Kingsley Manning, the new chair of the new Health and Care Information Centre, says information is set to become the critical factor in health service improvement over the next few decades.
And he is determined that the HSCIC should play its part by delivering on its remit to be the ‘safe haven’ for NHS data that will be the ‘single source of the truth’ about health and social care services.
“Organisations should speak truth unto power,” he says; although he stresses that it is for others to draw conclusions from the data. “The HSCIC will never comment or provide interpretation.”
From NHS IC to HSCIC
The HSCIC has grown out of the NHS Information Centre, which benefited greatly from the coalition government’s ‘open data’ and ‘transparency’ agendas.
The NHS IC was one of the few bodies to emerge unscathed from the Department of Health’s arms length body review back in 2010. Indeed, the review promised to put it on a statutory footing and to give it new responsibilities.
The Health and Social Care Act that enacted the government’s wider ‘Liberating the NHS’ reforms followed up on these pledges.
It gives the HSCIC the remit to become the “focal point for collecting, storing and disseminating national data from health and social care bodies” and publishing that data “for a wide variety of customers.”
As NHS Connecting for Health was wound down with the ‘end’ of the National Programme for IT in the NHS, the HSCIC also picked up many of its responsibilities for managing national IT systems and services, accrediting IT systems, and improving information governance.
Summing up the HSCIC’s role, Manning says it needs to become “the Office of National Statistics for healthcare” – a single source of information for all – or “the NICE of data” – as necessary to the future development of the health service as NICE is to drugs and treatments.
Reducing the data burden
The Health and Social Care Act also gives the HSCIC responsibility for reducing the burden of data collection on the NHS.
Manning says the organisation is acutely aware of its duty; although, drawing on Greek mythology, he compares the task of reducing data burdens, as “not unlike the labours of Sisyphus” – the King of Corinth forced to daily push a boulder uphill, only to watch it roll back.
Manning argues that the aim should be to extract data from primary systems and records, so it only has to be recorded once. “Strategically we are very supportive of extraction of data from primary records, but that will take time. It’s not going to happen overnight.”
One automatic extraction service that is already in place is the General Practice Extraction Service which, as its name implies, extracts information from GP IT systems.
However, it has proved controversial. Patients and GPs are supposed to be able to opt-out of GPES extractions, yet NHS England is proposing to use GPES for the very large primary care data set that it wants to feed into care.data.
This will link Hospital Episode Statistics with GP information and, eventually, with many other data sets; as well as with a fuller range of hospital data than HES covers at the moment.
For the moment, care.data is going ahead with an information governance assessment that says patients will be able to make a “reasonable objection” to their data being shared – although it is not clear how they will be informed or this will be achieved.
One thing the row reveals is the potential power that the HSCIC holds because it can require NHS and social care providers to release data. And Manning is convinced that data linkage will deliver huge benefits.
“This enables us for the first time to link data up to HES data and provide a full picture to providers and commissioners,” he argues. “The potential is only just starting to be thought about.”
Unsurprisingly, Manning also supports the government’s vision for publishing far more information to the public. “I’ve known Tim Kelsey [national director of patients and information] for an awfully long time,” he says.
“I’m totally supportive of Tim’s visionary zeal with regard to open data and the transformatory effect of that. I see one of our tasks as assisting Tim in realising that agenda.”
An ‘active’ chair in search of a chief exec
Manning was executive chairman of Tribal Health, a health and government consulting business, before it was sold to Capita in 2011. Before that, he was founder and managing director of Newchurch, a healthcare consultancy that Tribal bought in 2010.
As chair of the HSCIC, he will be leading a huge organisation. The NHS IC had just 300 staff. The HSCIC has 2,000 – although it is likely to shed staff as it works out what to do with its CfH inheritance.
Manning, who has been appointed for three years, tells EHI that he intends to be an “active” chairman. One of his first jobs will be to contribute to the appointment of a permanent chief executive for the HSCIC.
Alan Perkins has taken up the interim appointment and Manning says he expects the HSCIC to appoint a permanent chief executive “by the end of the year.” A new board is also in the process of being appointed.
Dealing with the CfH legacy
Manning acknowledges that the HSCIC has a mixed inheritance from CfH, and says the objective must be “to realise as much value as possible from the remainder of the deals” that NPfIT did.
Tim Donohoe, the senior responsible officer for the local service provider programmes, remains outside the HSCIC at the DH. But Manning says: “Our job is to support Tim at the local level.”
Asked about the remaining contract value of the deals, Manning says he doesn’t yet know. “It’s one of the first questions I asked.”
The Commons’ public accounts committee recently discovered that around £1 billion has still to be spent with CSC in the North, Midlands and East; with some £600m of that apparently earmarked for spending on the Lorenzo electronic patient record. So the sums are likely to be substantial.
The HSCIC also has “stewardship for national infrastructure” including the Spine, N3, Choose and Book and NHSmail. Manning says this means it will be doing those things that it makes sense to do nationally for the health and social care system as a whole.
A further major responsibility of HSCIC is to engage with the health IT industry and foster an innovative and vibrant market. This will be an interesting experience for Manning, whose background means that he spent most of the past decade on the other side of the fence.
“It [the supplier community] has not had a great experience the past ten years,” he notes wryly. “I’m very keen that we do our part to generate an innovative and entrepreneurial culture. We have to work with major partners, such as BT, but we want to work with the wider market.”
One source of the truth
Still, the key task is to deliver on the HSCIC’s information collection and publication agenda.
“Information has the potential to be the biggest driver innovation and improvement in health and social care,” Manning says. “I’m looking for us to be the source of evidence about both health and social care services.”