In what was a relatively quiet week in Australian digital health, New Zealand stepped up again with its data and digital dramas, but we also cast our eye on the new government in the UK, which has decided in its wisdom to attempt another digital revolution in the NHS.
Following the recent Darzi report, the new government has decided to plough ahead with plans to move the venerable institution from analogue to digital, which has become Prime Minister Keir Starmer’s new mantra.
Those of us who’ve been around for a while will remember well on 25 years of the UK attempting to create a joined-up health system through IT, including the legendarily disastrous National Programme for IT (NPfIT), which looked at introducing EMRs into every single hospital trust, and at programmes like care.data, which hoped to link hospital records with GP records but which was scuppered mainly by the privacy lobby.
Work has continued since to allow patients to have access to their NHS data through the NHS app, and most hospital trusts now have a functional electronic patient record (EPR), but the new government has seen the incredible inefficiencies that are caused by information silos and non-interoperable IT systems and, in its wisdom, has decided to do something about it.
This week, a new bill was introduced into Parliament by the Department for Science, Innovation and Technology that will require IT suppliers to the health and care sector to ensure their systems meet common standards and enable data sharing across platforms. This is a good first step, although the IT vendors are well advanced on this.
The government has also announced plans this week for a single record for patients available through the NHS App. Launching a public consultation on the new policy on Monday, Mr Starmer repeated his refrain that the NHS needed to go from analogue to digital, from hospital to community and from sickness to prevention. (We get the feeling that the long-suffering inhabitants of that sceptred isle will hear quite a lot of this.)
Mr Starmer said that in transforming the NHS from analogue to digital, the government will create a more modern NHS by bringing together a single patient record, summarising patient health information, test results and letters in one place. The energetic new Health Secretary Wes Streeting referred to it as a “patient passport”, which no one understood, but otherwise he does seem to be au fait with all the terminology.
The first step, according to Mr Starmer, was to open up a public consultation through a new website called change.nhs.uk that will help shape the government’s 10-year health plan, to be published next year, and asking the great British public to put forward their ideas. Said public, being what it is, had a great deal of fun when the site went live on Monday, coming up with all sorts of recommendations for how to improve the NHS.
There are currently 5000 posts on that site – although the BBC is reporting that quite a number have been culled for being inappropriate or too funny. Quite a few we saw mentioned big bugbears like the fact that many GP surgeries do not allow online appointment bookings, and that each hospital appears to use its own computer system.
However, the best comments we saw included one recommendation that doctors, who are all ‘woke’, should be replaced with iPads to allow patients to Google their own symptoms. Another urged getting rid of Britain entirely as nothing good has ever come out of it, with a side benefit that this action would reduce NHS spending.
There was a rather intriguing call to allow GPs to amend a patient’s will so they are no longer unfairly excluded from receiving inheritances from patients who pass away unexpectedly, signed by one Dr H Shipman.
Our favourite though was to fire the Right Honorable Member of Ilford North, also known as Health Secretary Wes Streeting, out of a cannon, although appointing chief mouser at 10 Downing Street Larry the cat as health secretary came close. This does represent however a bit of a step down from previous calls for Larry to be appointed prime minister.
A lot of fun was had but there are some interesting recommendations, and it appears that the government is intent on solving this problem. They could have a look at what we’re doing here in Australia with our HIE, or better yet closer to their own part of the world where a number of European countries are well on their way. Good luck to them all.
Back closer to our home, and the dramas continued this week at Health New Zealand’s data and digital division. We had a great big scoop, as hinted at in our blog from last week, involving a letter sent to Health Minister Shane Reti two days before this year’s budget, warning him that the budget cuts would leave the country’s health system exposed to cyber security concerns due to aged infrastructure, a lot of which is beyond end of life.
There were also warnings from Health NZ’s director of strategy and investment Darren Douglass that the budget cuts would affect a large amount of work that was then underway, some of which was part of the Hira program, and would restrict any further work or completely shut the programs down.
This included important services such as the National Terminology Service, work on a consumer digital health identity and also work on the NZ Patient Summary, an area that New Zealand is currently leading the world in. There was also a stark warning that three shared electronic health record services in the North Island would be at operational risk of failure. Read our story here and see the response from Health NZ here.
We have been assured that patient data is safe and that Health New Zealand had significantly enhanced cyber security capabilities over the past three years, and that Health NZ itself was working on a 10-year plan for infrastructure investment, which Mr Douglass said was well progressed.
This is due to be published in December, but in New Zealand’s straightened circumstances, we would not be surprised if few if any funds are forthcoming.
We asked your thoughts on this in our poll question from last week: Is digital health progress in New Zealand going to sink or swim under the weight of the cuts?
The prognosis is a bit grim, we’re afraid: 85 per cent of respondents think progress will sink. Here’s what you said.
Our poll question for this week is:
Can the UK finally succeed in its plans to share patient data?
Vote here and leave your comments below.
The will to succeed has grown. Naysayers have diminished. A new generation of doctors has emerged in the last 20+ years. The technological capabilities have been there for many years now.