NHS to invest in digital skills as Wachter review recommends phased digitisation

The Department of Health has announced an academy to train NHS staff in digital skills along with a suite of new digital services for patients in an effort to fast-track the NHS’ move to digitisation.

The NHS is to invest in staff’s digital skills – Photo credit: Flickr

The announcement comes in response to Bob Wachter’s review of healthcare information and technology, published today, which said that the challenge of digitising the NHS must not be underestimated.

“Many observers and stakeholders mistakenly believed that implementing health IT would be a simple matter of technical change,” the review said.

“In fact, implementing health IT is one of the most complex adaptive changes in the history of healthcare.”

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Indeed, the review warned that the £4.2bn provided by the Treasury in 2016 “is not enough” to allow full digital implementation across the country, and recommends a second tranche of funding be made available in 2020.

Digital exemplars and academy

Wachter’s review stressed the challenge of digitising the NHS, saying that it would require substantial and long-lasting engagement between leaders and the front-line users of the technologies.

The review said that an NHS digital strategy must have a good blend of funding and resources for IT purchases and infrastructure as well as leadership and training, the review added.

In response to this, the government has awarded each of 12 NHS organisations £10m to develop innovative approaches to digital services and help other trusts build up their digital expertise.

Part of the money will be used for training for staff and to encourage more people to become clinical information officers.

In addition, the government is asking universities to bid to host what it calls an “NHS digital academy” to help train healthcare professionals in digital skills.

A further £5m will be awarded to each of 20 trusts to become national exemplars that will receive “an intensive programme of support” from this academy.

In a statement, health secretary Jeremy Hunt said that the aim was to on the one hand give “pioneering NHS organisations the financial backing to unleash their full potential, while also making sure that we can build a digitally-confident workforce across the whole NHS”.

Phased approach

However, the Wachter review urged the government to be aware of not trying to push out digitisation too quickly, saying that there was “a risk in going too quickly”.

As such, it said that there should be a staged implementation, with only those trusts ready to digitise being asked to in the first instance.

“Those that are not ready should be encouraged and supported to build capacity, a process that will take several years,” it said.

This ties in with calls for a second round of funding for digitising the NHS: Wachter said that national funding and local resources should be combined to support a first phase of digitisation for the trusts that are ready.

Then, in around 2019, the review said that another tranche of government funding – which added was not yet allocated – should be used to support a second phase of digitisation, between 2020 and 2023.

And, although it recommends against overt pressure on trusts initially, the review added that trusts that are not largely digitised by 2023 should no longer receive government subsidies.

The review also said that national funding should be linked to a viable local implementation and improvement plan, which would allow for evaluation and accountability.

Discussing local and regional control, the review acknowledges the failed National Programme for Information Technology, which was shut down in 2011 after failing to achieve its goals.

The scheme was criticised for being too centralised, but the review said that government should “learn, but not over-learn” from those lessons, saying that some level of centralisation will be necessary.

Building public trust

Further recommendations are that the government carry out a long-term national engagement strategy to promote the case for healthcare IT.

This suggestion chimes with criticism levelled at the now canned patient data sharing scheme care.data, which was widely condemned for being badly explained to the public.

On the subject of data sharing, the review said that patients should be given full access to their electronic data, including clinician notes. In response, the government said it will provide instant access to personal health records online, in a system modelled on a US one.

It also said that it would be a “mistake to lock down everyone’s healthcare data in the name of privacy” and endorsed the recommendations of the national data guardian Fiona Caldicott’s latest review. That review, published in July, set out a set of eight principles for a new, simplified model for consent and opt-out for patients. A consultation on those proposals closes for submissions today.

A further recommendation of Wachter’s review is to appoint a national chief clinical information officer, which was trailed at the same time as the Caldicott review was published, as the NHS named Keith McNeil, the former boss of Addenbrooke’s Hospital in Cambridge who resigned as the trust faced major financial difficulties, for the role.

Meanwhile, the government has pledged that patients will be able to register with a GP, access healthcare records and get medical advice from their tablet or smartphone from the end of the year.

The government also outlined plans to establish a list of NHS-approved healthcare apps, and confirmed that NHS Choices will become NHS.UK and offer a wider range of information and services for patients.


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