NHS Connecting for Health

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Delivering IT for a modern, efficient NHS

• NHS Connecting for Health

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Vision for the future

• More choice and control for patients over their
  own health and care
• A health service designed around the patient
• Secure access to up-to-date, accurate information
  for diagnosis, treatment and care for all those
  involved in the care of a patient
• Easier access for patients to their own health
  and care information
• A more modern, efficient NHS

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Every day in the NHS
836,000 people consult their GP or practice
nurse
389,000 people receive care in the community
There are 50,000 visits to AE
124,000 people attend outpatient clinics
There are 114,000 emergency admissions
There are 44,000 elective (planned) admissions
There are 19,000 calls to NHS Direct
There are 7,000 visits to walk-in centres
73,000 adults receive NHS dental treatment
Source Chief Executives report to the NHS Dec
2005
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NHS Connecting for Health is delivering
We are continuing to see a step increase in
deployments. Millions of patients will receive
improved, safer care as a result.
Richard Granger, director general of NHS IT
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NHS Connecting for Health is delivering

• Modern, integrated IT systems and services,
  connecting
• 117,000 doctors
• 397,500 nurses
• 128,900 scientists and therapists 

Source Chief Executives report to the NHS Dec
2005
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Context
June 2002
Established April 2005
January 2001
September 1998
Established October 2002
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Scope

• NHS Connecting for Health is an agency of the
  Department of Health launched April 2005
• Responsible for delivering the National Programme
  for IT as well as business critical systems
  previously provided by the former NHS Information
  Authority

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IT systems and services

• NHS Care Records Service
• Choose and Book
• Electronic Prescription Service
• N3 national network for the NHS
• Contact national email and directory service
• Picture Archiving and Communications Systems
• IT supporting GPs, including QMAS, GP to GP
  record transfer and GP Choice

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NHS Care Records Service
I think for patients this is going to be a safer
system. At the moment records are kept in
separate, almost hermetically sealed places -
general practice, hospital and so on - and its
really difficult for me to access hospital
records or know whats happened to a patient
elsewhere. With the new system Ill have access
to that information.
Dr Brian Fisher, GP, Lewisham PCT
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NHS Care Records Service

• An individual electronic health care record for
  every patient in England
• Securely accessible by patients and those caring
  for them
• Today information is stored in a number of places
  and a variety of ways including paper,
  computers and film
• The lynchpin of new systems and services
• It delivers
• Health care records whenever and wherever they
  are needed

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Keeping patient information secure

• Access will be on a need-to-know basis
  according to job role
• State of the art authentication processes are
  being used
• All registered staff will access systems using a
  smartcard and PIN
• Patient information will only be shared in the
  interests of their care
• Audit trail of when, where and by whom patient
  records were accessed

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Choose and Book
Theres no wasted time for the patient, and
theres no wasted time for the NHS.
GP, electronic booking pilot site
Choose and Book is great because it gives
patients like myself the flexibility and choice
to choose the hospital, the date and the time
where I want to be treated.
Breda Calenti, Cambridgeshire Choose and Book
patient
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Choose and Book

• An electronic booking service
• It delivers
• greater choice of hospital or clinic for patients
  and more convenience in the date and time of
  their appointment
• less stress and uncertainty of referral for
  patients
• a reduction in the administrative burden of
  chasing hospital appointments for NHS staff
• fewer Did Not Attends (DNAs)

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Electronic Prescription Service
Adverse drug reactions may cause the death of
more than 10,000 people per year and may cost the
NHS up to 466m per year.
British Medical Journal 2004
One in ten patients admitted to NHS hospitals
will be unintentionally harmed. Medication
errors are the second most common cause of
patient injury.
National Audit Office report, A Safer Place for
Patients 2005
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Electronic Prescription Service

• About 1.3 million paper prescriptions are issued
  every working day in England
• Need to change the paper based system to an
  electronic one which is more efficient and
  consistently accurate

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Electronic Prescription Service

• It delivers
• increased safety, more choice and convenience for
  patients, better information for prescribers and
  dispensers and a reduced administrative burden
• In the next phase patients will be able to
  nominate their preferred pharmacy so they dont
  have to return to the GP surgery to collect a
  signed repeat prescription

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National Network for the NHS (N3)
This is definitely speeding up patient care.
For the first time we have a full, resilient
connection to the national network.
Michael Scott, IT manager, James Paget NHS Trust
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National Network for the NHS (N3)

• Provides IT infrastructure and broadband
  connectivity so patient information can be shared
  between organisations
• It delivers
• online access to records and visual images
  whenever and wherever they are needed, for faster
  diagnosis and treatment
• new broadband connections for NHS sites,
  including rural communities, through combining
  purchases of network connections

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Contact

• A national NHS email and directory service
• It delivers
• an email address for all NHS staff that stays
  constant throughout their career
• calendars and folders that can be shared with
  other users across the NHS
• the only email service approved by the British
  Medical Association as secure enough to transfer
  clinical information between NHS organisations
• access for staff based in multiple locations or
  in the community via NHSnet or the Internet

