Leontina Postelnicu

Approximately 120 apps are currently being evaluated by NHS Digital and two external assessors against key standards to be added to an NHS resource of trusted digital health and care tools for patients, citizens, healthcare professionals, and commissioners.

The UK’s HealthTech Advisory Board, created to help guide the government and look at transforming the use of technology across the NHS, will meet for the first time today, the Department of Health and Social Care (DHSC) has said. Health and Social Care Secretary Matt Hancock vowed to "sort out" the IT infrastructure of the NHS earlier this year, calling it “the world’s most frustrating place to work for its IT”, with “only 10 per cent of the challenge" being the technology.  “Ninety per cent of the challenge is the culture,” he said. The new initiative will bring together clinicians, academics and tech experts to explore and support efforts to harness innovation and reduce pressures on the system. “It will highlight where change needs to happen, where best practice isn’t being followed, and be an ideas hub for how we transform the NHS to improve patient outcomes, patient experience, and to make the lives of NHS staff easier," Hancock added. The board will be chaired by Dr Ben Goldacre, Evidence-Based Medicine DataLab Director at the University of Oxford, and members include NHS Digital Academy CEO and Director of Digital at the Salford Royal Group Rachel Dunscombe and Nicola Blackwood, Chair of the Human Tissue Authority and former Health Minister. Roger Taylor, who was appointed as Chair of the Centre for Data Ethics and Innovation back in June, will also be joining them, along with: Nicole Junkermann, NJF Holdings Founder Manoj Badale, Blenheim Chalcot Co-Founder David Gann, Imperial College London Professor of Innovation and Technology Management Sir Mark Walport, UK Research and Innovation Chief Executive Daniel Korski, PUBLIC CEO and Co-Founder Michelle Brennan, Johnson & Johnson Medical Devices Companies Group Chair Dan Sheldon, Well Pharmacy Head of Digital Jeni Tennison, Open Data Institute CEO Parker Moss, F-Prime and Eight Roads Entrepreneur in Residence. “To make the changes that are needed we must work together and have a common vision. We need to couple this with an agile culture where we constantly improve systems and champion the innovators," Hancock said at the Health and Care Innovation Expo in Manchester in September. “The culture change we need to see requires strong management and leadership. I’m determined to grow stronger leadership across the NHS. We should train more of our own, yes, and bring in more talent from the outside too who know how to inspire change.” In October, an initial digital, data and technology strategy was published by the DHSC, outlining plans to modernise the NHS IT infrastructure and introduce a clear set of open standards that all digital services and IT systems in the NHS would have to meet.  Asked how he would measure the success of innovation being embedded into the NHS at the GovTech summit in Paris last week, Hancock said: "When I'm no longer the world's largest owner of fax machines." Freedom of Information requests submitted by the UK's Royal College of Surgeons earlier this year indicated that NHS hospitals trusts in England owned more than 8,000 fax machines, and a report from DeepMind Health's independent reviewers panel from 2017 said the health service retained "the dubious title of being the world’s largest purchaser of fax machines". At the GovTech summit, Hancock added: "I want to see an improvement in the outcomes of government services and, so, I try to resist what is a pressure that all politicians come under, which is to give very fixed and specific targets, because (...) there may be even better technology that comes along that I might discover at this conference that we've never heard of before." Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

Nine councils in the UK have been awarded a share of up £700,000 to design and deploy digital innovations for social care through a project led by the Local Government Association (LGA), commissioned by NHS Digital. In June, it was announced that twelve local authorities would receive £20,000 each to identify how digital technology could help address local challenges and improve services, part of a "discovery" funding phase, and initial reviews have now been published by the LGA. “All of this year’s cohort have shown true innovation which made it extremely difficult to decide who to fund for implementation,” said Kate Allsop, Digital Lead on the LGA Community and Wellbeing Board. “The discovery phase has enabled a detailed study of user needs to determine the scope of some really interesting projects.” A pilot in Wirral will now see the council provide biometric wearable devices to people with autism and complex learning disabilities with a view to analyse the data collected to spot anxiety triggers. In London, Havering Council is looking to design an app for social care workers to streamline recruitment processes and ensure information such as employment history or training can be securely shared. The other seven projects will be led by Bracknell Forest Council, Isle of Wight Council, Lincolnshire County Council, Nottingham City Council, Shropshire Council, Stockport Metropolitan Borough Council, and Sunderland City Council. Last week, NHS Digital announced that the Care Provider Alliance would receive £784,000 to create a new service that would offer digital support for the care provider sector, looking to drive uptake of existing resources.  Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

