrastructure and applications such as electronic records;
• Electronic booked admissions, patient smartcards and the electronic staff record;
• Telemedicine and telecare for patients with chronic conditions;
• Clinical governance support systems;
• Staff training.
”Effectiveness will depend on the quality of the implementation, in particular, whether it takes place in an integrated manner with consistent standards across the service,” says the review report.
The review used scenario planning to look at the possible paths the NHS could take. It arrived at three scenarios – solid progress, slow uptake and fully engaged. As the scenario titles suggest they looked at how the health service would look at different rates of progress in implementing change.
Significantly for IT, the faster rates of change produced by the solid progress and full engaged scenarios both required an early doubling of technology investment with the money spent between 2003-4. IT investment delayed until 2007/8 was part of the slow uptake scenario that produced disappointing results in terms of life expectancy and improved health for the population.