The news that Monitor has issued a consultation on what might constitute a breach of the integrated care condition of the NHS provider licence has had a lot of hits on EHI this week. This is odd because, on the face of it, this is a story about a regulator doing some regulating that happens to have an IT component (Monitor has suggested that failing to share data, records or care plans might be evidence of a breach).

But of, course, there’s more to it than that. Back in the days when there was money around, the challenge facing the NHS was deemed to be quality, and trust competition for patients was seen as the way to raise it, Monitor was cast as a market regulator.

Now there’s no money, the challenge for the NHS is coping with rising demand, and integration is being put forward as the solution to that problem, Monitor is being asked to change focus. Which will be an enormous help to commissioners looking to get risk stratification and integrated care projects off the ground.

If NHS medical director Sir Bruce Keogh is correct, a lot of those risk stratification projects are going to lead to patients wearing monitoring devices that will make sure they get medical help long before they end up in hospital. It all sounds good as a vision. There may be a few cost, infrastructure, IG, acceptability, and organisational change issues to bring it to reality.

Trusts must back integration – Monitor

Failing to share health and social care records or care plans might be evidence of a breach of the new integrated care condition of the NHS provider licence, according to a consultation by Monitor.

Keogh predicts NHS wearables revolution

Wearable technology could lead to “a revolution in self-care” by improving the monitoring of patients with long-term conditions, NHS England’s medical director has said.

More action needed on IG – Caldicott

Dame Fiona Caldicott has warned that the “cultural change” that she called for in her second review of information governance in the NHS “has only emerged in parts of the system.”

Birmingham reboots central care record

A “proof of concept” trial for a Birmingham central care record is underway, following an overhaul of the troubled project.

HSCIC ‘chipping away’ at NME exit plans

Progress is being made in managing the transition away from local service provider contracts in the North, Midlands and East of England, the Health and Social Care Information Centre has said.

Gateshead completes imaging refresh

Gateshead Health NHS Foundation Trust has completed the implementation of a picture archiving and communications system and a radiology information system, both from Carestream, and a vendor neutral archive from BridgeHead Software.

EMRAD picks GE as imaging supplier

EMRAD, a consortium of seven trusts in the East Midlands, has agreed a £30 million contract with GE Healthcare to act as prime contractor for a cloud-based picture archiving and communications system, radiology information system and vendor neutral archive.

NHS 111 has been taking a beating as pundits cast around for a ‘cause’ of the ‘winter crisis’ affecting the NHS. The telephone helpline has been blamed for using “untrained” call handlers in thrall to computer algorithms that tell them to send people to A&E at the hint of a sniffle.

Why, Liberal Democrat MP Andrew George told care minister Norman Lamb in the Commons recently, one of his constituents had even been asked “Are you conscious” when he or she called over the Christmas period. The call has gone up: bring back NHS Direct. Which is odd, really, as nobody seemed all that keen on it when it was around.

My kind of thing

University Hospital Birmingham NHS Foundation Trust won the last EHI Award for the ‘best use of technology to share information with patients and carers’ for its myhealth@QEHB portal. Paul Curran finds out why.

“I have just over a week before having to commit the match funding to another project, if there is still no news. I can’t believe the lack of information – when there is a significant rush to spend Department of Health underspends with clinical commissioning groups.

“The NHS is in a position where a well planned, well evaluated, well governed bidding process will not deliver – when a similar amount [of money] will be divvied out through a ‘back of a fag packet’ bidding process to remove the surplus. Who could make this up?!”

“I see a time where someone who’s got heart failure, because they’ve had a previous heart attack, is sitting at home and wearing some unobtrusive sensors.

“[Then] his phone goes, [and] it’s a health professional saying: ‘Mr Smith, we’ve been monitoring you and we think you’re starting to go back into heart failure. Someone’s going to be with you in half an hour to give you some diuretics’.”

NHS England’s medical director, Sir Bruce Keogh, predicts a wearables revolution.