Inside e-health predicts a brighter future for NHS informatics
It may sound unlikely, but health informatics is set to become exciting, says Jon Hoeksma. Lord Darzi’s report on the future of the NHS was all about information, and the Health Informatics Review that followed promised more investment in IT and better careers for NHS informtion workers to deliver it.
Being an NHS information professional has often been a thankless task. Tell someone you are a health informatician and their eyes may glaze over – or you’ll be asked whether you can fix their PDA.
But after many years of less than benign neglect, health informatics may be about to get sexy. At the very least, it is going to get dusted off a little. The reason is simple: delivering Lord Darzi’s blueprint for the NHS will be impossible without far better availability and use of information to inform service management, clinical care and patient choice.
Down in the basement
“Even within the echelons of NHS management, information and the IT to generate it has come fairly low in the pecking order.”
IT and information has generally been viewed as a backroom support role in the NHS. At best, it’s seen as something that enables doctors and nurses to get on with the real job of the health service.
Even within the echelons of NHS management, information and the IT to generate it has come fairly low in the pecking order. Few boards have chief information officers (CIOs). Even when they have an IT director, it’s often the finance director, wearing an extra hat.
NHS organisations are more likely to have an IT manager cast in the role of supporting the finance directors, chief medical officers and chief executives who rule the higher reaches of the NHS’ organisational charts. It is far less common for a health service organisation to have a genuine CIO with the mandate, seniority and skills to drive the effective use of information across the business, to monitor performance in real time and improve the clinical delivery of healthcare.
The Health Informatics Review
The need to develop genuine CIOs within all NHS organisations is one of the central themes of the Health Informatics Review, published in June to enable the delivery of Lord Darzi’s Next Stage Review of the health service. The report’s author, Matthew Swindells, is an ex-NHS chief executive and CIO and he says the Darzi report is “is 50% about the use of information.”
The Health Informatics Review places a big emphasis on getting appropriate information to everyone who needs it across the health service, including patients. To do this, it stresses the importance of:
“The need to develop genuine CIOs within all NHS organisations is one of the central themes of the Health Informatics Review.”
• leadership
• better careers for informatics specialists
• IT training for other NHS staff
• building confidence in information governance
• providing new portals to deliver information where it is needed.
Among the recommendations on leadership, it says that strategic health authorities, primary care trusts and trusts should appoint CIOs at board level; starting with the Department of Health (DH) appointing its first “CIO for Health,” a move that Swindells believes should provide a “call to arms” for other NHS organisations.
The Health Informatics Review acknowledges that improving the number of informatics professionals working within the health service as well as the base level of informatics skills among all staff groups, particularly clinicians and managers, is a huge challenge.
“We need to continue to build on efforts to embed informatics within mainstream local planning and service delivery,” it says. “We need to support NHS managers and clinical leaders in owning the informatics agenda. Informatics planning must have board level ownership and support.”
Nice words, now for action
All of this has, of course, been welcomed by bodies representing NHS informatics professionals, such as the British Computer Society, Assist and UK Chip who have been campaigning for such changes for a long time.
But there’s the rub. Old NHS informatics hands may feel that despite hearing much of this before, they are still stuck in a mobile office or basement worrying about day to day issues, with no clear career path in front of them.
There are reasons to hope things will be different this time. The Darzi Review received a muted reception in the general press, which struggled to pick out big themes from its wide ranging and detailed recommendations. But it has been followed up by some important sector reports, of which the Health Informatics Review is one.
The DH is interviewing now for its CIO. It has promised that the Health Informatics Review will be crystalised into implementation plans as early as this autumn. At the very least, it is some time since the NHS informatics profession had a better time to make its case heard. A little excitement is in order.
About the author: Jon Hoeksma is a journalist specialising in the public sector and IT. He is co-founder and editor of the industry portal, e-Health Insider, and its European sister site.