The traditional model of outpatient care is creating unnecessary pressure on patients, clinicians and the NHS as a whole, a new report from the UK's Royal College of Physicians (RCP) has warned. Excluding A&E, outpatient appointments account for around 85 per cent of all hospital-based activity in the UK, and figures indicate that the number of consultations has nearly doubled in England in the past decade. Inefficient systems, poor communication, delays and long waiting times illustrate the need for a different approach, according to the RCP.  The NHS should “grasp the nettle”, said Professor Stephen Powis, NHS England national medical director, and leveraging the use of technology and innovation to reduce frustration among clinicians and patients should be a key part of the redesign process. “As part of the long-term plan for the NHS, it’s right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution and make the NHS more efficient,” Professor Powis added. Webinar: Essential Knowledge Series: Trends in Outpatient Practice Management and EMR Solution Adoption Recent research from charity Age UK, cited by the RCP, indicated that a fifth of pensioners attending an outpatient consultation in the past year "reported feeling worse afterwards because of the stress involved in the journey alone". Remote monitoring and telephone or video appointments could reduce the heavy reliance on face-to-face consultations, and the RCP said both clinical staff and patients “recognised the benefit” of these alternatives in appropriate settings. But evidence also showed that patients did not want to “lose in-person contact”, and doctors argued that the best approach would be a combination of telehomecare and face-to-face consultations. Tech allowing patients to submit personalised data could also be used to drive self-management and enable "clinical monitoring from a distance", but the RCP warned that "making good use of technology requires careful thought and planning". "It is as much about changing clinical practice and professional culture as procuring high-quality, tested products," doctors said. Their findings also suggested that a reluctance to adopt digital technologies was due to “concerns with locally available IT infrastructure and support, data protection, loss of remuneration from clinical commissioning groups and discrimination among patients less comfortable with the necessary technology”. “Having re-evaluated the purpose of outpatient care and aligned its objectives with modern-day living and expectations, we must ensure that the benefits are measured in terms of long-term value for patients, the population and the environment, not just short-term financial savings,” said Dr Toby Hillman, co-author of the report, clinical lead for the RCP sustainability programme and consultant respiratory physician. Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

The Welsh Assembly Public Accounts Committee (PAC) has questioned the “competence, capability and capacity" across the system to digitise healthcare services in Wales after an inquiry uncovered a “raft of problems”, from delays in the delivery of digital projects to “unclear” lines of accountability. The committee found that there had been 21 outages of national systems from January to July this year. A letter from the Cardiff and Vale University Health Board indicated that a national data centre failure that occurred between 3 to 5 August affected “all of Wales”. The PAC said it was “deeply concerned about the slow pace of delivery of modern informatics systems”, asking the Welsh Government to set out a “clear timetable” to put the infrastructure on a “stable footing”. Webinar: The INFRAM: Your Pathway to Healthcare Infrastructure Development “We trust our inquiry and this report will be a wake-up call to all those involved in harnessing the power of digital innovation to improve healthcare in Wales. We believe it’s time for a reboot," said Nick Ramsay, PAC chairman. Dr Peter Saul, Royal College of GPs Wales Joint Chair, said the report, released today, raised "alarming findings about the weaknesses of IT in the Welsh NHS". "Data outages can be extraordinarily disruptive for practices and for patients. They affect appointments, prescriptions and the nuts and bolts of a functioning practice and can take hours to recover from. Unfortunately these data outages are becoming all too common, leaving GPs scrambling to find solutions or workarounds while waiting rooms fill up. "Embracing safe, reliable and innovative technology will be vital for the future of healthcare, but that will be undermined if the Welsh NHS cannot get its IT right. Whether it's the basics like appointment booking, or larger projects such as electronic prescribing or electronic patient records, we need IT that works," Dr Saul added. Government to review committee's findings The inquiry follows a report from the Wales Audit Office, published at the beginning of the year, which indicated that the NHS as a whole spends less than two per cent of its budget on ICT. It estimated that around £484m would be needed, on top of existing budgets, to digitise services. “There is a need for clarity from Welsh Government as to whether the tentative estimate is in the right ballpark, and the witnesses we asked thought it was, and whether significant resources will be set aside and over what time frame,” the committee said.  Their findings also indicated that the NHS Wales Informatics Service (NWIS), the organisation responsible for IT, was “being asked to do too much within its current resources and needed clearer priorities”, and concerns were raised about the cybersecurity risk posed by the CaNISC cancer IT system, which has not been supported by Microsoft since 2014.  "The Committee would like to see CANISC replaced urgently and as soon as is practicably possible," PAC members wrote in the report. "Given the red risk rating and the cybersecurity issues, there is a compelling argument for accelerating the work if possible. However, the Committee recognises that this would require careful consideration of the knock-on consequences." The Welsh Government and the NWIS said they would review the committee's findings in detail. “We welcome the report published today by the Public Accounts Committee into the use of information technology and the vital role it plays in our Welsh health and care system," said a spokesperson for NWIS. “We participated in the Public Accounts Committee review in April and July this year and were pleased to share insight into the specification, planning, delivery and management of national digital health and care services for Wales. “As an NHS organisation we are working with our partners across the health and care system to make the most of the benefits that digital services can offer to health and care professionals, patients and citizens." Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

