IT development is a good place to test out the benefits of local autonomy in the new NHS. It's time for joined up information-gathering
Like me, you may well have ‘government document fatigue’. Page upon page of optimism and bureaucratese after a while comes to resemble staring at a blank wall. And life, after all, is too short.
Such were my uncharitable thoughts one hot evening last week, as I settled down to read: The power of information: putting all of us in control of the health and care information we need, a new offering from the Office of Public Sector Information.
Yes, there is some waffle in there. But the paper is the best attempt so far at weaving together a lot of threads into what could eventually become a unique rich cloth.
‘Unique’ because the NHS is probably the only health system in the world with such comprehensive data on health and health care for the whole population - plus, on the network of groups and institutions affiliated to the NHS which collect relevant data that can be linked to.
This major inheritance of having a single payer and universal comprehensive coverage has hardly been drawn upon. No one can fail to notice how NHS care in the UK lags behind other industries in how it uses information to inform and increase convenience for consumers.
Now is the time to do it, and The power of information does a good job of tracing a pathway for the next decade. The basic task is to speed up, join up, open up.
In these kind of documents, the ‘making it happen’ chapter is usually the shortest. And given the new Health and Social Care Act, the levers of power have changed, so the chapter is even shorter.
No targets for now then, but actions that are usefully summarised as what is commitment, planned central action, necessary local action or encouraged local action.
As ever, most action will be local, but what will speed change here is less explicit, except that there will be a capital fund – held by Department of Health – for investment. With national standards ensuring inter-operability, the emphasis is on harnessing local talent to link a patchwork of clinical systems and develop them.
Planned central action includes setting standards for national and local networking of systems, to allow data sharing and to make huge data-sets available for analysis. What exactly the DH will do versus the NHS Commissioning Board and others, such as the Care Quality Commission and Monitor, is opaque in places – clearly there is much still to be worked out.
One obvious omission is, if the future is all about eking out more value for money, where do data on NHS finances fit in? Our forthcoming analysis of what can be done with patient-level costing systems shows the power of these data.
National initiatives, such as the pledge to link a unique patient identifier (the NHS number) to all patient records collected by 2015, is crucial and should be backed up by a central capacity to analyse the data.
Engaging doctors, managers and patients to innovate in this environment will be hard. But the need to take difficult decisions may actually speed up initiative-taking.
Jennifer Dixon is director of the Nuffield Trust
