The Health Informatics Review and some workforce and professional development implications

The Health Informatics Review and
some workforce and professional
development implications
BCS HIF
7 October 2008
Luke Davie
Health Informatics
Review
Summary
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Background to the Health Informatics Review
Health Informatics Review findings
Building an “Informatics Literate NHS”
Next steps
Background to the Health Informatics
Review (HIR)
Background to HIR
• Commissioned by NHS Chief Executive & DH Permanent Secretary in
September 2007
• Originally led by Matthew Swindells
• Over 1400 stakeholders consulted:
 1000+ frontline NHS staff
 public opinion researched - deliberative event & surveys
 voluntary organisations &professional bodies
 SHA Chief Executive Officers and Chief Information Officers
• Findings published as part of NHS Next Stage Review on 10 July 2008
• More detailed Implementation Report by the autumn, aimed at
informatics specialists
HIR scope
Health Informatics Review Programme
Project 1
Meeting the
information needs
of the
DH and NHS
“Information”
Project 2
Project 3
Maximising the
benefits from
NHS CRS & SUS
Creating an
information system
and management
structure
“NHS CRS and
SUS”
“Governance”
To outline an information and IT architecture capable of supporting
the world-class NHS envisaged in the NHS Next Stage Review
NHS Next Stage Review
High quality care for all:
NHS Next Stage Review
Raising standards
Help to stay healthy
Empowering patients
Quality at the
heart of the NHS
Most effective
treatments for all
Stronger involvement of clinicians in
decision making at every level of
the NHS
Fostering a pioneering NHS
Keeping patients as
safe as possible
High quality care for
all
High quality
care for patients
and the public
Freedom to
focus on quality
Empowering frontline
staff to lead change
that improves
quality for patients
Valuing the work of
NHS staff
Need for high quality
information never greater…
•
People want to:
 understand choices about care, & how to stay healthy
 be confident that health & social care staff have the
information needed to provide care effectively & safely
•
Care professionals need information & evidence when providing
care, regardless of where the person was previously seen
•
Commissioners need information to plan & redesign services
•
Public expects that managers of health & social care services use
information to:
 monitor & assure quality
 make decisions based on evidence & best practice
 account for their actions
•
Regulators need information to assure NHS & independent sector
care providers
Health record securely
accessible to clinicians
and patients
Share information
securely with partners
Personalised
wellness support
for
patients & public
Public access to
health information
Delivering
better, safer
care
Quality at the
heart of the
NHS
Empowering
patients and
the public
High quality
care for
patients and
the public
Public access to
service information
Information available
at the point of care
Empowering
staff to
improve NHS
performance
Freedom to
focus on
quality
Improving
information for staff
Improving clinical
quality and safety
Improving
performance
management
HIR strategic findings
Patients
Success is getting from:
• Patient records held on paper, hard for the
•
patient to access or understand
Choice poorly understood and limited
information available to support patients
Public
• Disparate sources of information to inform
•
the public about health and wellbeing with
little control of validity
Perception that NHS is not delivering value
for money
• Variable access to up to date, timely and
Staff
•
•
accurate clinical information causing
errors and cancellations
Management decisions often based on
inaccurate operational and performance
data, or no data at all
Few systems to provide staff with access
to targeted information to help them do
their jobs or personalised information on
their development and learning
…to:
• I have access to my record
• I understand what is going to happen to
•
•
me and my options
I can make informed choices to receive the
best possible care
I can be involved in my own care
• I know where to find trusted answers on
•
•
health and wellness
I can see how my local health services are
performing
I can see information about the quality of
services provided
• Single source of patient & clinical
•
•
•
information available at the point of care
Electronic records will reduce the burden,
help to join-up treatment along care
pathways, & lead to improved patient care
Clinical performance indicators available
for individuals, managers & organisations
to improve patient care
Staff have access to relevant information &
an employment, knowledge & learning
support system
HIR key themes
• Delivering better, safer care: person-based information for
clinical & care processes, shared across organisational
boundaries
• Empowering staff to improve NHS performance: research,
planning & management, improving quality of care & supporting
regulatory activities
• Empowering patients and the public:
 making information available about health, services, &
patients’ own health & wellbeing
 providing patients with secure access to their own electronic
records & increasing their involvement in shaping the NHS
• Focusing on IT alone will not meet the needs of the NHS.