Ten UK health tech start-ups to receive £40,000 through KQ accelerator Ten UK start-ups working at the intersection of biomedical and data science have now been selected to take part in the £400,000, 16-week KQ (Knowledge Quarter) Labs accelerator run by the Francis Crick Institute in London, meant to speed up development and adoption of data-driven technologies addressing global health challenges. Vision Game Labs, which is creating home-monitoring and remote-diagnosis vision kits for smartphones, using gaming techniques to gather visual data and diagnose eye disease, is one of the start-ups that will receive £40,000 to validate their business proposals through the programme, which is funded by Innovate UK, before looking for further investment. “The start-ups all have the potential to make an impact on global health outcomes and will have access to unrivaled support and resources. “These ventures will help shape the future of health in a sector that is a vital part of the government’s modern Industrial Strategy,” said Chris Sawyer, Innovation Lead, Digital Health at Innovate UK. Ireland’s largest acute hospital finalises Cerner Millennium implementation Ireland’s St James’s Hospital has now completed the rollout of the Cerner EPR, with every inpatient specialty and department going live with upgraded Millennium functionality in a programme labelled “Project Oak” – referencing the move away from paper-based processes. The functionality is set to reduce duplication and allow quicker access to clinical information, with 2,400 staff members receiving more than 21,000 hours of training ahead of the implementation, according to the supplier. “We are in the early stages of the launch, but careful planning has ensured that patient care has not been disrupted significantly over the weekend,” said Dr. Gráinne Courtney, Chief Clinical Information Officer at St James’s Hospital. “The implementation of this system is set to bring a raft of benefits to patients attending the hospital as health records are available instantly to those caring for a patient. Increased efficiencies mean patients will wait less time for their diagnoses, treatments and care. Over the course of the coming months and years we anticipate this will translate into shorter wait times and hospital stays.” HITN sister publication MobiHealthNews reported last month that the European Investment Bank was backing the implementation of Ireland’s eHealth programme with a €225m loan to support the creation of a “modern patient-centred health service”, according to Health Minister Simon Harris. NHS trust goes live with Patient Administration System East Kent Hospitals University NHS Foundation Trust has gone live with an Allscripts Patient Administration System (PAS) in a project that involved the migration of 42 million records to the new system. The trust runs five hospitals and community clinics, providing a range of services to a local population of around 695,000 people. “Deploying a new PAS is a major undertaking, but our old system was outdated and we had to change it to move onto the next stage of our IT development," said Andy Barker, East Kent Hospitals IT Director. "The Allscripts PAS gives us the platform to move forward with an electronic patient record." East Kent Hospitals ran a joint procurement for a new PAS with Maidstone and Tunbridge Wells NHS Trust back in 2015. Both trusts will now be deploying the Allscripts Sunrise EPR. Maidstone and Tunbridge Wells went live with the Allscripts PAS in 2017. Neurology advice line for GPs saves the NHS £100,000 a year An advice line run by the Walton Centre, a specialist hospital trust, in Liverpool, enabling GPs in the north west of England to call neuro consultants for advice, reducing the need for additional appointments, is saving the NHS £100,000 a year. According to NHS England, nearly 40 per cent of 181 calls received in 2017-18 were solved by GPs, saving around £52,000. Karen Kirkham, NHS England National Clinical Advisor for Primary Care, said the NHS would be looking to scale up similar innovations, with a long-term plan expected to be published later this year. “The Walton Centre’s advice line is an example of integrated care in action, connecting GPs with hospital specialists to provide more joined up care for patients. We often find these kind of improvements also make savings that can be reinvested back into the local NHS. “In this case patients also need less time off work because they need fewer appointments and to travel less, which is also good for the environment,” Kirkham added. Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

Five new AI centres will be created in London, Leeds, Oxford, Coventry and Glasgow.    

