We can’t have a safe NHS unless we have an intelligent NHS

With everything from electronic records, to online GP services, genomics and flagship programmes like care.data on NHS England’s agenda, Tim Kelsey tells Highland Marketing about progress and responsibilities.

A man with a vision

Tim Kelsey has a reputation as a visionary in the NHS. A man who has dedicated his professional life to the sharing of information, Kelsey has certainly been making his mark on the health service.

Since taking on the mantle of NHS England’s national director for patients and information back in 2012, he has set about bringing technology and data to the fore, with the aim of radically transforming how health services are delivered.

“This is no less than an industrial revolution we are witnessing,” he says. “Industrial revolutions are about the way in which man, through ingenuity and enterprise, scales new heights of knowledge. We are entering a period of human history where we are about to experience an extraordinary and profound knowledge revolution, particularly focussed on the kinds of data that are about us.”

The fact that the health service is now moving into this era is crucial. Kelsey tells Highland Marketing that the NHS is now starting to gain a foothold on the exponential curve of the data and technology revolution. And with an impending 2018 deadline for a paperless NHS and an even closer deadline looming for patient access to information by 2015, big strides are already being taken to accelerate change.

Unprecedented electronic interoperability – preconditions for a sustainable NHS

“We have made genuinely remarkable progress,” says Kelsey. “We have made a very significant start. In some ways the most important long-term precondition for the sustainability of health service is the work we have been doing on promoting interoperability.

“Currently we rely on paper based records, which can get lost, which can be inaccurate or duplicated. These things are administratively insensible and costly and are also potentially very dangerous for patients. They don’t promote any proper integration for the patients’ journey through their healthcare,” he explains.

Work on developing electronic records and enabling information to flow freely between different doctors and clinicians, so they can improve the quality of patient care, has been central to changing this, Kelsey says.

The Safer Wards, Safer Hospitals Technology Fund, which has seen an injection of £250m from the Department of Health, matched by a similar amount from the health service, has been driving forward electronic record keeping in trusts. “This is an unprecedented incentive to really get a focus from the frontline as a top priority,” he says.

And much more besides is being achieved.

“We are looking at major programmes of work being prioritised by the Prime Minister, the success of which is determined by collaboration with industry,” he adds. “A key example is genomics and life sciences.

“We have published large amounts of data on general practice. This has broadened out access to useful information on local services. In addition we have published, for the first time anywhere in the world, information on surgeon outcomes.

“On the participation side we have launched a series of initiatives which will be genuinely transformative for the patients and citizens. GPs will have to offer online services to their patients.”

Liberating the power of people

These formative changes that will, for example, allow patients to book appointments online, order their repeat prescriptions online and access their medical information over the internet, are all long overdue, he adds, especially when compared to how the internet is already reaching other parts of everyday life.

But they are crucial when it comes to changing how healthcare is delivered. “The idea that we want to leverage the power of the data that is generated in and around the patient and citizen as they interact with their care is fundamental,” says Kelsey.

“We can’t properly improve care unless we are able to understand at what standard the outcome is delivered. From a purely clinical and patient perspective we need to use every data resource we have to ensure that the health and care system as a whole delivers high quality care for all.”

This data is also key to liberating the power of people, he adds. “A very important component of the future our health and care system is that we as citizens take on more responsibility for our wellbeing and take on more responsibility for managing our care for ourselves.

“We can’t do that and the tools to manage those opportunities can’t be developed without the data about us and our behaviours in healthcare being available.”

Care.data – people have a responsibility to share data safely

The much publicised care.data initiative is all about the safe sharing of anonymised patient data to power those applications, he says.

Care.data, which has attracted significant media debate over privacy concerns, is not only important, but is addressing a “desperate” need to give clinicians the information they need and is necessary to stop the NHS “flying blind” when it comes to quality, says Kelsey.

“The more data the health service has about the quality of care it provides, the better the quality of that care becomes,” he says. “Historically we only had access in any meaningful way to hospital data – which was very limited.

“It has become increasingly desperate that we are able to give clinicians access to data about general practice and in a way that safely links general practice data to hospital data so that we can start to look at the outcomes that patients experience as they travel down the pathway of that care.

“The vast majority of the population would expect us to be doing that kind of scrutiny and to be holding ourselves to account for good outcomes.

And reflecting on historic reminders such as failings at Mid Staffs, he adds: “We can’t have a safe health service unless we have an intelligent health service.”

Kelsey insists that care.data will give clinicians a much more intelligent resource to manage services and at the same time protect the identity and confidentiality of the patient.

“There is a small minority of people who don’t believe we will manage their data confidentially,” he says. And those citizens’ rights have been respected absolutely, says Kelsey, which he adds is evidenced by the ability to opt-out of sharing their general practice data.

But is opting out the right decision?

“Those people who opt-out, do deprive society of fragments of intelligence that could turn out to be very, very important,” says Kelsey.

“People have a responsibility to share data safely so that other patients can benefit and we can build a high quality health service.”

The NHS must become much more accessible for industry

The NHS has clearly been given lots to think about since Kelsey took up his post. And there is now much more to come as the journey for a people and patient centred health service continues.

One challenge is whether the NHS can improve as a customer to make sure it can embrace what suppliers have to offer.

“Creating a sustainable health system can’t be achieved without a very different approach to harnessing the innovation and expertise of all sorts of people in industry and in and amongst entrepreneurs of all sizes,” Kelsey explains.

Work has already commenced to address this. For example NHS Choices, which receives tens of millions of visitors every month, is being re-launched to become a platform for service providers, app developers and others to start promoting different tools and services to the general public that will help them manage their own health and care.

But Kelsey does acknowledge that there are still many issues, obstructions and challenges that face potential partners, especially in areas like procurement.

“We are really focussed on managing those,” he tells Highland Marketing. “We are completely committed to a deep and meaningful relationship with industry.

“It is a really important priority that we do find ways to make the NHS as a partner much more accessible. We are really thinking differently.”