NHS told to get ready for info strategy

David Nicholson

The Department of Health’s annual ‘to do’ list for NHS managers has urged them to prepare for the elusive information strategy.

The Operating Framework for the NHS in England 2012-13 puts a particular emphasis on trusts continuing to meet the “quality and productivity challenge” that is supposed to deliver £20 billion of efficiency savings in four years, and on coping with the latest NHS reforms.

In his forward, NHS chief executive Sir David Nicholson, who is now also chief executive of the NHS Commissioning Board in Leeds, says there are “encouraging signs” that the NHS is delivering on the quality, innovation, productivity and prevention agenda.

He says this is “impressive” given the “complexity and uncertainty of the environment that we are operating in” and the “personal and professional uncertainty that many across the NHS continue to face.”

But he adds that the health service will need to take “bold, long-term measures” to keep up the pace, with a renewed focus on “innovation”, which he describes as the “forgotten element” of QIPP.

Nicholson holds up telehealth as an example of innovation, and says a forthcoming innovation review will “create the right conditions for the rapid diffusion of good practice.”

The Operating Framework includes a section on the information strategy for the NHS, which focuses on the need to give patients choice. It says this will be of “little value” if there is a lack of meaningful information.

“NHS organisations need to prepare for the forthcoming Information Strategy for Health and Social Care,” the operating framework states, although it does not say when it might be published.

The strategy was supposed to follow on from the ‘Information Revolution’ consultation that concluded at the start of the year.

But the managing director of NHS informatics at the Department of Health, Katie Davis, told an audience at EHI Live 2011 earlier this month that it was likely to be released this ‘winter’.

She also urged organisations not to rely on the strategy to provide a roadmap for the future of NHS technology and IT systems.

The framework says trusts should immediately work to give patients better access to their records, provide information on outcomes to support choice, enable the appropriate sharing of information between organisations and allow for better use of aggregated information.

It goes on to say that the data sets identified for public release this summer will be released in 2012-13, and that NHS organisations must make sure they are available.

The operating framework makes a further attempt to get NHS organisations to use the NHS Number, which has been repeatedly mandated.

Any organisation which is not compliant with the consistent use of the NHS Number by March 2013 will be subject to “punitive contract sanctions” – and commissioners will be responsible for linking the use of the NHS Number to contract payments.

Predictably, much of this year’s operating framework is devoted to the mechanics of closing down strategic health authorities and primary care trusts and preparing for the introduction of the new NHS first outlined in the ‘Liberating the NHS’ white paper.

However, Sir David picks out a number of media issues for attention, including the treatment of elderly patients and the high number of patient information breaches that continue to afflict trusts.

“Incidences of data loss continue to occur and in some cases these are both significant and clearly in breach of national guidelines,” the operating framework says, adding that this is “unacceptable” and organisations should be “vigilant” – particularly during the changes.

The operating framework also draws attention to the new Summary Hospital Mortality Indicator, and says that all organisations, regardless of their performance, will be required to examine and explain their score, and identify and act on ways they can improve.

Sir David adds that the NHS needs to ensure that tragedies such as that at Mid Staffordshire do not recur, and claims that compliance with the operating framework will help to make sure that they don’t.

“The on-going Mid Staffordshire Inquiry should act as a stark reminder if we fail to focus on the fundamental quality of care and to listen to the concerns of patients and relatives,” he says.