The Department of Health has launched its information strategy document, outlining a vision for how patient data will be at the core of an integrated, demand-driven NHS service.
The document says that all patient records will be available securely online by 2015.
Mobile apps, cloud-hosted services, online bookings and automated repeat prescriptions are headline ideas in the strategy – which departs from the discredited NHS National Programme for IT (NPfIT) by aiming to support “imaginative” local decision-making.
The document comes in the wake of Health Secretary Andrew Lansley's NHS reform programme being pushed through Parliament – a controversial package of policies that sees healthcare providers recast in a care-purchasing role, with greater private-sector involvement.
Recent comments from CSC and other IT service suppliers to the NHS have suggested a close, emerging relationship with individual trusts rather than the top-down, centralised service of the past.
Unlike previous information strategies, this strategy "does not reinvent large-scale information systems or set down detailed mechanisms for delivery,” said the department. “Rather, it provides a framework and a route map to lead a transformation in the way information is collected and used.
"It provides the infrastructure to support the things that need to be done system-wide but – recognising that information technology is always advancing – it promotes flexibility and local innovation.”
The document says that the strategy's main ambitions are that information will be used “to drive integrated care across the entire health and social care sector, both within and between organisations”.
This is in line with the thrust of government data policy in 2012 towards dynamic information-sharing between public- and private-sector organisations, rather than within a monolithic IT infrastructure of the kind envisaged by Tony Blair – a vision that led to the disastrous, delayed and massively over-budget NPfIT.
However, data protection watchdogs and privacy campaigners have been warning for some time that not all such data-sharing policies are supported by current legislation – either in spirit or fact – and may force certain areas of data protection law to be redefined.
This reading of the new information policy for health is reinforced by some ambitious, but vaguely worded concepts: “A change in culture and mindset” is needed, says the document, “in which our health and care professionals, organisations and systems recognise that information in our own care records is fundamentally about us”.
The document talks about an information-led culture where “all health and care professionals – and local bodies whose policies influence our health, such as local councils – take responsibility for recording, sharing and using information to improve our care.”
The strategy says that information should be “regarded as a health and care service in its own right” with “appropriate support in using information available for those who need it, so that information benefits everyone and helps reduce inequalities”.
The document outlines a policy of information being recorded once, at a patient's first contact with "professional staff" – rather than specifically with doctors or nurses, for example – and shared securely between those providing care.
This will be "supported by consistent use of information standards that enable data to flow (interoperably) between systems, while keeping confidential information safe and secure", explains the document.
The ultimate aim is an information system “built on innovative and integrated solutions and local decision-making, within a framework of national standards that ensure information can move freely, safely, and securely around the system."
Electronic care records will “progressively become the source for core information used to improve patient care, improve services and to inform research”, says the document – which suggests that government may be planning to sell patient data – anonymised or otherwise – to private companies.
An emerging policy of creating what Computing has termed "The Data Bank of England", via fostering the sharing of private data between public and private organisations, appears to be gathering pace by stealth and via piecemeal policy announcements.
One route towards recovery, suggest recent government policy announcements, is to see citizens' data as a commercial asset that is managed by the state – evidenced by David Cameron's instruction to Lansley that he wanted to see the NHS becoming a "fantastic business” for the UK.
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