COMMENT
monitoring systems will have a big part to play in health services.
“Clearly you can’t have GPs constantly hav- ing to deal with email and bureaucracy, but there are ways and means of dealing with that. Being close to the public and recog- nised in communities is what all public services should aspire to, and we should be using technology, not resisting it.”
There are serious issues to resolve regard- ing data protection and privacy on the one hand, and transparency and patient access on the other.
Creese comes down fi rmly on the data-free- dom side of the fence, saying: “Transparency will be a high priority in the changes ahead. Local authorities have set a lead in pub- lishing spending, salary, performance and other data. In the future, we can expect to see patients in more control of their health records, and the true cost of health provi- sion open to more scrutiny. Assets will be openly documented and performance clearly published. Security controls and privacy matter greatly, but these cannot be used as an excuse to remain ‘closed’.
“Coupled with this, should be the creation of marketplaces for service outcome and demand-led approaches to health infor- mation systems provisioning that will fa- cilitate personalised choice of health and social care services. This will include the facility to discuss your own records and to see your ‘health account’ – in the way you can see your bank account online.
“This may imply a different relationship
between healthcare professionals and the public they serve, but it will, in my view at least, be generally welcomed and more ef- fi cient.
“It will, however, require integration of sys- tems, data quality improvement and greater sharing of information securely across lo- cal public services. It will also mean a tran- sition from a decade of central decisions on national IT projects to much more locally- based decisions and autonomy around IT. Gone are the days also of heavy reliance on private sector IT consultants and contrac- tors to deliver change, with internal profes- sionals often not feeling in control of that agenda. IT professionals can now work to- gether with health care and social care pro- fessionals to create a new approach.
“This move to localism does not mean that there is not a need for a consistent way of delivering health information and services across the country. It is essential that we have consistency in the way we capture and share information such as patient records and standards for technical infrastructure that allow safe sharing of those records and unifi ed communications. Health records in particular need to be shared across geo- graphic as well as service boundaries and unifi ed communication can save money.
“What is odd is that these sort of problems were solved by the fi nance sector many years ago, with records easily shared across boundaries of fi nancial institutions and ge- ography, with the necessary security.”
And Creese argues: “In the changes ahead there is a real opportunity for local health
services to determine how they wish to bring together the necessary infrastruc- ture and support services as well as profes- sional healthcare, to best meet the needs of an area, working with local government. Whilst these fundamental changes are not easy, the potential effi ciency gains are very large and can help to protect resources for frontline delivery.
“We know that trying to prescribe all this from the centre doesn’t work well, because it fails to recognise those local differences and opportunities – existing healthcare provision, buildings, geography, demog- raphy, ethnicity, cultures and the quality of services. It also does not capture local enthusiasm and commitment to change necessary for success.
“Doing better with less is more likely to be achieved through ‘localism’ – recognis- ing and working with the diversity of local places across the UK – rather than impos- ing sub-optimal, state-led uniformity.”
Jos Creese is President of Socitm, Chief Information Offi cer for Hampshire County Council and founder of the Local Public Service CIO Council, which he chairs.
Jos Creese FOR MORE INFORMATION
To see the full Socitm response to the Government’s ‘Liberating the NHS: An Information Revolution’ document, visit:
www.socitm.net/downloads/ download/376/
public sector executive Mar/Apr 11 | 19
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