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Radical reform of NHS information strategy on the way

Douglas Carnall, BMJ

The new information management strategy of the NHS will make support of clinical activity its most important function. The final strategy is due to be published in late July.

Frank Burns, head of NHS Information Management and Technology, told an audience of NHS information technology professionals in London last week that the function of the systems would be to support the "capture, use, and impact of information on health care and population health," with "seamless, integrated, person based records."

Mr Burns criticised the present system of "tribalised professional clinical records," in which "pharmacists and nurses still take pride in their ability to decipher illegible prescriptions." He said that the current information technology strategy had for the past six years served managers and not clinicians.

Information support for professionals--of whom the NHS currently "expects the sheer human impossibility of reading and remembering a literature that doubles in size every 10 years"-- will be at the heart of the strategy. Content will be "sifted, sorted, and accredited as fit for purpose" by the proposed National Institute for Clinical Effectiveness on the NHS network.

Mr Burns claims strong support from ministers for his strategy, who, he says, "see it as a straightforward part of modernising public services." Mr Burns said that the arguments for the new systems were self evident. "Can we really imagine NHS resistance to a new technology that enables students to gossip across continents on the internet, while six forms, 10 people, two vans, and six days are required to return a laboratory result to a general practitioner's surgery?"

But although the process of implementing the new technology can be painful, and the benefits not always immediately apparent, the fear of failure that has dogged NHS information technology projects should come to an end. "Rushing to judgment over new systems is a mistake: you don't plug in a computer one day and change the world the next. And while the opportunity costs of a new system--typically of the order of £200 000 [£320 000] a year for an acute trust--are substantial, it is a pretence to imagine that high quality clinical information for an organisation is anything other than central to its purpose. We can afford anything if we think it is important enough."

A major shake up of individual NHS information departments also seems to be coming: "We should not be selfish with the skills of the information technology community we have got: the white paper gives a clear lead to initiatives which integrate and harmonise organisations that serve a given population, and it would be madness to try to replicate the full set of skills in each and every one."
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