Delivering Darzi: Microsoft’s NHS Summit 2008

At Microsoft’s annual NHS summit in Reading recently, delegates were impatient to see IT being used to support Lord Darzi’s ten year vision for the health service, but wanted to know whether it would be delivered at national, regional or local level.

Speakers argued that while some of the strategic systems to be delivered by the National Programme for IT in the NHS are delayed, there is still plenty to be done. Lyn Whitfield reports.

The publication of the final report of Lord Darzi’s Next Stage Review of the NHS underlined the importance of information and therefore IT to the health service.

Indeed, High Quality Care for All identified “our developing information society” as one of the biggest challenges facing health and social care. In the future, Lord Darzi reasoned, both NHS staff and NHS users would expect to use IT to access information about the quality of services and to deliver or receive them smoothly and effectively.

The question posed by delegates at Microsoft’s annual NHS summit was who would be responsible for delivering this IT, and what the respective roles of the Department of Health (DH), NHS Connecting for Health, regional and local bodies would be.  

The national programme: late but still useful

One of the earliest question and answer sessions turned into a debate among audience members about the role of the National Programme for IT (NPfIT) in the NHS. It was set up to deliver “strategic” care records systems to the health service, but these are running at least four years late.

One member of the audience argued the delay meant there was a “disconnect” between the DH’s present policies and the delivery schedules for NPfIT services, which were drawn up some years ago.

However, another argued that the DH was moving to align its policies more closely with their information and IT requirements and that the NHS still needed the electronic records that NPfIT is due to deliver. In the meantime, he argued “there are plenty of things that we can be doing now.”

London: delivering across the capital

Kevin Jarrold, chief information officer for London, said that in the capital at least, the NPfIT’s approach had changed over time. He said that since 2006, London’s local service provider BT had adopted a “best of breed” strategy to getting new IT systems into community and mental health organisations and hospital trusts.

To maintain the original vision, he said, London is working on its own shared record, which would be developed over the next two years.

“Our approach has always been that trusts can decide whether to take part in the programme or not,” he said. “Our view is that if we have fit for purpose products to offer people they will take them. So the difficult bit is to get the fit for purpose product.”

London had an early taste of Lord Darzi’s ideas, since he conducted a review of the capital’s healthcare before joining the government and heading up the Next Stage Review. One of the ideas that London is now pressing ahead with is polyclinics to bring together GP, minor diagnostic and some hospital services.

The London Programme for IT has been working with Haringey Primary Care Trust, which is building a network of similar services, to identify their IT needs, where its services and products can be used to meet them, and where the PCT will need to procure its own solutions.

This work has suggested that LPfIT has a lot to offer in terms of standards, Spine connectivity, the RIO electronic patient record that is being deployed in community organisations, the products available to GPs under the GP Systems of Choice initiative, and the Microsoft software available through the enterprise agreement with the NHS.

But this still leaves many things for the PCT to think about, including mobility, generating better business information, and providing IT training and support to healthcare staff.

World class commissioning for SHAs and PCTs

In another presentation, Matthew Swindells, managing director of Tribal Health, focused on the importance of PCTs generating the information they need to tackle the world class commissioning agenda of focusing on clearly defined populations and issues to achieve defined outcomes.

“We can talk about things like getting discharge data, but we should be looking at public health data, census data; bringing it all together so we can say this street seems to have a particular problem and get in and analyse it and really target a solution on it,” he said.

Chris Evennett, director of strategy and reform at NHS South Central, told the summit his strategic health authority (SHA) was looking at world class commissioning as “personalised commissioning.”

He said the SHA is looking to IT to give it more information about health service users, to develop “patnav” services to help patients navigate around complex health and social care systems, to support patients in their own homes and to encourage them to keep healthy; learning from the popularity of electronic games that encourage people to stick to exercise programmes.

“We have lots of exciting technologies, so what is stopping us?” he asked. “I would suggest it is you and me. It is organisational culture. We need to stop looking up [to the next tier of the NHS]. We need to become customer focused.”

Better information for hospitals and frontline staff

Meanwhile, Dr Steffen Achenbach, clinical lead, Microsoft Amalga, described how it can help NHS trusts to make the best use of their existing systems by bringing together the information that is held in them and presenting it to staff in ways that allow them to do creative things with it.

“Amalga does not just give you information on one patient, because patient administration systems already do that,” he said. “It gives you possibilities to work with that data in different ways. And it can give ideas to clinicians. If a cardiologist or a nurse has a good idea that needs data, it can help them to achieve it.”