King’s Fund calls for “definitive” NHS digital funding strategy
Think tank backs need for clearer aims and timeline around government's £4.2bn commitment to transform care following the recent publication of the ‘Wachter review’
Authorities must set out a “definitive” plan for expanding the use of digital technologies in the NHS with regards to funding timescales and how to proceed with key issues such as data sharing to ensure significant progress can be made to transform care delivery, the King’s Fund has said.
In a briefing looking at progress on key plans like implementing electronic patient record systems or repeat prescription services, the think tank warns that clearer goals and funding plans need to be set out to address “patchy” progress so far within the digital transformation of UK healthcare.
The calls match similar conclusions published earlier this month from an independent, government-commissioned review that favoured ensuring all NHS trusts have obtained ‘digital maturity’ by 2023, while also calling for clear objectives to be published by the end of the year for how a £4.2bn funding pledge will be spent.
According to the findings looking at how UK healthcare groups can best realise the potential of technology transformation, which was overseen by University of California Professor Bob Wachter, previous targets for creating a “paperless” NHS by 2020 were dismissed as being unrealistic. The report also highlighted a need for further funding beyond the £4.2bn already budgeted by government to ensure aims for nationwide digital maturity in the NHS can be met over a wider seven year period.
In responding to the Wachter report, the King’s Fund has accused authorities of giving mixed messages around how the £4.2bn financing will be allocated, which it said could undermine the efforts of trusts to meet national technology aims.
“This requires urgent clarification about when funding already announced will be available and how this can be accessed,” said the document.
“Holding back investment until the end of the parliament, as appears to be planned, will impact on the ability of local areas to make significant progress.”
Aside from its conclusions over the need for clear funding and implementation strategies, the King’s Fund also called for ensuring clinical staff are fully engaged within digital plans to ensure patients were benefitting from genuine service improvements, as opposed to solely focusing on cost cutting.
Other key considerations from the briefing included concerns about a perceived discrepancy between the “considerable progress” in digital transformation made by primary care providers when compared to secondary care in hospitals, which was found to be lagging behind.
Data sharing was also highlighted as an essential component to plans around research and improved care, as well as providing interoperable services that can link up the NHS and social care providers.
On the back of a review of data sharing practices in the NHS by National Data Guardian Dame Fiona Caldicott released this year, a consultation is underway to set out how best to move forward following the cancellation of the care.data programme that aimed to share patient data extracted from GP records to inform clinical decision making.
After a number of delays resulting from concerns from privacy campaigners about permission to use patient details and how they might be shared, the project was scrapped in July, with no decision yet taken on any possible successor.
However, the King’s Fund briefing played up the importance of data sharing.
“The recent Caldicott and Care Quality Commission reviews present an opportunity to address legitimate public concerns about data sharing in the NHS,” said the King’s Fund. “However, it is also critical that information governance is not a barrier to progress.”
King’s Fund policy researcher Matthew Honeyman also used the briefing to question whether previous commitments playing up a paperless NHS might actually be scrapped for a broader set of goals on the strength of the Wachter review.
“While [paperless healthcare] has often been used to provide clarity around some of [health secretary] Jeremy Hunt’s desired outcomes, it gets in the way of articulating a more fundamental case for change. It begs the question ‘what for’? And that’s something we think continues to be a challenge for national NHS bodies,” he said.
Honeyman cited Wachter’s findings directly in concluding that rather than playing up a single objective, such as going paperless, going digital or saving money, the ultimate technology aim for UK healthcare should be to try and improve care delivery for patients.