The general election
Brian Derry, chair BCS ASSIST national council
I’d like to see recognition of the key role played by health informatics in the delivery of frontline services. Making NHS IT a subject for Punch-and Judy politics may be a source of amusement for some, but it besmirches all committed health informatics professionals. It also risks missing answers to the core quality and productivity challenges that are now faced by all public services.
IT-enabled change can be very powerful; IT-imposed change rarely succeeds. Most importantly, I’d like to see proper planning and discipline by the Department of Health for the informatics consequences of new initiatives. IT and information are not free goods and delivery of new systems and data collections take time, care and resources.
The burden of central returns remains a major direct cost and distraction for front line services and – despite national pan-government targets, QIPP and much rhetoric by all central agencies – shows no real sign of any real reduction. Information is still too often used a as a weapon and punishment rather than as a tool for improvement.
Julia Manning, chief executive of centre-right think tank, 2020health.org
The next government must not throw out the NHS IT baby with the bathwater. IT-enabled new ways of working are essential to help the NHS to meet ever-growing health demands whilst also achieving its productivity targets and improved outcomes.
Three keys to achieving success are firstly allowing trusts to set their own direction to meet local clinical priorities, in accordance with nationally agreed standards. At the same time, those parts of the National Programme for IT in the NHS that are a valuable platform for the future should be developed, including N3, PACS and the Electronic Prescription Service. The Summary Care Record project should be halted and reviewed to examine where the real value lies – which we feel is in the form of an Urgent Care Record.
The third key is exploiting telemedicine and mobile health technology, including monitoring and enabling self-care. In other words, a radical reorientation and downsizing of the central IT organisation is needed for it to become more transparent and accountable to the NHS, in combination with a consolidation and strengthening of IT provision at the local level.
Murray Bywater, managing director of Silicon Bridge Research
I would like to see a reduction in the number of often pointless and counterproductive political ‘initiatives,’ a more pragmatic approach to standards, and a recognition of the industry contribution while supporting solutions that are good enough to do the job – not necessarily perfect.
I would also like to see the successful infrastructure components of NPfIT nailed down and to sunset the rest, while getting the IT ‘monkey’ firmly back onto the shoulders of local trust management and encouraging clinicians to lead transformational change at health community level.
I think it needs to be accepted that medical technology, not IT, will determine standard clinical process. Local organisations need to fund their own IT projects without central interference; central IT funding should be restricted to essential infrastructure projects and services only. On top of that we need to stop pretending the NHS can meet all future expectations solely from taxation and motivate individuals to take an active role in providing for their own healthcare.
Cornelia Wels-Maug, senior analyst IT services, and Mike Davis, senior analyst information technology management, Ovum
The most important thing for healthcare delivery and the supporting services is stability. If an incoming government is going to make further changes in the NHS structure, it should do it in the first year and then leave highly paid and skilled people to get on with the job. If healthcare IT staff are tied up with all the detritus of reorganisation, such as provisioning and equipment moves, then they cannot be cleaning data sets or aiding process change.
On a similar theme, when I left the NHS, my chief executive had 51 top priority targets – all of which required monitoring and reporting. Strategic health authorities should be told to give three relevant targets for each trust and then to leave the professionals employed to go and deliver.
Jonathan Edwards, research vice president healthcare, Gartner
I hope that the next government starts to tackle the question of payment reform in the NHS. Many of the things that the NHS wants to achieve with IT – such as a single view of the patient, coordinated care, joint working with social care, remote patient monitoring, better management of chronic diseases, a change from focusing on procedures and payments to focusing on quality and prevention – are extremely difficult to pull off in a system that pits primary care trusts against acute trusts, acute trusts against each other, and healthcare against social care.
Around the world, the successful IT-enabled healthcare change initiatives are found in environments where there is close alignment between the payers and the providers of healthcare. It is not surprising that Scotland, Wales and Northern Ireland, where the incentives are better aligned, have made more progress with initiatives for health information exchange than has England.
Jeremy Nettle, chair of the Intellect Healthcare Council and director of health science at Oracle
With a real commitment from government, the technology industry can help make this vision a reality. Procurement needs to be smarter, cheaper and more efficient to drive savings and ensure frontline staff have the tools they need to deliver better care.
But more needs to be done to stimulate innovation. There should be better access to innovation sandpits that allow companies with new products to innovate within a safe environment of standards and interoperability. There should also be a commitment to continue and extend tax credit support R&D.
Roz Foad, chair BCS Primary Healthcare Specialist Group, speaking in a personal capacity
I would like the next government of this beleaguered country financially support interoperability between existing clinical systems and give this priority over national data hoarding. We have excellent, innovative suppliers, most of whom have a proven track record of working together. Give them the incentives and the tools to develop shared information pathways, including patient access, whilst saving on the expense and security issues of creating and synchronising massive government databases.
I would like all GP practices to receive the sort of data quality training provided by PRIMIS as a right, built into the GP contract, and the need for an assessed level of quality to be achieved before information is released by practices into wider NHS arenas. I would also like the next government to commit to a genuinely fast broadband deployment for all primary care sites. The current levels are not nearly sufficient to deliver the fast data processes required by the new enterprise systems.
Zack Pandor, joint director of ICT for Herefordshire NHS and Herefordshire Council
Some of the things that I would like to see in a manifesto include better integration of health and social care. On the IT front, I’d like to see better co-ordination of the IT initiatives that come out of different government departments. In particular, I’d like to see more joined up thinking between the departments that cover health and communicates and local government. At the moment, we have to go through duplication information governance processes for the NHS to use N3 and local government for CoCo.
I’d also move national programme funding down to local health communities so they can make their own decisions, with the centre providing a standards and interoperability framework rather than mandating solutions. And I’d like patient access to both health and social care records. Finally, from where we sit, better connectivity with Wales and Scotland would be great for patients who live near and therefore cross borders for treatment.
IT director at a trust in the North East
It would like to see better and more complete standards for the interchange of information and greater licensing of systems and products for use in the NHS, based again on standards. There also needs to be better communications with the coal face and devolved budgets (minus any government savings).
E-Health Insider would like to hear what readers would like to see in the party manifestos. What should they commit the health service to delivering, and how should IT be organised to support it? Are there any specific technologies that politicians should be supporting – and the electorate demanding? What daft ideas should the politicians avoid? Add comments below, or email the news team.