Monday, July 14, 2008

NHS Informatics review

At the end of last week the Department of Health published the Health informatics review report led by Matthew Swindells.

Much of the coverage has focussed on the new "freedom" for trusts to purchase "Interim Solutions" until Connecting for Health products are available eg E-Health Insiders "NHS Informatics Review says trusts need 'interim' systems" and Computer Weekly "Health chiefs tell NHS trusts not to wait for NPfIT".

These are important, however some of the other areas of the report are also worthy of consideration. The need for leadership in the Health Informatics domain at local and national levels is discussed with several recommendations for initiatives to develop the informatics workforce and training for the clinical workforce, and sharing learning from implementations. It would have been nice if a little more detail about the education and training initiatives had been included.

The report talks about "Creating confidence" and I would agree that "stakeholders" (patients and staff) and their feelings about the programme are key to success, however I'm not sure that some of the platitudes about improving confidentiality, security and governance of information will achieve this. The NHS Care Records Guarantee is held up as an example of good practice, but some of its inherent weaknesses identified in the Report of Evaluation of Summary Care Record Early Adopter Programme in May, are not addressed.

Additionally, issues around the interface between the NHS Care Records Service and other bodies including social care, voluntary sector organisations, independent sector treatment centres, hospices etc for the exchange of information and dissemination of information by the Secondary Uses Service from the NHS Information Centre are alluded to - with plans for consultations. I would suggest that these issues, which some of us were highlighting years ago should have been addressed by now.

NHS Choices and HealthSpace are held up as examples of good practice (and I understand are now receiving enhanced funding) and they are important, but they do not make up for the delays and deficiencies in the delivery of the Care Records which were a primary purpose of Connecting for Health.

It will be interesting to see if the Health Informatics Review implementation programme which is being set up, and the "enhanced" local ownership predicted will be successful in breaking some of the log jams which are currently blocking progress and I look forward to their more detailed report which is promised for the autumn.

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