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Picture Archiving and Communications Systems
(PACS)
The greatest benefit PACS brings to patients
is that we no longer have the problem of lost
images, which might lead to postponed or
cancelled appointments. Also, patients no longer
have to bring their x-ray images with them each
time they come in to see a clinician, which helps
enormously.
Dr Alan Grundy, consultant radiologist, St
Georges Hospital, London
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Picture Archiving and Communications Systems
(PACS)

• Capture, store, distribute and display static or
  moving digital images such as electronic x-rays
  or scans
• It delivers
• faster access to medical images for clinicians
  which can lead to speedier availability of
  results to patients
• fewer unnecessary re-investigations, reducing the
  amount of radiation to which patients are exposed

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IT supporting GPs
GP to GP transfer of electronic patient records
will be an enormous benefit for patients and
practices alike and is a very welcome component
of the modernisation agenda.
Dr Paul Cundy, chair, IT Committee, British
Medical Association General Practitioners
Committee
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IT supporting GPs

• Quality Management and Analysis System (QMAS)
• 28,365 users across all 8,659 GP sites in England
• delivered on time, on budget and completed in 28
  weeks
• Support for the Quality and Outcomes Framework
• GP to GP record transfer
• GP Choice

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Achievements to date
184,450 NHS staff registered to use the NHS Care
Records Service 294,031 prescriptions
transmitted using Electronic Transmission of
Prescriptions 114,862 bookings made using Choose
and Book 817,913 studies stored using Picture
Archiving and Communications
Systems 13,397 NHS locations with broadband
access via N3 28,365 active users of QMAS
Figures at 08 February 2006
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Working with the NHS to prepare the ground
We're relying on staff to understand, seize and
exploit the opportunities that will come from
implementing new IT and the better use of
information in the NHS.
Richard Jeavons, NHS CFH director of service
implementation
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Working with the NHS to prepare the ground

• Service Implementation team helping the NHS
  exploit the potential of the new technology
• National Clinical Leads leading engagement with
  the professions
• National training materials, tools and techniques
• Best current knowledge delivered to
  professionals and patients

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Do Once and Share
The application of knowledge is the single most
important thing we can do in the next decade to
improve health and disease.
Sir Muir Gray, NHS CFH director of knowledge,
process and safety
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Do Once and Share

• Engaging and enabling clinicians, healthcare
  providers and patients to share their knowledge,
  skills and experience
• Focused action teams based in local health
  communities (e.g. diabetes or lung cancer)
• Build on own local work and undertake extensive
  national consultation to create national
  guidelines and models of best practice
• Influence the development of the new IT systems
  and services and identify how they could improve
  the quality of care provided

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Benefits for patients
Im a more confident and informed patient and
having my record gives me greater confidence in
the treatment I am getting.
Fred Webber, patient Has had access to his
electronic health care record for five years as
part of a trailblazing patient involvement project
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Benefits for patients

• Easier, secure access to their own health and
  care information
• Faster, safer diagnosis and treatment
• Faster, easier, more convenient way to make
  hospital appointments
• Safer way to obtain medication

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Benefits for clinicians
Different professionals in different places will
be able to view the same information at the same
time for a virtual consultation a major
improvement on the problem of notes or x-rays
being unavailable in a different building or
location.
Jan Laidlow, allied health professional national
clinical lead
The IT being implemented will mean that we no
longer see patients out of hours with no
information about what drugs they are taking or
see temporary residents in our surgeries where we
have no details about them and their medical
history.
Professor Mike Pringle, GP clinical lead
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Benefits for clinicians

• Ready access to more comprehensive, up-to-date
  patient information
• Fast, reliable and secure means of sending and
  receiving information
• Streamlining of clinical practice and smoother
  handovers of care, supporting multi-disciplinary
  team working
• Online decision support tools, easier access to
  best care pathways and faster access to
  specialist opinions and diagnosis

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Benefits for clinicians

• Guidance on referral procedures and clear
  protocols for clinical investigations
• More efficient referrals, alerts to
  contra-indicated therapies, and early detection
  of disease outbreaks
• Reduced administration, paperwork, repetition,
  duplication and bureaucracy less time spent
  chasing missing notes, x-rays, referral,
  admission or discharge information

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Benefits for the NHS
We need to ensure we are getting best value for
money, through products which can deliver real
change whilst keeping costs to an absolute
minimum. This enables us to put more money into
frontline care delivery.
Iain Marsland, chief information officer Essex
Strategic Health Authority
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Benefits for the NHS

• Better intelligence on how the NHS works, and on
  the health of citizens - real numbers, in real
  time
• Value for money and millions of pounds of savings
  on hardware and software through national
  procurement of IT
• Further savings over the lifetime of IT contracts
  through direct negotiation with prime contractors
  and Enterprise Wide Agreements with
  sub-contractors

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How is the new IT being implemented?

• Working with suppliers to implement new systems
  and services in planned phases
• National Application Service Providers are
  responsible for purchasing and integrating IT
  systems common to all users nationally
• Local Service Providers (LSPs) will deliver IT
  systems and services on a local level for five
  regional clusters of strategic health authorities
• LSPs supply and integrate systems to perform
  functions in the local setting and to interface
  with the national system

NHS CFHs five regional clusters
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Delivering IT for a modern, efficient NHS

• NHS Connecting for Health