Here comes 2011

Christine Connelly, director general informatics, Department of Health

Innovation will grow at a local level as the wider NHS reforms progress during 2011.There are two key ambitions I hope to see begin to be realised during the year. We will encourage transparency by publishing data before it has been ‘polished’. We will also encourage data collection at the point of care, so we can improve its quality and accuracy, instead of relying on “after the event” memories. Finally, there is a great opportunity to help the efficiency and productivity drive by offering parts of the service online. Being able to communicate via secure email with a clinician, rather than waiting for an appointment, gives patients an accessible service, responsive to their needs.

Frances Blunden, senior policy manger, NHS Confederation

The vision outlined in the ‘information revolution’ consultation sets out significant opportunities and challenges for the NHS and its use of IT. Information and IT are expected to be central to the delivery of NHS care, with the electronic care record becoming the foundation of all information gathering in the NHS; the deployment of telehealth and telecare to transform the way care is provided; and the use of IT to communicate much more information to patients and clinicians to drive choice and quality improvements.

However, there is a significant gap between this vision of the future and the reality of where the NHS is now, with some significant parts of the NHS still operating only on paper based records. There is little indication of how this shift will be achieved, particularly given the significant financial pressures currently faced by the NHS and that there will be no new money to achieve the changes. Additionally, the impending loss of PCTs and SHAs will result in a loss of strategic leadership and direction on ICT matters when it is most needed.

Jonathan Edwards, research vice president, Healthcare Providers, Gartner

I expect to see happen the reorganisation, combined with the growing squeeze on finances, to slow down investment in IT generally. However, there are a few acute trusts with money to spare and a need for a new electronic patient record. They will move quickly to choose a supplier before the money disappears. Most trusts lack the money needed for a full EPR, so we will also see more trusts adopting clinical portals and electronic document management.

With the end of NPfIT, I would like to see happen a re-evaluation by acute trusts of the real value of a comprehensive EPR that includes e-prescribing, clinical decision support, care pathways and so on. This is worthwhile, because the actual work of preparing for an EPR brings the opportunity to redesign care processes and brings a lot of inherent benefit. I would also like to see trusts and local health communities using the reorganisation as an opportunity to create new models, based on a tighter relationship between the payers and providers of care and a shared financial responsibility.

Tola Sargeant, research director, TechMarketView

Next year will mark a period of transition for NHS IT. As the mists begin to clear around the remains of NPfIT, I expect an increasing number of NHS trusts to gain the confidence to procure systems independently. There is therefore a real danger that the Department of Health will struggle to get sufficient trusts to sign up to local service provider solutions.

In primary care, the transition of power away from primary care trusts will be top of the agenda. Primary care IT procurements could be delayed as a result, although IT supplier opportunities will surface as GP commissioning plans take shape, particularly for those with business process outsourcing credentials.

TechMarketView forecasts a much tougher year for NHS IT overall, with the market expected to contract by around 7% in 2011 and 4% in 2012 before returning to growth. It’s not all doom and gloom though – as ever, there will be opportunities for some suppliers; with areas such as business intelligence and business process outsourcing potential bright spots.

Murray Bywater, managing director, Silicon Bridge Research

I’m pleased that there is now more transparency around LSP contracts – revealing the true absurdity of LSP pricing levels – that open market conditions for NHS IT are finally returning and that NHS trusts are realising they each have unique characteristics that need to be reflected in individual IT strategies.

I’m confident that given support and encouragement from local trust management, clinicians have the ability and motivation to drive real improvements in patient process and workflow – provided trust management grasps the opportunity. However, I’m concerned about NHS trusts facing immense additional challenges to deal with a new GP commissioning regime likely to put unprecedented pressures on them for data collection, integration and contract management.

Mik Horswell, spokesperson for UK Council for Health Informatics Professions

My main concerns come in three areas. Firstly, money. Will there be much around for investing in new systems and to implement the ‘information revolution’ strategy? Will we be able to move forward with electronic records in the acute and community sectors and can we afford to employ enough healthcare informatics professionals to get the job done?

Secondly, people. Will the government clarify its position on accreditation and registration of professionals and will we be able to demonstrate careers in HI that will attract and retain professionals? Finally, policy. Standards; we have lots of them but who will decide which ones to use and how to maintain them? Leadership; when the reorganisation bites and we lose SHAs and PCTs there are no levels between Christine Connelly and the individual trust chief information officers. What will happen to HI leadership in the GP consortia as they emerge?

Richard Vautrey, deputy chairman of the GPC

If consortia commissioning is going to be a success, it will need to be built on a foundation of good quality information. In 2011, we need better and timely activity data and discharge information alongside improved technology to support communication between GPs and specialists to be able to make both savings and improvements in patient care.

We must also support practices make the best of their electronic records by putting in place robust hardware renewal programmes, fully rolling-out GP2GP transfer, and ensuring a follow-on for GPSoC is secured. And please let’s see common sense prevail and resolve the issues that have dogged the Summary Care Record.

Jon Lindberg, Intellect Healthcare programme manager

We expect to see efficiency savings continuing to dominate trust board agendas, with a number recognising technology’s enabling role. Moving forward, the NHS will also need to harness the power of technology to preserve the corporate memory of the ‘old organisations’ and transfer that expertise into the emerging organisations.

We want commissioners to make better use technology to improve the commissioning of health and social care services by providing more visibility of information and support for decision-making. We’d also stress the importance of focusing on information sharing rather than information systems, a move away from the system centric obsession we’ve seen in the past.

John Cruickshank, NHS IT expert 2020health.org

2020health’s hopes that we see no more announcements about yet another NHS telehealth pilot! Rather we would like to see some determined action towards propelling telehealth into mainstream care – with government addressing the reimbursement and governance blockages, the National Commissioning Board giving leadership to local consortia about making it happen at scale – and the Royal Colleges giving it their full support.

Assuming that the NHS reform plans are ratified by Parliament in early 2011, Ovum foresees more investment in healthcare IT in the primary healthcare space. This will be aimed at making patient information available between care givers [and therefore include] electronic health records, admin and billing systems, and scheduling. This will create more opportunities for system integrators, as well as solutions that enable such an exchange.

There is also a growing understanding that preventing rather than curing illnesses will curb the costs of healthcare delivery. Although there is little money left to invest in preventative measures, Ovum anticipates that vendors will try to sell – to a much higher degree than previously – health devices and applications using well-established consumer mass market channels to reach out to a wider audience.