By John Thornton | 1 July 2012
The NHS remains stubbornly paper-dependent despite the huge benefits to patients, staff and services that basic technology could bring
There is immense frustration in many parts of the NHS at its failure to embrace and utilise basic technologies that would dramatically improve the quality of care for patients and substantially improve efficiency.
At this year’s Health Informatics Congress, where you would normally expect to find the cheerleaders for ICT, many of the speakers were openly critical of the progress that has been made. They decided to be brutally honest rather than putting the usual gloss on projects they are supporting.
A health visitor said her working life had been almost untouched by modern technology. Her office had one computer for six people, which they were not allowed to use to ‘communicate with patients’. Scheduling and diary management consisted of a chart on the wall, coupled with various sheets and diaries that had to be manually completed.
She also showed a photograph of her ‘knowledge management portal’ – a bag of brochures, books and laminated information sheets. The latest innovation was to give each health visitor a wheelie case in order to transport this mass of paper and allow access to it while visiting patients.
As she pointed out, in almost any other industry, a senior mobile worker would probably have a tablet PC with web access to data and advice, email, linked calendars and shared information resources.
In another session, a medical director described how the premature birth of his baby son led to six different NHS records spread over three hospitals, three London boroughs and two community health systems. There were no links between these systems, so there was no sharing of information between clinicians.
He explained in graphic detail how his wife and baby became victims of an inefficient and uncoordinated system that threatened the quality of care rather than enhancing it. He asked how PC maker Dell was able to personalise, build and ship its computers to every customer, allowing them to see progress at every stage, while the NHS was unable to record and track the progress of its patients. Surely, the patient should be the common factor linking all of the records?
The answer is to have the right information, in the right place, in the right format, at the right time.
These simple but demanding aims are at the heart of the new NHS information strategy, The power of information: putting all of us in control of the health care information we need. The strategy seeks to use better information to improve health outcomes, empower users, facilitate integration and encourage greater productivity. The strategy is unashamedly aspirational, and should be read by everyone with an interest in improving health and social care services.
The big question is whether the strategy will succeed where the National Programme for IT failed, especially as it will not have the £11.4bn of national funding that supported the programme.
The aim is that it will be more locally driven, capitalising on local innovation and adaptation, sharing information through common standards. This has to be the right way forward.
However, to succeed it will require vision and a massive cultural shift, coupled with strong local leadership. It will also require realistic levels of investment.
The new clinical commissioning groups should play a pivotal role. They have the opportunity to use their powers to push for the development of a new and more integrated service. But the danger is that they will merely commission similar services to those already provided.
It is to be hoped that the frustrations being felt by NHS staff will yet prove influential in making local teams adopt common-sense solutions and more modern ways of working at local levels.
John Thornton is a director of e-ssential Resources, and an independent adviser and writer on business transformation, financial management and innovation