Strategic vision
•
Patient information available at the point of need
•
Strategic solutions making patient/client information available
securely across care settings
•
People will be able to:
 access their own care record securely
 have information to make informed choices about their own
healthcare and wellbeing
•
Additional services available to patients on-line
•
Information should be:
 collected once, as a by-product of care
 used many times, only creating new data when absolutely
necessary;
 with an integrated programme to improve data quality
Conclusions
• Information and IT are central to:
 improving health & social care services
 empowering service users & staff
• New CIO for Health: reports to NHS CEO & on NHS Management
Board - underlines importance of informatics & provides a model for
the NHS
• Investment in IT gives the opportunity to make a leap forwards in the
scope, availability & use of information
• Emphasis on information about the quality of care, for patients, the
public & staff, with major new national systems
• Renewed focus on delivering systems now to meet clinical priorities
• Reinforces the importance of informatics skills &
gives impetus to developing the informatics
profession and workforce
An informatics literate NHS
Needs an
“Informatics Literate
NHS”
Health record securely
accessible to clinicians
and patients
Share information
securely with partners
Personalised
wellness support
for
patients & public
Public access to
health information
Delivering
better, safer
care
Quality at the
heart of the
NHS
Empowering
patients and
the public
High quality
care for
patients and
the public
Public access to
service information
Information available
at the point of care
Empowering
staff to
improve NHS
performance
Freedom to
focus on
quality
Improving
information for staff
Improving clinical
quality and safety
Improving
performance
management
Informatics Literate NHS
Informatics Literate NHS
Strong informatics governance
Sound
leadership
Within
DH &
NHS
Outside
DH &
NHS
Skilled staff
Good
processes
Standards
governance
Policy
integration
Investment
assessment
Informatics
staff
Other staff
Sound leadership
• New CIO for Health – Christine Connelly - Board level post
reporting directly to the NHS CEO
• CIO has formal responsibility for providing professional
leadership to the major informatics organisations inside and
outside the Department of Health
• Expectation that SHA, trust and PCT boards include a CIO,
following the model of the CIO for Health
• National informatics leadership to
 develop the profession
 co-ordinate the existing expertise
 build the informatics capability of the general and
management workforce
Informatics literate NHS
Informatics-literate NHS
Strong informatics governance
Sound
leadership
Within
DH &
NHS
Outside
DH &
NHS
Skilled staff
Good
processes
Standards
governance
Policy
integration
Investment
assessment
Informatics
staff
Other staff
Good processes
•
Improved arrangements for :
 early assessment of the informatics implications of new policy,
 addressing national and local operational requirements
•
Ensure that IM&T priority and funding is given to the most
appropriate requirements
•
Mainstream IM&T planning and Governance
Policy & Business Informatics Process
PBIS area of responsibility
Policy
liaison
Support for
DGs
Roadmap of
policy
developments
Priorities for
action
Pro-active help
to policy teams
Emerging
areas
Informatics
Impact
Analysis
Identification of
interdependencies
and areas
for potential
new work
including
standards and
architecture
Policy development
Feasibility
and options
appraisal
Delivery teams
Business
case funding
& commission
Initial feasibility
study of new
areas
Formal
evaluation with
business case
production and
Risk
assessment
approval
Options for
delivery with
impact on
current
programmes
Include in
work
programme
Implement
evaluate and
manage
benefits
Commission
work with
formal
sponsorship
Support for
DGs
Equality Impact
Assessment
Include within
programme
portfolio
Programme
Initiation and
Governance
Programme
adopted by
delivery team
Investment proposal
Implementation
Roadmap of
policy
developments
Priorities for
action
Monitor
implementation
Delivery and implementation
Mainstreaming planning and
governance
•
IM&T planning part of mainstream NHS planning & service
delivery, with Board-level ownership & support
•
Increased dependency on the Secondary Uses Service (SUS)
requires more robust processes & IT systems, by April 2009
•
Each local health community to have roadmap for achieving
strategic vision, by end March 2009, as part of NHS IM&T
Planning process & NHS Operating Framework.
•
Governance arrangements:
 to ensure robust & effective decision making
 communicated effectively (local, SHA and national level)
& with suppliers
 ensure clarity on roles, responsibilities and
accountabilities.
Roles & responsibilities
• NHS CFH:
 include social care, voluntary & independent sector
 lead on national elements of all approved IT programmes
• NHS IC:
 independent experts overseeing data capture, coding, grouping
and analytical access, on behalf of the NHS & Social Care
• DH Information Services:
 supply internal IT to the DH, standardising where appropriate with
the NHS & driving DH knowledge infrastructure
• NHS CFH & IC further to empower frontline, by clarity about their
programmes & flexibility in implementation.
