Presenting the Challenge

Dr Peter DruryHead, Information Policy Unit

2nd National PRIMIS Conference

23 April 2002

Challenge? What Challenge?

• Vision• Integrated care• Integrated systems• Integrated information• Data quality• Outcomes• Meeting our challenges

Principles of Information for Health

• Information and information systems will be person-based

• Systems will be integrated to achieve a whole systems approach

• Management information will be derived from systems used in direct patient care

• Information will be secure and confidential• Information will be shared across the NHS

and ultimately across health and social care

The NHS Plan

“Step by step over the next ten years the NHS must be redesigned to be patient centred – to offer a personalised service” (NHS Plan para. 1.3).

July 2000

Wanless - Final Report April 2002

“National, integrated ICT systems across the health service can lay the basis for the delivery of significant quality improvements and cost savings over the next 20 years. Without a major advance in the effective use of ICT the health service will find it increasingly difficult to deliver the efficient, high quality service which the public demand. This is a major priority which will have a crucial impact on the health service over future years” para 6.22

Wanless - the provisos

• Recommends a doubling of ICT spending, provided:

• the Government and the health service must ensure that they have clear and well developed views about the benefits which they want to achieve, with patients at the core of the system

• stringent standards• budgets to be ring-fenced and achievements

audited

Why is PRIMIS needed?

“The most valuable repository about the current health of the population may well be GP records and it is ironic that these are virtually unused for local health surveillance and service audit”

Information for Health, NHS Executive 1998

Why is PRIMIS Needed? “Primary Care organisations need high quality

data to support greater integration of care, National Service Frameworks and the process of clinical governance, evidence-based practice, and performance targets that focus on the quality and outcome of services…..The need to ensure accurate and complete recording of health events on computer systems, as well as the ability to extract relevant and useful information from them, forms the foundation of the services which PRIMIS offers”

http://www.primis.nhs.uk/why_is_primis_needed.htm

Integrated Care• Patient

– Personalised care (with convenience & choice)– Whole system, not just the parts

• Healthcare professional– multi-professional teams– multi-site; 24/7– shared meanings

• Citizen– Integrating care of our health with (and for) the

rest of our life

Integrated systems

To support integrated care requires systems that integrate:

• Organisations - joint planning e.g. LISs, LIPs, FPs• Service delivery - coordination e.g. referrals

discharges• Training, HR - developing skills, ESR, NHS U• Standards of care - e.g. NSFs, clinical governance• Resources - money, estate, PEOPLE• Information - standards, services, systems

Integrated Information• Infrastructure -

– Confidentiality & security, channels– Standards

• Electronic Records– patients– organisations & communities– national

• Applications - e.g. Bookings, Prescribing• Knowledge - e.g. NeLH, NHS DirectOnline, nhs.uk• Quality Management

– processes and outcomes

Data Quality• “Data quality is becoming increasingly important

in a world of public scrutiny. I would encourage NHS Chief Executives to look again at data within their own organisation and consider whether you are happy with the quality and the range.” CE Bulletin April 2002

• Data should be right first time, and captured once• NHS organisations to nominate a senior manager

responsible for data quality by 30th June 2002 -see http://www.pcimb.nhs/downloads/pcoguide.pdf

Outcomes

• What have we delivered?• What have we learnt?• What can be contributed to a

common/specific pool of knowledge?

• Was it appropriate in context?

IM&T Strategy Model

SERVICE USERS•Citizens/patients•Professionals•Business/Public Sector

•CHANNELS– Connectivity– Channels strategies

InternetNHSnetPhoneDigital tvetc

•STANDARDS–Information standards–Information Governance

INFRASTRUCTURE

IM&T Strategy Model

SERVICE USERS•Citizens/patients•Professionals•Business/Public Sector

•CHANNELS– Connectivity– Channels strategies

InternetNHSnetPhoneDigital tvetc

•KNOWLEDGE•RECORDS•APPLICATIONS

•STANDARDS–Information standards–Information Governance

INFRASTRUCTURE E-SERVICES

IM&T Strategy Model

SERVICE USERS•Citizens/patients•Professionals•Business/Public Sector

•CHANNELS– Connectivity– Channels strategies

InternetNHSnetPhoneDigital tvetc

•KNOWLEDGE•RECORDS•APPLICATIONS

RESOURCES, IMPLEMENTATION

•STANDARDS–Information standards–Information Governance

INFRASTRUCTURE E-SERVICES

IM&T Strategy Model

SERVICE USERS•Citizens/patients•Professionals•Business/Public Sector

•CHANNELS– Connectivity– Channels strategies

InternetNHSnetPhoneDigital tvetc

•KNOWLEDGE•RECORDS•APPLICATIONS

•PROCESSES e.g.–Performance–Data

•OUTCOMES, e.g.– Lower morbidity– Patient satisfaction

RESOURCES, IMPLEMENTATION

•STANDARDS–Information standards–Information Governance

INFRASTRUCTURE QUALITY MANAGEMENTE-SERVICES

IM&T Strategy Model

SERVICE USERS•Citizens/patients•Professionals•Business/Public Sector

•CHANNELS– Connectivity– Channels strategies

InternetNHSnetPhoneDigital tvetc

•KNOWLEDGE•RECORDS•APPLICATIONS

•PROCESSES e.g.–Performance –Data

•OUTCOMES, e.g.– Lower morbidity– Patient satisfaction

RESOURCES, IMPLEMENTATION

•STANDARDS–Information standards–Information Governance

INFRASTRUCTURE QUALITY MANAGEMENTE-SERVICES

KNOWLEDGE

Meeting our challenges

• All of us have many of them!• How to align available resources

to deliver data, information and systems that support improvements in the quality of integrated care in a decentralising NHS

• The challenges for PRIMIS?

Lessons learnt from PRIMIS

• Continuing requirement to support culture change in the use of information in the consultation and to support the delivery of care

• Extending geographical coverage, and continued support

• Good quality data can now support comparative analyses, research etc

• Demonstrable experience and expertise

Why is PRIMIS Needed? Is it...

Primary Care organisations need high quality data to support greater integration of care, National Service Frameworks and the process of clinical governance, evidence-based practice, and performance targets that focus on the quality and outcome of services

http://www.primis.nhs.uk/why_is_primis_needed.htm

Or, to put PRIMIS into context, is it...

Greater integration of care needs greater integration of systems, information and data quality. This is needed to support National Service Frameworks and the process of clinical governance, evidence-based practice, and performance targets that focus on the quality and outcome of services provided, e.g. by Primary Care Organisations

In short..

• How does PRIMIS help embed computers in clinical practice,

• improve clinical data in the process, and

• support clinical governance and the NSFs by providing comparative data so as to

• support the delivery of integrated care?

Find out by making the most of this Conference!

PRIMIS

23rd April 2002Metropole Birmingham