Care record board to focus on communication

Harry Cayton, who is also the Department of Health’s patients’ tsar, told his first media briefing on Wednesday: “I think if I look at it myself from outside, I think a legitimate concern… is that we haven’t communicated as effectively as we should have."

He said that communication would be the focus for his work on the board, which was formed in July to replace the Patient Advisory Board and the National Clinical Advisory Board (NCAB) just nine months after their inception.

The board abolishes the divide between clinicians and citizens and Cayton says he has also shifted away from the idea of simply assembling representatives from formal bodies to recognising that there are thousands of people in the NHS who should be engaged directly.

This is a significant move from the previous structure of the NCAB which was dominated by medical and nursing royal colleges and NHS organisations. They all lose the right to automatic representation.

Cayton said the board’s first national conference on 25 November would be restricted to around 500 attendees, though he saw no reason why there should not be 5000 in five years’ time.

But major contracts are in place and systems are chosen. Isn’t the communication drive too late, Cayton was asked.  Moreover, wasn’t the communication wrongly timed to take place after key decisions had been made rather than before?

Cayton confirmed the communication would not be about the form that the electronic systems would take.  "That has been decided.  It’s about how we use it. 

“Within the contracts we have signed there is scope for us to have a dialogue with the people who are developing the software about how we use it and, as I understand it, it’s not massively fixed so that it can never be changed. It’s about learning how to use this software and applying it in ways that are effective," he said.

Cayton said the national programme was set to run over 10 years and there was no point at which it would be finished. Medicine would continue to change.

Paul Whatling, a senior clinical consultant with NPfIT who is an executive member of the board, said systems were being specified in a “fairly generic” way.  He cited the example of functionality which was being created to intercept errors. “It’s our job to define what those errors are," he explained.

Asked whether he would intervene on controversial matters such as choice over GP systems, Cayton – who has a formidable reputation as a patients’ champion – said this was not really within the remit of the board. 

However he added: “I’m an independent chair and I wrote into the terms of reference that one of our jobs was to keep the National Programme for IT aware of risks and difficulties that came to our attention. I’m not remotely afraid to raise issues I think are in the interests of patients."

The inaugural meeting of the board will take place next week.  It has a core of executive members and is currently selecting 12 other members from an open recruitment process that attracted over 100 applications. Minutes will be published along with summaries of discussions.  Members will not be barred from talking to the media to express personal, rather than board, views.

Cayton said: “The board’s job is to set priorities for the development of the care record; to establish action teams who are going to do the work and to quality assure the process.” He said it was not the board’s job to “invent everything". 

The action teams will work through the steps needed to make care records useful and practicable for people within the service who will need to work with them.  Cayton gave the example of a group had been set up to look at the care pathway for people with diabetes.

“They are going to be about how the NHS uses the electronic system to improve care," he said.

Details of the CRDB’s national conference can be found at http://www.npfit.nhs.uk/crdb/conf_1104/