RECORDS, DATA & DOCUMENTS
All NHS patient records digital and interoperable by 2020
All NHS patient and care records will be digital, real-time and interoperable by 2020, under new plans unveiled by national health and social care organisations. David Stevenson reports.
T
he ‘Personalised Health and Care 2020’ report, released in mid-November, explains how the NHS will go about giving patients digital access to all their records by 2018, and how the Care Quality Commission (CQC) will regulate the quality of record- keeping from April 2016.
From March 2015, as previously pledged, all citizens will have online access to their GP records through approved apps and digital platforms. By 2018, the record will be interactive: all individuals will be able to record their own comments and preferences on their care record.
The report was published by an alliance made up of the Health and Social Care Information Centre, Monitor, the CQC, the NHS Trust Development Authority (TDA), Public Health England, the Local Government Association and clinical leaders.
By spring 2015, the National Information Board (NIB) – the government body that represents England’s public sector care services – will coordinate agreement on national technical and professional data standards required to achieve digital real-time and interoperable care records.
In the following year, NIB will publish a ‘roadmap’ for moving to a whole-system, consent-based approach, which respects citizens’ preferences and objections about how their personal and confidential data is used, with the goal of implementing that approach by December 2020.
Accredited safe havens and care.data
As part of the new proposals, it was noted that subject to ongoing evaluation, and with full safeguards, the delayed care.data programme to link hospital and GP data will be extended nationally to other care settings to enable safe data-sharing for better analysis of care
outcomes.
A consultation this summer suggested the introduction of ‘accredited safe havens’ (ASHs) to “provide a secure environment within which data that could potentially identify individuals can be lawfully processed for a limited range of approved purposes, under controls that minimise reliance upon identifiable data and constrain how the data is processed in the ASH”. These would build on proposals from the 2008 data sharing review and the 2013 information governance review.
The ASHs would be for purposes other than ‘direct care’, however. On care.data, that consultation noted: “It has become clear that many people are unhappy about information being passed – even in a form where the risk of re-identification of individuals is remote – to insurance companies or commercial bodies that might seek to use it for purposes that many would find unacceptable.”
The authors of the new report added that by June 2015, the NIB will agree a core ‘secondary uses’ dataset that all NHS-funded care providers have to make available to support commissioning, regulation and transparency.
The dataset will be reviewed regularly and developed in line with general and specific confidentiality requirements.
Making the NHS a digital pioneer
Tim Kelsey, National Informatics director at NHS England, said: “Our ambition is to make the NHS a digital pioneer for our patients and citizens.”
The alliance’s report sets out examples of where this is already happening, adding that technology will play a vital role in helping contribute to the £22bn in efficiency savings needed to sustain the NHS, as set out in the NHS Five Year Forward View.
Health secretary Jeremy Hunt said: “Given that much innovation saves money as well as lives, we need to change the NHS from a lumberingly slow adopter of new technology to a world-class showcase of what innovation can achieve.”
In addition, by the end of 2015, NHS ‘Kitemarks’ will be introduced for trusted smartphone apps, which will help patients access services and take more control of their health and wellbeing.
Other proposals include abolishing paper in A&E by 2018 and applying an NHS verification to third-party health apps so they can be “prescribed” by GPs.
From April 2016, the CQC is to take performance against the data quality standards into consideration as part of its regulatory regime.
SNOMED CT
The NIB also endorses the move to adopt a single clinical terminology – SNOMED CT – to support direct management of care, and will actively collaborate to ensure that all primary care systems adopt SNOMED CT by the end of December 2016; the entire health system should adopt SNOMED CT by April 2020.
It was stated that the proposals set out in the paper must also be delivered “within available resources”. However, the alliance partners noted that “we do not know what a future funding settlement will be for the Department of Health and the NHS, nor for its technology priorities. The Five Year Forward View identified that delivering on the transformational changes it proposes and the resulting annual efficiencies could – if matched by staged funding increases as the economy allows – close the £30bn gap by 2020-21”.
FOR MORE INFORMATION
W:
www.gov.uk/government/publications/ personalised-health-and-care-2020
national health executive Nov/Dec 14 | 67
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