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NHS’s “basic IT infrastructure lacking” trusts still paper-based

"One of the things I never quite hear is that there is a programme to say ‘we are going to fully digitise the NHS’..."

The NHS’s “basic IT infrastructure” is still deeply lacking, with 20% of all the UK’s healthcare trusts still largely paper-based, a new parliamentary report reveals. And while there “enormous potential for technology to  support a transformation in NHS care that will bring benefits for patients and staff alike”, it notes, “this  potential will not be realised while many providers still struggle with basic IT infrastructure.”

The comments came in a new House of Commons Health and Social Care Committee report.

The report calls on NHS England, the government organisation that manages the health service, to produce a "roadmap" for better use of technology. It comes in the wake of a November 2021 review of NHS IT organisations by Laura Wade-Gery that emphasised how digital transformation is currently fragmented across the NHS, siloed between different agencies and is “often overshadowed by requirements of the day-to-day”.

The report also comes six months after the publication of the NHS Data Strategy, which laid out aggressive efforts to tackle what the strategy described as “cultural, behavioural and structural barriers” to the broader sharing of healthcare data.  That report espoused the vision of a "modern architecture in which data can be accessed real-time through APIs via a national gateway" but acknowledged that this "cannot be achieved when the data is held in silos within individual electronic patient record (EPR) systems" (and, of course, on paper...)

Read this: The NHS data strategy: 5 things to know, from data sharing, to OSS, and synthetic data.

As one member of the select committee lamented in a hearing: “I know there is NHS Digital, NHSX and all of those things, but one of the things I never quite hear is that there is a programme to say ‘we are going to fully digitise the NHS’ and that in 10 years’ time a patient will not have to repeatedly put in the same information, and the GP will not have to give the same information to a pharmacist that they have done 10 times over.”

The Health and Social Care select committee urged: "NHS England must produce its roadmap in response to the Wade-Gery report on Putting data, digital and tech at the heart of transforming the NHS at the earliest
opportunity so that we and others are able to scrutinise it ahead of implementation."

It also called for the Care Quality Commission (CQC) -- the independent regulator of health and social care services -- to be given responsibility for checking on the "effective use of technology within the domains it inspects", saying that this would "encourage futher progress on integration."

The report, "clearing the backlog caused by the pandemic" notes that tackling the impact of the backlog on the NHS caused by Covid "presents a major -- if unquantifiable -- challenge. There is potential for that challenge to catalyse service transformation... our key new recommendation is that, by April 2022, the Department of Health and Social Care works with NHS England to produce a broader national health and care recovery plan that goes beyond the elective backlog to emergency care, mental health, primary care, community care and social care."

It adds: "NHS England has already commissioned an evaluation of the role of digital tools in primary care. We recommend that it publishes that evaluation at the earliest opportunity and uses it as a basis to produce clear and consistent guidance on best practice in a) Reducing bureaucracy and day-to-day IT administration tasks, including those associated with referrals, routine blood tests, and follow-up appointments. b) The use of remote consultations in general practice. This should include guidance on how to approach conversations with patients about remote care, considering that while patients may not necessarily always be able to have a face-to-face appointment, they should have input into the decision and the rationale for any refusal should be transparent and consistent. We further recommend that NHS England looks beyond primary care in its assessment of the use of digital tools and considers the impact of an increased usage of such tools not only on patients, but also on other parts of the health and care system, especially at the primary care and secondary care interface."

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