The ‘IT Crowd’ can help to deliver more integrated care
In the second of our opinion pieces in Health and Social Care Week, Karl Goatley, director of IT at Sussex Partnership NHS Foundation Trust, says a fresh approach to IT for healthcare is taking hold
When it comes to technology and the NHS, the IT Crowd can often get a bad press, largely because our complex technical world is not easily understood by front line staff. We work in silos, we invest in the wrong technology and then we fail to think about how data can be shared and used effectively in order to improve patient care. These were some of the findings of 2016 The Carter Review into the productivity within hospitals and they reflect more widely held views about NHS IT.
I would argue that these views are somewhat unfair and already out of kilter with the a fresh approach to IT for healthcare taking hold today which is much more focused on enabling collaboration – not just within the NHS but with our wider partners involved in the planning and delivery of health and social care.
There is a good example of this in the south east, where the focus of the South East of England data Networks (SEEN) partnership is to put in place the IT infrastructure we need to better enable connectivity and sharing across organisational boundaries in order to improve health care.
Our initial aim was deceptively simple: for any health and social care professional to be able to get access to data and work seamlessly in any of the health or social care buildings across our region.
Making that a reality, is of course, more complicated than it sounds. While the imperative to share and work seamlessly is clear, the base systems simply don’t allow that. Our job is to change that situation.
We have started out by acknowledging that the issue is one which requires a commitment and an understanding from NHS and local authorities about the barriers we need to address as a priority. To achieve that SEEN brought together ICT leads from across those organisations to agree the fundamentals required to address the challenge.
We quickly found commonality with our base issues which currently hinder sharing: from how we configure our networks to securing boundaries, routing issues, and non-compatible firewall settings. Our first commitment was to agree the changes that would make integration of our systems a reality.
While the ideal fix would to replace all the networks across the South East with a new ‘super integrated network’ the reality is that a project like that would be too big and too complex to achieve in a timely manner. So we started off by focusing on something which we know we can deliver, which is the creating a joined up ‘federation’ of our six networks – three of which are NHS and three are local authority public services networks (PSNs).
While we know this is possible because it has been done elsewhere, the real challenge in making this happen is less technical and more about people and incongruent organisational priorities: getting buy-in at different levels across multiple organisations.
We started doing this by working from the bottom up among the technical community. Here the main task was to shift focus from identifying the potential barriers (negative thinking) to the art of possible (positive thinking) and getting them to accept our goal was not only a valid one but one which could be delivered.
Having secured buy-in, the next step was to get senior level commitment from the chief execs and other key leaders across the south east. This mandate for IT leads to make change happen, combined with the getting the technical people on board first, has been key to our progress so far, but not without the need to constantly push, cajole, and influence.
That isn’t to say there aren’t blockages which are slowing collaboration and integration. Chief among these is the issue of sharing patient information across systems. This is something which is carefully safeguarded by information governance teams, and quite rightly so, but the tracking and management of consent for sharing makes true information sharing between teams exceptionally challenging.
NHS England are now leading the way with the health and social care integration agenda through 44 Sustainability and Transformation Plan (STP) footprints across England. Connectivity is one of the key enablers for the three STPs which span SEEN’s geographical area, so we intend on transferring responsibility for delivering the SEEN vision to the STP governance model. We are confident that this will ensure the delivery of new integrated care models is not hindered by not having the basics in place.
But if there is one area where new nationally mandated policy could contribute immensely it would be with a set of new regulations about the sharing of patient data/information which clear up the confused state of affairs associated with consent.
If we can solve that problem then one of the key barriers to better patient care would rapidly diminish, allowing the ‘IT Crowd’ to expedite their contribution to the goal of health and social care integration, and ultimately better care.
Karl Goatley is the director of IT at Sussex Partnership NHS Foundation Trust, where his role underpins the Trust’s strategic objectives detailed in the ‘2020 Vision’. Karl is a member of the Eduserv Local Government Executive Briefing Programme Steering Group and contributed to its recent research on Health and Social Care Integration, including the Confronting the Challenges (Part 1) and The Potential of Digital (Part 2) reports.