The UK government has released today a new policy paper outlining Health and Social Care Secretary Matt Hancock’s vision to transform the use of technology across health and care, setting out plans to introduce a set of national open standards that all IT systems purchased by the NHS will have to meet, while existing solutions will have to be upgraded.
The Future of Healthcare document reiterates some of the priorities previously outlined by Hancock in a speech at the Health and Care Innovation Expo in September, where he vowed to “sort out” the digital architecture of the health and care system, now with a “new approach” based on open standards, secure identity and interoperability.
“Technology systems used daily across hospitals, GP surgeries, care homes, pharmacies and community care facilities don’t talk to each other, fail frequently and do not follow modern cyber security practices. As a result, some people are getting suboptimal care, staff are frustrated and money could be saved and released for the front line," the paper reads.
“Open standards are not an abstract technical goal. They permit interoperability between different regions and systems but they also, crucially, permit a modular approach to IT in the NHS, where tools can be pulled and replaced with better alternatives as vendors develop better products. This, in turn, will help produce market conditions that drive innovation, in an ecosystem where developers and vendors continuously compete on quality to fill each niche, rather than capturing users."
NHS Improvement will reportedly be asked to assess NHS trusts' compliance with the standards, which will also be part of the framework for GP systems providers and Local Health and Care Record Exemplars, while NHS England will include these in the standard financial contract to ensure that “all purchasing is consistent with best practice".
Separately, the Care Quality Commission will be consulted on how to reflect the standards in their inspections of providers, while NHS Improvement and NHS Digital will “work together on the use of spend controls to enforce the use of standards when procuring new systems for the NHS, looking at additional controls for spend on systems and services that are below current thresholds”.
A questionnaire has been set up for stakeholders to provide feedback.
“A modern technical architecture for the health and care service has huge potential to deliver better services and to unlock our innovations. We want this approach to empower the country’s best innovators — inside and outside the NHS — and we want to hear from staff, experts and suppliers to ensure our standards will deliver the most advanced health and care service in the world," Hancock said.
Meanwhile, HIMSS Chief Clinical Officer Charles Alessi told MobiHealthNews the new paper was "welcome in a whole host of dimensions".
"It delineates very comprehensively the need for England to “step up and deliver” and this is an urgent call for action as there have been a few false dawns in the past. Furthermore, its focus on people is particularly welcome.
"The challenge is aligning these approaches with policy changes affecting health and care models and with the metrics that drive them. The likelihood of success will increase exponentially if this alignment is satisfied."
'We recognise that the implementation journey is complex'
NHS Digital has published today a draft version of the digital, data and technology standards framework. Sarah Wilkinson, NHS Digital Chief Executive, said:
“We are going to build the detailed guidance on these standards in partnership with technologists across the system and with industry partners.
“We recognise that the implementation journey is complex. Through consultation we will seek to understand in detail what the challenges are for different parties and throughout implementation we will focus on providing clear specifications, detailed guidance and extensive support. Our goal is to ensure successful implementation through engagement and facilitation, ensuring that changes that are mandated are reasonable and achievable."
However, commenting on today's announcement, Sam Smith, coordinator of privacy group medConfidential, said:
“The widely criticised National Programme for IT also started out with similar lofty vision. This is yet another political piece saying what 'good looks like', but none of the success criteria are about patients getting better care from the NHS. For that, better technology has to be delivered on a ward, and in a GP surgery, and the many other places that the NHS and social care touch. Reforming procurement and standards do matter, and will help, but it helps in the same way a good accountant helps – and that’s not by having a vision of better accounting.
“There’s not much detail in here. It’s not so much ‘jam tomorrow’, as ‘jam… sometime’ – there’s no timeline, and jam gets pretty rancid after not very long. He says 'these are standards', but they’re just a vision for standards – all the hard work is left to be done.”
Editor's note, 26 October: This article has been updated to include a statement from HIMSS Chief Clinical Officer Charles Alessi.