Healthy Ambitions - NHS Yorkshire and the Humber

Resources

Supporting Resources >

Information Management and Technology

8
The SHA's National Programme for IT team, working in partnership with Local Health Communities (LHCs), has a key role in developing the information and IT infrastructure to underpin the models of care set out in Healthy Ambitions.

What is needed to support delivery of Healthy Ambitions?

9
The SHA’s NPfIT team aims to support delivery in the following ways:

Delivering better, safer care: by ensuring that there is person-based information for clinical and care processes, which can be shared across organisational boundaries and available at the point of need, along with innovative technology to promote care closer to home
Empowering staff to improve NHS performance: making information available to support research, planning and management, thereby improving the quality of care
Empowering patients and the public: making information available about health, services, patients’ own health and wellbeing and providing patients with secure access to their own electronic records thereby increasing their involvement in shaping the NHS and the choices available to them.

The longer term strategic aims of the NPfIT team, working in partnership with LHCs, are identified below and include those outlined in the 2009/10 Operating Framework.

Electronic administrative systems (Advanced PAS)
Electronic ordering and receipt of pathology and radiology tests (Order Communication)
Electronic prescribing, dispensing and stock control linked to medical records (ePrescribing)
Electronic production and transmission of clinical letters
Systematic use of clinical codes in every NHS IM&T application
Shared electronic patients records (the Detailed Care Records Service)
Diagnostic images available electronically (PACS)
Secure electronic communication between GPs and consultants
Secure remote access to clinical systems.

All of the Clinical Pathway Groups identified that effective and integrated informatics and exploiting the use of technology was essential to the provision of high quality care for patients and the attached table indicates some of the current key developments and which pathways the SHA in partnership with local teams can currently, or potentially support.

The Clinical Pathway Groups which made particular recommendations requiring support from the NPfIT team are listed below:

End of Life CPG recommended that:

High quality communication systems between services are required with the effective use of IM&T, to support seamless care.

Cross organizational care planning and communication processes across the health care system are already being developed and there is a clear recognition of the importance of effective communication between services for patients receiving end of life care. An event is planned in February 2009 looking at the benefits of an integrated system in palliative care services.

Maternity and Newborn CPG recommended that:

The introduction of the maternity phase of Connecting for Health should be accelerated.

See section 11 in the attached table. Interim solutions are being developed where national solutions are not yet available. National contractual constraints often take priority over both the timing and priority of system release.

Long Term Conditions CPG recommended that:

In order for our recommendations to become a reality, it is vital that support is given to providing the necessary joined up IT, information, premises and trained workforce.

The Yorkshire and Humber model for the future of Diabetes Care (see section 17 in attached table) paves the way for how technology can support integrated care planning to improve the care provided to people with Long Term Conditions.

Planned Care CPG recommended that:

Clinical IT systems must be integrated, and fully utilised by clinicians. Integration of safe clinical services will not happen without robust IT systems.

A number of developments are underway which support this including work to ensure clinical requirements are captured by developing effective clinical engagement and understanding of IT systems. This ensures that systems are fit for purpose (see section 16 of attached table).

Many people would like more care to be provided at home. In our focus group work, more care at home attracted the most support from a range of proposals. Technological developments in treatments and health monitoring means that the current range of home treatments should be expanded and be more widely available.

A number of projects are currently underway where technology is being used to support mobile working (section 9 of table), particularly for district nursing teams. Remote tele-consultation services are also available, for example in the prison service. Further opportunities for supporting patients in their own home are being explored currently.

In addition to the ready availability of relevant clinical information for the treating clinician the CPG considered there should be a much more up-to date IT use by patients. This includes:
- Expanding patient booking of generalist care appointments on line
- Patients seeing the test results on line
- Patients tracking progress along their care pathway on line
- Making Choose and Book two way, that is enabling specialist clinicians to send discharge information and book patient appointments on generalist clinics for stitch removal or other similar reasons
- Supporting self-care.

A number of initiatives underway support IT use by patients. For example health space (section 12 in attached table) is available for patients who wish to have access to a web-based health organiser to support self care.

Acute CPG recommended that:

The Y&H IT strategy should address the need for the rapid transfer of patient information in the urgent care setting. NPfIT solutions that allow the transfer of patient information (electronic record, electronic prescribing etc) should be accelerated such that is becomes the norm to share records across different parts of the NHS (with appropriate confidentiality safeguards).

Work around these requirements is underway for example in a number of A&E departments and Out of Hours services across the region the use of Systmone is supporting better consistency of care across routine primary and urgent care (see point 8 in attached table)

Mental Health CPG recommended that:

Using choose and book methodologies (and IT) the gateway person could book a new referral into a slot in the diary of the therapist/MH practitioner allow rapid access with no queues.

Although Mental Health is not part of the Choose and Book targets it is possible for this recommendation to be achieved if IT systems currently used are Choose and Book compliant or replaced with Choose and Book compliant systems.

Who is taking this work forward?

10
Locally, information management and technology plans are being developed which are aligned with the Healthy Ambitions pathway recommendations and with national and local NHS priorities. These plans will be underpinned by an assurance process run by the SHA to ensure that the appropriate infrastructure, including capacity and capability, exists locally.

To ensure NPfIT and wider technology development supports commissioning and contracting processes and into wider service development the SHA NPfIT team is working with LHCs to developing capacity and capability to deliver robust business change and ensure wise investment for the future. The SHA NPfIT team continues to support deployments of primary, secondary and community systems.

When is it happening?

11
All the work mentioned above, and in the table at fig.1 below, has started. However different areas are at different stages in the process and the programme of work is also influenced by national developments; particularly in relation to contractual detail. The SHA assurance framework will be developed over the next few months and local IM&T Plans to be assessed against this.

Where is it happening already?

12
Fig.1 demonstrates the more detailed work the SHA’s NPfIT team has underway and the ways in which this supports the delivery of Healthy Ambitions recommendations.

Who will make sure that this work happens?

13
Both the SHA assurance process and the local accountability structure for delivery of IM&T strategy will ensure that the platform for delivery is in place.

View full size image