Informatics Literate NHS
Informatics Literate NHS
Strong informatics governance
Sound
leadership
Within
DH &
NHS
Outside
DH &
NHS
Skilled staff
Good
processes
Standards
governance
Policy
integration
Investment
assessment
Informatics
staff
Other staff
Skilled staff – general
workforce & informatics
specialists
• Creation of a health informatics career framework, to guide the
development of staff who wish to progress
• Health Service leadership to:
 address the skills needed in the NHS needed to deliver large
scale IT-enabled change
 develop the Informatics Profession
• Informatics content in core training & professional development
programmes for NHS clinicians and managers
• SHAs and NHS CFH to work with suppliers on supplier capability
to help ensure that planned milestones are met & products are fit
for purpose.
Developing the informatics
workforce – key elements
Leadership
Performance
management
Workforce
development
and planning
Attraction,
motivation
and retention
Career
pathways
Leadership – HIR commitments
• CIO for Health, reporting to NHS CEO and on the NHS
Board as a model for NHS bodies
• CIO for Health formal responsibility for professional
leadership to informatics organisations inside and
outside the Department of Health
• Leadership required at national level to address skills
shortages and develop the profession; co-ordinate
exiting expertise to achieve most impact
• Develop effective professional leadership at local levels
• Establishment of new Leadership Council with focus on
standards; will commission programmes
Leadership - actions (so far)
 CIO – Christine Connelly – started 22 Sept
 CEO NHS CFH – Martin Bellamy – started 22 Sept
 Research into leadership development needs of
aspiring Heads and Directors of informatics
 Accessing & influencing the new Leadership
Council
Attraction & Motivation –
HIR commitments
• Form a pool of informatics specialists
• Strengthen long term planning of informatics workforce requirements
and expand recruitment sources
• Generate excitement around a rewarding career in informatics in
health and social care
• Ensure recognition of success
• Ensure management commitment to supporting informatics staff
• Strengthen the competitive position of critical informatics roles
relative to other opportunities, in IT, IM and analysis
• Consider local Recruitment & Retention premia consistent with
Agenda for Change
• Attract and develop more individuals through the existing graduate
training/fast track scheme
Attraction & Motivation actions
 New NHS careers materials; promotional videos
(eSkills); promotions
 National HI Graduate Training Scheme pilot (20
trainees in 2007 & 2008); integration with other
national schemes from 2009 (20 trainees a year)
 Developing informatics apprenticeship and talent
management schemes
Career Pathways – HIR
commitments
• Embed HI in the NHS Career Framework
• Create options for different paths to support
different individual skills and aspirations
• Clearly define standardised pathways with criteria
for advancement
• Develop informatics apprenticeship and talent
management schemes
Career Pathways -actions
 Career Framework launched Spring 2008
 Phase 2 development with Informing Healthcare
in Wales underway
 Early adopters being identified
 Support for Apprenticeships
Workforce development &
planning - HIR commitments
• Provide skills and training modules linked to each
career level
• Encourage the development of a skilled talent
pool with relevant qualifications through
partnership with educational establishments
• Knowledge sharing supported by technology;
benefits and change support should be available
Workforce development &
planning - actions
 ASSIST workforce surveys 2007 and 2008;
exploring options for central collection of
workforce data
 Health Informatics Quality Scheme for Learning
and Development (HIQS)
 eSpace; Health Informatics Community and NHS
Faculty of Health Informatics
Performance Management –
HIR commitments
• Reinforce expectations and accountability for
individual performance
• Introduce strong performance feedback systems
to promote personal growth
• Develop mechanisms for providing assurance
about services, processes and people
Performance Management actions
Actions
 Support for certification of individual practitioners
(UKCHIP)
 Health Informatics Quality Scheme for Learning
and Development (HIQS)
 Health Informatics Services Benchmarking and
Accreditation
Developing informatics skills in the
general workforce: care
professionals, managers and
administration staff
General workforce – HIR
commitments
• Informatics specialist curriculum for medical staff
in training
• Work with Royal Colleges to incorporate
information and IT training into the basic training
for doctors, nurses and other clinical staff
• Standard packages for graduate and
postgraduate management and other courses
• Linked informatics training schemes for staff from
Ward Clerk to Board Member
• Further develop CFH’s eLearning toolset
General workforce - actions
 Revising curriculum framework “Learning to
Manage Health Information”
 Planning conference for clinical educators
 Establishment of informatics clinical educators
special interest group on eSpace
 Ensuring HI embedded in CPD for nurses
 Input into AHP career modernisation activity
 Analysis of current informatics education and
training for health staff, and links to NHS Career
Framework
Next steps and conclusions
HIR next steps
• Collating detailed implementation plans
• Produce more detailed report by the autumn, aimed at
informatics specialists, with implementation update &
plans
• Continue stakeholder engagement – SHA road shows
• Embed as “business as usual”
Questions?