HC Deb 05 April 2000 vol 347 cc511-3W
Mr. Campbell-Savours

To ask the Secretary of State for Health what changes in working practices have been introduced by health authorities following Her Majesty's Government's consultation exercise on the application and use of information technology in the NHS. [116855]

Ms Stuart

Our consultation exercise on the application and use of Information technology in the National Health Service resulted in the national information strategy "Information for Health" (published September 1998). This strategy introduced programmes of work to achieveLifelong electronic health records for every person in the country. Round the clock on-line access to patient records and information about best clinical practice for all NHS clinicians. Seamless care for patients through general practitioners, hospitals and community services sharing information across the information highway. Fast and convenient public access to information and care through on-line information services and telemedicine. The effective use of NHS resources by providing health planners and managers with the information that they need.

This work is being carried forward by the NHS Information Authority established in April 1999. The timescale for completion of the work described in "Information for Health" is by 2005.

Current changes in working practice at grass roots level, driven by changing approaches to information management and technology, are growing day by day. Some recent examples given by NHS professionals are: Health visitors being able to access and use information from GP systems and as a result improving approaches to monitoring and taking action in cases of eg child protection, high dependence families, mental health and post natal depression GPs using a computer programme (PRODIGY) to share information about specific conditions and the best ways of treatment with patients and concluding the consultation by printing off a patient information leaflet. A health authority provides advice about a more beneficial drug. The hospital incorporates the advice into its clinical information system so that when the old drug is prescribed, information about the more beneficial treatment is displayed. The system enables the clinician to change to the new prescription very easily. Patients leave hospital on the new drug and as a result GPs also change their practice, resulting in better care and a significant cost saving. The rate of this change has been shown to be significantly accelerated by the use of the computer system. Introduction of best practice guidelines into systems supporting clinical decision making result in changes to practice with resource and patient benefits eg less pre-operative chest x-rays, more appropriate use of contrast media and endoscopes. Pointing out trends in the utilization of clinical resources by named healthcare professionals brought about a reduction in the variation in practice. (eg ordering laboratory tests—those ordering least tests ordered slightly more but those ordering most tests reduced significantly.)

Mr. Campbell-Savours

To ask the Secretary of State for Health if he will make a statement on the role of the Information Management Group in terms of advance guidance and direction in the application of information technology in the NHS. [116856]

Ms Stuart

The Information Management Group (IMG) was part of the National Health Service Executive responsible for the development and maintenance of our Information Management and Technology Strategy for the NHS. Its role was to maintain and develop the strategy in consultation with the NHS, professional groups and industry, and to manage national strategic projects.

It was disbanded in April 1999 in line with the recommendations of "Information for Health" and was superseded by two bodies.

One is the NHS Information Authority, which was formally established as a special health authority in April 1999. The role of the NHS Information Authority is to manage an agreed and focused work programme to develop those products and standards which can best be developed at national level, in order to support local implementation.

The other is the Information Policy Unit, a small group within the NHS Executive with overall responsibility for delivery of the strategy. The role of the unit is to review and develop the strategy in consultation with a wide range of stakeholders, and to contribute to the NHS Executive's wider policy development and management functions. Part of the IPU role is to support the National Information Partnership and the Information Policy Board, and to commission and monitor national work programmes and projects on information and IT in healthcare (in particular from the NHS Information Authority). The Policy Unit also provides advice and guidance to the NHS on strategic issues, for example guidance on local implementation strategies published as Health Service Circular 1999/200.

Mr. Campbell-Savours

To ask the Secretary of State for Health what measures have been introduced in the last three years by Her Majesty's Government to reduce(a) the level of bureaucratic duplication, (b) burdens on professional staff and (c) administrative difficulties in the application and use of information technology at a local level. [116857]

Ms Stuart

Our consultation on information management and technology in the National Health Service resulted in the publication of the national Information Strategy "Information for Health", which describes a number of national measures that are intended to reduce the administrative burden on NHS staff.

"Information for Health" is a national strategy for local implementation. Each health community is responsible for developing its own Local Implementation Strategy (LIS). The purpose of the LIS is to describe how each local community will develop its own information systems to improve the effectiveness and efficiency of care, including reducing unnecessary bureaucracy and administrative duplication.

The national initiatives that are intended to support LISs and local health organisations are wide ranging and include: A reduction in the number of central communications and changing the style of communications to electronic format. Since February 2000 the Department has been issuing weekly chief executive bulletins by e-mail to NHS organisations and local authorities. The number of circulars is being greatly reduced and used only for urgent and high priority messages. The full circulars are published on the Department's website and the e-mailed bulletin provides an immediate notification and summary of what has been published with a link to the full document. Project Connect" will provide 24 hour, 7 day a week, desktop access for general practitioners and primary care teams to an improved service covering e-mail, online information and knowledge, appointment booking, referrals, discharge summaries, radiology and laboratory test results. The costs of connecting primary care to NHSnet are being met centrally. After considerable work on this project over the last two years, a significant watershed is now being reached with critical mass of infrastructure and connection of GPs being achieved in many places. NHS Direct" was launched two years ago. Researchers have found evidence to suggest that the introduction of "NHS Direct" has been associated with halting an upward trend in demand for out of hours services. The "NHS Direct" on-line website service launched last year provides the public with a direct gateway to the best of health information on the internet. A national procurement review has been undertaken to identify what can be done to ensure that local health organisations do not have to undergo unnecessarily burdensome bureaucratic processes when purchasing information systems. The aim is to ensure that work undertaken by local organisations will ensure the best possible solution for local healthcare delivery, keeping administrative overheads to a minimum. To achieve this communities are expected to implement nationally agreed standards, and make use of national call-off contracts and supporting documentation. The NHS Information Authority is in the process of developing, agreeing and implementing a range of national information and information technology standards that will then be implemented as part of LISs. The standards will facilitate a reduction in the number of times patient information is collected; improve the quality of communication between healthcare professionals and the quality/consistency of information available across the health service. Electronic access to this information throughout the NHS will multiply the benefits already experienced by more advanced sites locally and have a significant impact upon the administrative burden. Information for Health" is underpinned by an education, training and development strategy "Working Together with Health Information". This strategy, published in December 1999, builds upon previous work to develop NHS-wide standards for information proficiency, and will make use of virtual technologies to provide local NHS staff with the access to learning resource that they need. The initiative will ensure that the lessons learned in one health organisation are available to other organisations and thereby allow more informed decision-making about the kinds of intervention required. At the same time the approach will help prevent duplication of effort where effective solutions have been identified.