A clear direction for NHS IT was set in 2014; but could be disrupted by the general election due on 7 May.
Asked for their predictions for 2015, the 15 IT directors, suppliers and other experts contacted by EHI mentioned the ‘Five Year Forward View’ and ‘Personalised Health and Care 2020’ as foundation documents for the future of the health service and its technology.
But they also warned that a change of government, or even of health minister, could halt momentum. Natalie Bateman, head of health, social care and local government at Tech UK, pointed out that: “[Health secretary Jeremy Hunt] is a technology evangelist.
“But will the new secretary of state (if it isn’t Hunt) understand the importance of technology to patient outcomes, safeguarding the NHS, and contributing to UK Plc? It is the responsibility of the industry to make sure that he/she does.”
The Five Year Forward View was published by NHS England’s new chief executive, Simon Stevens, in October. It calls for a new focus on public health and new service models to help the NHS close the gap between rising demand and flat funding that was identified by his predecessor, Sir David Nicholson, and which could reach £30 billion in 2020-21.
Personalised Health and Care 2020 is the National Information Board’s IT framework that was published in November. It seeks to align NHS IT strategy with these policy imperatives, and to set out the role of national and local organisations in delivery.
In the ’15 predictions for 2015’ feature published today, Tim Kelsey, the director of patients and information at NHS England, and the chair of the NIB, argues that the framework takes NHS IT out of the “cul-de-sacs” that it has gone down over the past decade.
He also argues that it “provides the first blueprint that all national bodies, clinical and civil society leaders have agreed” and that represents an ambitious plan to create integrated digital records, to which patients have access, alongside kite-marked apps and new digital services by 2020.
The suppliers asked to contribute agree; with most arguing that the first impact will be seen on trusts, which will have to develop new, integrated records to support new, integrated ways of working, and then on patients, who will come to expect digital interactions with the health service.
Markus Bolton, the joint chief executive of System C, says: “Hospitals are going to be adapting to the new world of shared records and cross-organisational pathways; the way that end-of-life care is managed, and the IT systems that support it, are already showing the way.”
While Chris Spencer, the chief executive of EMIS Group, says: “The ever increasing pressure on the NHS for lower-cost healthcare will drive an increase in personalised health budgets, making the citizen the customer rather than the patient.”
Trust IT directors and clinical leaders concur, albeit with some suspicion about the political ‘spin’ that will be put on developments in the run-up to the election.
“The NHS electoral debate will re-present the connected health framework developed over the past ten years as an opportunity to exploit the real possibilities of health IT – booking online, virtual health advice, and personalised health,” says Charles Gutteridge, the chief clinical information officer at Barts Health NHS Trust.
“Expect new use of old ideas claiming originality through political prestidigitation.” While Adrian Byrne, the director of IM&T at University Hospitals Southampton NHS Foundation Trust, says: “There’s an election. It feels gloomy.”
Assuming the election doesn’t stop healthcare IT dead in its tracks, EHI’s experts predict that 2015 will also bring renewed debates about the role of standards and open source in delivering on the NIB’s plans, and on confidentiality and the use of data.
Andy Williams, the chief executive of the Health and Social Care Information Centre, says that building public trust will be one of its big focuses for the year; and one of the things that it will be keeping in mind as it sets out new rules for accessing information for commissioning at the end of January.
Phil Booth, the co-ordinator of medConfidential, says building public trust will also be essential as the government pushes ahead with the care.data programme to link the Hospital Episode Statistics to other data sets and release them to researchers and companies. Booth says care.data and similar programmes “must be about medical ethics: not ‘what can we get away with’.”