1. www.npfit.nhs.uk IPPR: Front Line Delivery Challenges Wednesday 15 December 2004 Gordon Hextall

2. Programme objectives Not just an IT programme but a patient safety and clinical governance programme ………… ………..to deliver a 21st century health service through efficient use of information technology Modernisation of the NHS - 10 year programme initiated July 2000 - Enables improved Access & Choice - Enables care pathways and patient focus - Should improve accuracy in treatment - Opportunities for Improved efficiency - Front line challenges: patients and staff IT is the underpinning enabler of NHS modernisation

3. Delivery challenges: context

4. Trusts -Most systems do not support the movement of information between buildings and departments -Several records often created for the same patient Delivery challenges: context

5. Primary Care - Most individual practices now have their own IT applications and databases -Patient records are not easily transferred to other practices or care providers -Development and effective implementation of care pathways is inhibited -Paper-based records delay modernisation and the delivery of National Service Frameworks Delivery challenges: context

6. Choose and Book BMS BMS EBS EBS EBS EBS BMS BMS BMS BMS Internet Internet Patient via Internet & Unique Booking Ref No Booker (via New NHS Network: N3 ) Referrer or Booker (via Primary Care System ) Patient confidence Confidentiality issues Access controls: new processes GP acceptance: changes working practice Availability of hospital specialties Availability of consultants slots Compliant and reliable IT systems Delivery challenges: e-booking

7. Electronic Transfer of Prescriptions Delivery challenges: e- prescriptions Three tier computerisation (Prescriber; dispenser; re-imburser) Compliant and reliable GP and pharmacy IT systems Electronic authorisation signatures Culture change: - nomination of pharmacies - detailed prescribing history - drug costs Counter fraud paperchase

8. Picture Archiving Delivery opportunities: PACS Clearer digital images (x-rays, scans etc) Reduced diagnostic waiting times (images instantly available) Patient convenience Enables remote diagnosis – incl. paramedics Quicker and more accurate archive retrieval Reduced film, chemical and storage costs

9. NHS.uk & Healthspace Delivery opportunities: NHS e- portal Single NHS web portal: NHS.uk Personal records web access: Healthspace Access to treatment: NHS.direct Access to appointment booking: chooseandbook Access to information on all NHS services Access to NHS Care Records Service Telemedicine Self diagnosis, monitoring and treatment Knowledge, information & decision support

10. www.npfit.nhs.uk IPPR: Front Line Delivery Challenges Wednesday 15 December 2004 Gordon Hextall