The Chief Clinical Information Officer for the NHS has unveiled his strategy to create a data-driven NHS that supports the technology vision of health secretary Matt Hancock.
Hancock launched his tech vision in October 2018, announcing it will be the foundations for a new generation of digital services in healthcare that draw on real-time data and minimum technical standards that would make outdated and obstructive NHS IT systems "a thing of the past".
NHS CCIO Dr Simon Eccles threw his support behind Hancock's vision in a speech at the Westminster Health Forum, where Eccles outlined his own plans for NHS technology.
"We have a degree of political support for this agenda that I have never previously experienced, and I've been through seven secretaries of state," said Eccles.
"It is phenomenal, and actually genuinely impressive...He's published his tech vision about how we drag the NHS out of being special and different and having to do it our way and into modern enterprise tech and has put money behind it."
Eccles has built on this vision with his own strategy for using data to improve the NHS by joining services together, giving frontline staff better systems for entering and accessing information across organisations, and working with research and industry to share data in a way that citizens accept.
His own concept is of digital-first interactions with the NHS whenever appropriate, citizens co-producing their own digitally-accessible care plans alongside their clinicians, intuitive tech for staff that reduces their workload, interoperable systems sharing data and offering real-time advice to staff, and appropriately-governed access to data for research and industry.
“If we get all of that right, we generate self-regulating, self-improving system that does not inspectors to come in every couple of years and to rummage through the drawers of the system," explained Eccles. "That's the win. That's the phenomenal thing for everybody."
Putting plans into practice
Eccles wants to support a whole system transformation that allows patients to be treated at home rather than in the hospital with real-time physiological monitoring and easy access to care in the community when required. The patient would thereby avoid a hospital stay and the associated loss of independence and health and the NHS would save money, space and staff time.
In five years time, he envisions using data to help patients self-monitor, self-manage and self-serve and to help clinicians target preventions and make better decisions while reducing the time spent on low-value tasks.
To get there, he wants the NHS to digitise providers through nationally mandated common standards with locally-driven supplier frameworks that enhance procurement and compliance and address the right priorities.
This will help ensure that systems are interoperable and data can be shared
"It is ludicrous that you have a blood test taken at one organisation and then another organisation can't see it, in some case even though it was done in the same lab," said Eccles.
Correcting past mistakes
The growing support at national has been accompanied by a new focus on locally-led solutions in an effort to avoid the type of errors that wrecked the NHS National Programme for IT.
Eccles was Medical Director for the controversial programme, which was finally scrapped in 2011 after becoming MPs on the Public Accounts Committee called one of the "worst and most expensive contracting fiascos in the history of the public sector".
Read next: The UK's worst public sector IT disasters
"I wear those scars still," Eccles admitted. "It was an interesting attempt to drive all of this from the centre and if we learnt nothing else for £12.4 billion it's that you can't drive it all from the centre.
"The flipside is I would say in all seriousness it probably ended up delaying the widespread adoption of digital technology in the NHS as people got quite frightened by it and having had a period of looking up to the centre in order to make decisions that adaption to a locally-driven agenda wasn't rapid."
To help devolve decision-making, standards will be nationally coordinated and best practices spread through central roles such as Eccles' to local organisations.
"We need to digitise the NHS and we need to transform our care processes," he said. "And I put to you that we have been reasonably good at both but not necessarily at joining them together...We've got to bend both of those arrows so if you're changing care process you're doing that in a way that's digital and you're able to measure your outcomes, and if you're digitising stuff you're doing it in a way that transforms the care because that's how you get the benefit."
Eccles wants the NHS to update the model of care that has remained in place since the health service was founded in 1948, "with the GP in the surgery, the community practice and the district nurse in the car, and the hospital and the consultant with the junior doctors in white coats trailling around after them."
Critics have expressed concerns that embracing Hancock's focus on disruption could easily lead to destruction, but Eccles believes an overhaul of existing practices is essential for the future.
"There are whole areas where we don't have to do it the way we do it now, and if we free the data up completely then it doesn't need to sit inside the bricks and mortar structure that it's always been in, and that’s where he’s coming from."