Public Health England will bring together a group of experts to scale up the agency's work on "predictive prevention", enabling people to take greater control of their health and care through personalised advice and interventions, according to a new policy paper released this week. “We are testing new ways of providing people with preventative advice, using cutting edge technology often called 'predictive prevention'," the government said. "Innovations like these provide exciting opportunities for the future of health and social care - offering earlier diagnosis and more targeted treatments, supporting self-management of conditions, making health and social care more convenient, and joining up data across services securely to deliver better and more personalised care." Leveraging the use of digital technology and data, the PHE-led programme will be “founded on the highest standards of data privacy”, being compliant with the Data Protection Act 2018, the GDPR and the work of the National Data Guardian. “The Government wants to see health and social care exploring digital services that use information (which individuals choose to use) to offer people precise and targeted health advice - specifically designed for their demographic and their location; their lifestyle and their circumstances; their health needs and their health goals. “Targeting interventions this way not only means we can direct specific public health interventions towards those most at risk - it means that those who want it can have preventative care that is relevant to them and more effective than ever before,” the document reads. While no further details about the PHE project were released today, the paper outlines plans to "prevent people from becoming patients" and realise the government's vision to improve healthy life expectancy by at least five extra years before 2035, including through virtual consultations or the use of social media. A recent NHS Digital programme saw a 13 per cent increase in first time attendances for breast screening over a four-year period in Stoke-on-Trent after the North Midlands Breast Screening Service started sharing information about the process and its importance on Facebook community groups.  "The NHS must go from being the world’s biggest buyer of fax machines to the tech pioneers of the future. And I know we can do it," Health and Social Care Secretary Matt Hancock said earlier today at the annual meeting of the International Association of National Public Health Institutes in London. The government is expected to publish a green paper on prevention next year. Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

NHS Scotland has signed a new agreement with Microsoft to deploy Office 365 and migrate all systems to Windows 10 E5 during the next three years in an effort to boost cyber resilience and mitigate any potential threats. "We're creating the environment and the tools to allow staff and services to flourish. At the moment they are too often hampered by systems that don't join up or make collaboration easy,” said Jeane Freeman, who was appointed as Scotland’s Health Secretary in June this year. Freeman explained this included the development of a new national digital platform and setting out “common standards and approaches for healthcare systems”. HITN sister publication MobiHealthNews reported in August that Dr Alistair Hann, former Skyscanner Chief Technology Officer, had joined the NHS Digital Service, based within the national health board NHS Education for Scotland, to help build the new platform, working with Geoff Huggins, Director of the NES Digital Service, and Liz Elliot, former Chief Operating Officer at the Health Data Research UK institute. Webinar: How Cybersecurity Leaders Avoid Data Breaches in Healthcare Commenting on today’s announcement, Huggins told HITN: "We're building a joined-up health and social care system, based on a National Digital Platform, so that people can get the best care, regardless of where they are. Moving to 365 is a fundamental building-block in that process." Earlier this year, the Department of Health and Social Care agreed a centralised deal with Microsoft, enabling all NHS organisations to use Windows 10 and strengthen their cyber defence capabilities, nearly a year after the WannaCry attack disrupted operations at around one-third of NHS hospital trusts in England and 603 primary care and other NHS organisations. NHS Scotland has the option to extend its three-year agreement with Microsoft for a further 24 months under similar terms. Twitter: @1Leontina Contact the author: lpostelnicu@himss.org

NHS Digital will cut around 500 jobs in a major restructure expected to "change the skills and capability of its workforce", Health and Social Care Secretary Matt Hancock has said. Hancock confirmed earlier reports that the reconfiguration of NHS Digital would be delivered in a “series of waves”, set to be completed by 2020/21. “At this stage, NHS Digital estimates that a net overall reduction in headcount of circa 500 full time equivalents is expected. A programme of staff engagement and discussions with staff representatives is in place. All staff will be affected by the restructuring and will be required to apply for posts in the new organisation structure,” the secretary told Parliament this week. NHS Digital employs more than 2,500 staff around the country, including in London, Southport, and Southampton, while its head office is based in Leeds. Computer Weekly reported earlier this year that NHS Digital organised several meetings with its staff to inform them of the restructure, with documents sent to employees indicating that those not be appointed by December this year would be offered the option to consider voluntary redundancy, according to an email seen by the publication. Hancock said the agency would “provide every facility to help staff secure suitable alternate employment”. “A professional outplacement service has been secured to work with displaced staff and NHS Digital is seeking opportunities with other public and private sector employers in the areas affected,” he explained. Sean Walsh, NHS Digital Director of Regions and Professions, said: “This restructure is about skilling up our workforce and rethinking our structure. This will ensure that we have the deep skills and technical expertise to deliver the best service for both patients and customers, and that our structure allows us to flex according to the needs of the health and care sector. “We estimate that the restructure will lead to a net reduction of around 500 full time equivalent roles across the organisation. Where possible, this will be through a combination of redeployment, natural turnover and suitable alternative employment. “It is important to note that we cannot be precise about the exact numbers at this stage because they may change to reflect the outcomes of the proposals for change, as well as external influences which may affect us. “This is understandably a difficult and challenging time for our hardworking employees and we are taking every possible step to provide them with all the help and support they need.” Twitter: @1Leontina Contact the author: lpostelnicu@himss.org