Cabinet Office Chief Information Officer

What we have achieved so far

The National Programme for Information Technology [External website] is a transformation programme for the NHS. The Programme will deliver system reform and enable changes to the way the NHS works.

Staff and patients can now see that the majority of systems promised are working. Particular progress has been made through the Choose & Book system, Electronic Prescription Service, Picture Archiving & Communications System and N3 Network that joins the NHS up electronically. The NHS Care Records Service, which ensures every patient has a secure accessible electronic record, has been successfully piloted in Bolton, Bury, Dorset and South Birmingham primary care trusts.

This hard progress has been made against a 20–year history of not delivering modern information technology to the NHS. Naturally, this long history made many people sceptical that such challenging technology could ever be delivered. We can now confront that scepticism and in the future, while technical challenges remain, focus on the human factors necessary to make such a change a success for patients and the NHS staff.

Engaging with clinicians and the NHS
The 2006 National Audit Office report on the National Programme highlighted that one of the main challenges for NHS Connecting for Health, the Department of Health and the NHS would be “winning the support of NHS staff and the public in making the best use of the systems to improve services”.

Professor Michael Thick joined Connecting for Health as Chief Clinical Officer in 2006 and has been keen to strengthen clinical authority within the overall programme. The Chief Clinical Officer will:

• work to ensure that risk management and patient safety is embedded in every aspect of the programme
• coordinate clinical and appropriate external input into the programme’s activities and decisions
• ensure that Connecting for Health programmes have suitable and adequate clinical input and provide a support mechanism for the continued professional development of clinicians working on the programme
• have overall responsibility for managing clinical risk
• develop and maintain relationships with key clinical, patient and public stakeholders.

Working with the strategic health authorities
Important changes have been made to bring ownership of the changes required to deliver, and make use of, the technology, closer to the citizen customer.

Accountability for the delivery of the National Programme for Information Technology transferred to strategic health authorities on 1 April 2007, as part of the Local Ownership Programme. NHS Connecting for Health has been working closely with the ten strategic health authorities to help with the transition and the subsequent transfer of activities. Strategic health authorities, Chief Information Officers and their teams have been fully involved throughout the process.

To ensure relationships with Local Service Providers continue effectively, NHS Programme for IT Management Boards have een established in three geographic areas to:

• Act as a forum for Chief Executive discussion and decision making, in line with the strategic health authority mandate, and provide strategic direction within a defined geographic area.
• Ensure a joined–up approach in implementing National Programme for Information Technology across constituent Strategic Health Authorities.

Transforming healthcare developments in 2008

Personal medical record pilots
People have a right to expect that their basic healthcare data is available to the NHS staff treating them and that it is held securely. This makes it easier to choose where and when you are treated, and for the clinician to administer the right care. Under the traditional paper–based system this was not always the case. 2007–2008 will see increased piloting of the Summary Care Record.

The Summary Care Records will hold information about patients such as:

• medication;
• allergies; and
• any adverse reactions to medicines.

This information will be available for healthcare professionals treating patients in a range of locations such as the GP Out of Hours Service,Walk in Centres and A&E.

Access to the Summary Care Record will only be available to authorised NHS staff if they are involved in treating the patient and there are strict security measures in place.

Pilots have begun and the first clinical records have been uploaded to the national Spine User Directory.

NHS Choices [External website] – online access to health information and services

Better information about healthcare can help people look after themselves and take control of their own care. Searching for health related information is very popular on the internet.

NHS Choices [External website] aims to become the primary online destination for citizens and patients to access health information and services. The website was launched on 19th June 2007, making NHS–accredited information and services accessible, for the first time, to the public, and the professionals and mentors that support them. By July 2007, the new service had already received over two million visits.

NHS Choices also seeks and reacts to the feedback and needs of its users. People feel passionately about their local healthcare and an active debate will ensue on the site in 2007–2008. The work flowing from the Power of Information report [External website] will help inform the Department of Health in participating in the debate. NHS Choices integrates with other citizen facing services, such as Directgov [External Website].

Key achievements in 2007

Over 29,000 IT systems have been delivered, including the following examples, which illustrate the extent of individual systems that have gone from work–in–progress to 100% completion:

• Choose and Book is a national electronic referral service which gives patients a choice of place, date and time for their first outpatient appointment in a hospital or clinic. Patients can choose their hospital or clinic and then book their appointment to see a specialist, either with a member of the practice team, at the GP surgery, at home by telephone or over the internet, at a time more convenient to them.
• Electronic Prescription Service (EPS) will enable prescribers – such as GPs and practice nurses – to send prescriptions electronically to a dispenser of a patient’s choice (such as a pharmacy). This will make the prescribing and dispensing process safer and more convenient for patients and staff.
• GP2GP enables patients– electronic health records to be transferred directly and securely between GP practices. It improves patient care as GPs will usually have full and detailed medical records available to them for a new patient’s first consultation.
• Picture Archiving and Communications System (PACS) enables images such as x–rays and scans to be stored electronically and viewed on screens, so that doctors and other health professionals can access the information and compare it with previous images at the touch of a button. It makes x–rays on film a thing of the past, leading to faster and improved diagnosis methods.
• NHS Care Records Service (NHS CRS) will improve the safety and quality of patient care. It will give health care staff faster, easier access to reliable information about patients to help with their treatment.
• The Social Care Integration Project (SCIP) is an NHS Connecting for Health project which aims to enable improved outcomes for people using health and social care services, through enabling better, more seamless service delivery between NHS and adult social services.