Government plans for the future shape of NHS IT will be difficult to put in place in the current era of financial constraints, and so safeguards must be put in place to protect patient confidentiality, the British Medical Association has warned.
Under the banner of an "information revolution", a new direction for the National Programme for IT was unveiled by the government last September, under which the focus was shifted from a national approach to a more locally-led plural system of procurement, in a bid to allow NHS groups to instill smaller, locally tailored and more manageable changes to their IT structures as well as shave £700 million of the scheme's costs.
On the other side of the fence, patients in England are to be given more access to NHS data and a greater degree of control over their health records, with proposals such allowing patients online access to records online and the ability to share their own data. Plans include allowing patients to access their records online and to share them with others as they see fit, and for more information to be recorded at the point of care.
In its response to the government's consultation over its ideas, the BMA says it agrees that the NHS "should be more intelligent in its use of data", and that patients should have better easier access to their own health data. However, it is concerned that a significant number of NHS organisations simply do not have the means to put the government's plans into practice, particularly as IT is often first up for the chop in times of hardship.
“Improving NHS IT while the NHS is under huge financial pressure will be extremely challenging," stressed Chaand Nagpaul, a GP and member of the BMA’s Working Party on IT, and he argues that "delivering the information revolution cost-effectively and equitably will depend on building on the systems that are currently in place and working well, and on involving clinicians".
The Association also points out that giving patients an open pass to share their records online requires strong safeguards to ensure they don't disclose more information than they intend to, and, on a separate note, warns that the proposals could deepen health inequalities across the country between patients who have access to technology and those who don't.
Unhelpful and alarming?
And while it welcomes the intention to improve patient access to NHS data, it argues that as health information is often subjective and intended for clinician use it could actually be unhelpful or even alarming to patients, particularly if there is speculation on a particular diagnosis, for example.
Along the same lines, the BMA is also concerned over the 'Publish and Improve' policy, under which it is envisaged that patients will use information such as outcomes data to make choices on where to receive care. "While such information can be valuable as long as it is presented in a way that does not mislead or confuse, raw data can be misinterpreted and external factors, such as the demographics of a hospital’s catchment area can have a significant impact upon outcomes data", it warned.