Martin Ferguson, Socitm’s director of policy and research, says that the review of health information technology led by clinician and IT expert Bob Wachter has missed the opportunity to include local government perspectives.
The Wachter review proposed a phased approach to digitisation of the NHS – Photo credit: PA
Yesterday, the government published the Wachter review, Making IT Work: Harnessing the power of health information technology to improve care in England.
While Socitm welcomes the focus on the ten principles listed at the start of the report – they seem sensible and pretty much all of them we’d advocate in local government.
For instance, the recommendation that the NHS must digitise for the right reasons, embrace user-centred design and so on.
Indeed, much of what is said in the review reflects the concerns we voiced as long ago as 2002 about the top-down, centralised, technology-driven National Programme for IT in the NHS, which was eventually cancelled in 2011.
What is disappointing with all of this is the heavy focus on secondary care and almost non-existent coverage or recognition of health and care systems operating as a whole.
This holistic approach requires the sharing of information across places so that the needs of a person can be addressed by people acting as one team, from organisations behaving as one system.
To enable this, and therefore enable the delivery of the commitments made in the NHS’s Five Year Forward View, the professionalism of staff across the whole system, rather than just the acute sector, is essential.
However, all but one of the ten recommendations are focused on acute healthcare digitisation. That is recommendation nine, which talks about interoperability and data sharing for seamless care delivery across traditional organisational boundaries.
It says that plans for interoperability should be harmonised with other ongoing efforts to join up elements of the health and social care systems, such as those represented by the Sustainability and Transformation Plans.
However, all the other recommendations focus exclusively on health care missing the opportunities to manage the whole spectrum of care in ways that allow people to live better, have a better quality of life (and health) and to reduce demand on secondary, acute health care.
As such, we believe that the review’s recommendations do not make enough of the interface with local government and social care.
Most, if not all, of the review’s recommendations could be extended across the full spectrum of health and social care in the areas represented by the recently completed Local Digital Roadmaps. They could also be better and linked to the emerging devolution deals for local government.
This is doubly disappointing given the excellent work being achieved through health and social care integration, not to mention digitisation in many areas like Leeds, North West London, Southampton and South Tyneside. This was noted in the input to the review from representatives of the local government digital and social care communities.
Moreover, numerous representatives from the local government digital and social care communities contributed to the review, and so we must conclude that the review team chose not to take on board the recommendations coming from local government and the social care sector.
That said, Socitm and its members continue to work hard with the Local Government Association, the Association of the Directors of Social Services, Health CIO and CCIO Networks, NHS Digital, NHS-England and others to secure a place-based, holistic and digitally-transformed approach to personalised care.
Through this, we draw on the work of the Health and Social Care Integration Pioneers, Vanguards and Better Care Fund projects.
We intend to continue this work, and we also look forward to collaborating with the 12 global exemplars that were announced yesterday.
Only by working together in this way, can we unlock the opportunities created by a digitally enabled care across the spectrum.