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Data Communications between the NHS and Independent Sector Clinicians in England.

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Presentation on theme: "Data Communications between the NHS and Independent Sector Clinicians in England."— Presentation transcript:

1 Data Communications between the NHS and Independent Sector Clinicians in England

2 Prof. Ricky Richardson BSc MBBS MRCP(UK) FRCP FRCPCH DCH DTM&H Consultant Paediatrician Visiting Professor of eHealth - Imperial College Director of Global eHealth Ambassadors Programme Chair, Independent Doctors Federation IT Committee 2

3 The Problem Hospitals Primary care Tertiary Care Labs Home Care Registries Clinics 3

4 Independent Doctors Federation Formed in 1989 as a Forum, became the Federation in 2009 Represents independent doctors in all matters relating to private medicine, education, appraisal and revalidation. Currently members –67% Consultants, 33% GPs –43 corporate sponsors Supports excellence in independent medical practice Seeks to influence Government and regulators in all aspects of independent medical practice. 4

5 IDF IT Committee IDF IT Committee was reconvened in 2009 and asked to establish: 1. What IT systems are currently being utilised by practitioners and small specialist clinics within the independent sector 2. Which IT systems are being utilised by the current major independent sector providers. 3. Develop active links between Independent Sector and the Department of Health to define a process for patient data held under the NHS to be more readily available to the independent sector, and vice versa 5

6 IDF IT Committee Prof Ricky Richardson (Chair)Consultant Paediatrician Dr Ralph AbrahamConsultant in Diabetes and Endocrinology, London Medical John CoulthardDirector of Healthcare and Life Sciences, Microsoft UK Stephen GatleyCEO, Sybermedica Michael GogolaDirector of IT&S, HCA International Limited Rachael GrangerIT Manager, The London Clinic James GreenmanChair Independent Sector IT Council, Group IT Director, Care UK Prof Richard Kitney OBEProfessor of Biomedical Systems Engineering, Imperial College Mark LargeIT Director, Great Ormond Street Hospital for Children Brian PaintingNHS Business Manager, Microsoft UK Mike RobertsIT Director, The London Clinic Sally TaberDirector, Independent Healthcare Advisory Services (IHAS) Mark TreleavenFirst Databank Europe Ltd, representing Intellect Harvey WhiteConsultant Surgeon, representing the Royal Society of Medicine 6

7 Research & Analysis Survey of IDF members Online questionnaire, 80+ responses Additional discussions with: –Independent Providers & Practitioners –System Suppliers –Defence Medical Services –Great Ormond St Hospital for Children NHS Foundation Trust 7

8 Research & Analysis 72% use software to manage practice 8

9 Research & Analysis 23% use custom or no software to manage practice 9

10 Research & Analysis 92.5% of respondents exchange patient information with NHS using a variety of means 10 Some survey respondents used more than 1 method

11 Research & Analysis The vast majority of independent doctors have no means of exchanging data electronically with the NHS Only 5.7% claim to have some form of network connection 11

12 Research & Analysis 83.6% of respondents did not know if their practice management system complied with current NHS requirements for secure data transfer. 13

13 Research & Analysis The impact on patient care arising from an inability to exchange patient information 12 Source: Survey of IDF Members

14 Report Conclusions Serious lack of integration between NHS and Independent Sector IT systems Absence of a clear NHS strategy for systems that permit data sharing Need for co-operation between state and private sector organisations to create a cost effective mechanism for clinical data exchange – between "qualified providers" notably those with smaller practices Potential benefits for a move towards a culture of shared ownership of data (and risk) between clinicians and patients 14

15 Recommendations 1.Engage with DH to: Facilitate access by Independent Doctors to the NHS National Network Work to agree common standards for the exchange of patient data with NHS systems Help raise awareness of confidentiality and security requirements affecting patient information and data transfer Encourage adoption of electronic practice and clinical management systems by the Independent Sector 15

16 Recommendations 2.Set up a Clinical Expert Working Group: To study information pathways in various patient constituencies with similar issues and barriers Illustrate practical problems and viable solutions 16

17 Next Steps Produce evidence through case studies: –Care for Service Personnel –Care for Paediatrics/Children –Care for the Elderly –Care for Offenders 17

18 Care of Service Personnel 18

19 Casualty Analysis & Reporting 19

20 A Personal Experience We were all issued with morphine. You self-administer that the moment you're injured. There was a good chance you'd arrive at Camp Bastion conscious but delirious. And certainly bewildered and shocked. You'd quite possibly then be sedated and not wake up until you arrived in Selly Oak in Birmingham. David Cotterell, Artist 22

21 Patient Journey Overview 20 Casualty Field Casualty Stabilisation Transfer to Camp Bastion, Helmand, Afghanistan Airlift transfer to UK hospital Rehabilitation

22 British Casualty Rates - Afghanistan 23

23 British Casualty Figures in Afghanistan 1 January 2006 to 28 February 2013 ( Source: ) 24

24 Issues Inpatient care when necessary is provided by the NHS, contracted by the MoD Longer term mental health care contracted to independent sector Issues faced by the Defence Medical Services in dealing with the NHS: –lack of standards to provide a common language for communications between systems –inconsistencies in process, e.g. payments for cases 21

25 Care of Paediatrics/Sick Children 25

26 Care of Elderly 26

27 Care of Offenders 27

28 Case Study Objectives Review all activities that contribute to the treatment and pathways of care in the immediate and long term Identify the information flows required at each stage of treatment along the pathways of care Identify and understand all existing or potential barriers which prevent the timely or efficient transfer of patient information in any format between practitioners at each stage Comment and draw conclusions on the findings of the study Suggest appropriate modifications to current practice and make recommendations for their implementation (in areas which might include process, system interoperability, information governance and information management) 28

29 Independent Expert Working Group Part of Imperial College iHealth initiative Chaired by Prof Dick Kitney, Professor of Biomedical Systems Engineering To include IDF and other contributing partners Issues are wider than original remit 29

30 Patient-held Records Policy 30

31 No Barriers – Less Risk Clinics Hospitals Primary care Tertiary Care Labs Home Care Registries 31

32 In Summary No policy on sharing patient data between systems Freeing-up commissioning is valid but patient safety is compromised because systems dont talk Current IT systems use proprietary not open architectures Moving to a patient-held record environment with patient-specific apps. 32

33 Learning To Share 33

34 Prof Ricky Richardson Office Tel:


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