A duty to share and care

Last week HSJ ran an extremely significant story relating to the sharing of data and information governance. While few media outlets seemed to pick up on the news and industry stayed similarly quiet in their response, HSJ’s announcement that the Caldicott Review is likely to recommend a new duty to share information between agencies, where it is in a patient’s best interests, is a significant milestone in my eyes.

The announcement came from an exclusive interview with Dame Fiona Caldicott, who has been leading the review into information governance in health and social care for the past year.

Dame Fiona said the duty to share would apply to NHS and social care providers and commissioners and that a change in attitude among these groups would essentially help to remove the tendency towards caution over sharing sensitive information, even where it could lead to better care and patient outcomes.

Previously I have blogged about how reluctance to share information can be more harmful to a patient’s health than beneficial to confidentiality, so perhaps most interesting is how the NHS appears to have come to a turning point where it understands the relevance and benefits of such information sharing.

Dame Fiona describes how if this ‘duty’ to share is unmet, NHS and social care organisations could see financial implications arise, which of course follows similar ‘incentives’ by health secretary, Jeremy Hunt that financial penalties could be enforced if the foundations for electronic patient records are not put in place by 2014.

Dame Fiona said: “One of the things that we’re interested in is whether there are less extensive penalties that could be more straightforwardly applied within organisations to make it clear to staff that they have to apply the rules.”

In my mind, not only could this be the step change that encourages widespread integration across the NHS but it also presents an enormous opportunity for IT suppliers. In her interview, Dame Fiona specifically acknowledges that not only is there a cultural issue in the NHS around information sharing but also that the IT systems in many trusts are a big barrier in enabling integration and data sharing to happen. IT systems “will need a lot more work going forward to achieve what we want for integrated care,” she said.

The NHS is rapidly changing especially with the creation of Clinical Commissioning Groups, Clinical Support Units, and nine Data Management & Integration Centres (DMICs), all recently approved by the NHS Commissioning Board. These will all form  part of a sub-national infrastructure that will provide data management services, as well as  thirteen Academic Health Science networks, all aiming to come online from April 1^st 2013. And whilst innovation might not be happening as rapidly as it might do in other industries, the recent series of announcements around the importance of digitisation, data sharing and generally creating a culture of ‘openness and transparency,’ has huge potential to spur on greater acceptance of technology in supporting patient care.

The Caldicott Review is due to report back to Jeremy Hunt by the end of March and is currently expected to be published, along with the health secretary’s response, on April 17, potentially at HC2013. I eagerly await to see how much of a push secure and relevant data sharing will really get.