The public do not trust the NHS to look after personal health information, the health secretary admitted at the HSJ annual lecture on Thursday evening.
Jeremy Hunt spoke for nearly three-quarters of an hour outlining his vision for an NHS that “empowers” patients through the best use of technology.
Mr Hunt told the audience that the “plain truth” is the NHS “has not yet won the public’s trust that it is competent in protecting basic information”.
He added: “Hospitals, GP surgeries and social care organisations do not yet all have data security protocols in place.”
He said this was why the new data guidelines being developed by national data guardian Dame Fiona Caldicott alongside a CQC review into data security “will be absolutely vital”.
Mr Hunt outlined four “elephant traps” that the NHS needs to avoid if patients are to be “empowered”.
These were in the areas of:
- excessive costs; and
- data security.
Mr Hunt said the digitising of health records in the United States has led to increased bureaucracy, and has met with “huge resistance” from doctors because it reduces the amount of time they can spend with patients.
He added: “The lesson here must be to ensure that new IT systems improve, rather than reduce, clinician productivity so that it helps rather than hinders them in their jobs.”
He said one of the best reasons for investing in digital records is to allow communication between multidisciplinary teams and organisations but there is also “a risk that accountability to the patient is blurred”.
He added: “One of the biggest lessons that I’ve learnt in my time as health secretary is that if the buck stops with six people it stops with no one… We must never let shared records become an excuse for diluted accountability or the lack of a personal touch.”
Mr Hunt paid tribute to the Academy of Medical Royal Colleges’ recommendation, published today, that patients outside of hospital should have a named accountable clinician for their care.
He said “incremental improvements closely tied to clinician productivity” are as valuable as “big bang changes which carry much greater risk”. He cited the example of the £9bn Connecting for Health IT project as “our biggest ever IT disaster”.
Mr Hunt outlined five suggestions to make “a reality of patient empowerment”.
He set out his vision for Ofsted style ratings for clinical areas to “plug the transparency gap that we still have”. He said these ratings would be made “not by an algorithim but by expert committees” and will be revisited annually.
He added: “We should not underestimate the boldness and the radicalness of the ambition to publish these ratings about the performance of entire local healthcare economies.”
The second was an accountability gap, which can be tackled by giving every patient a named clinician, he said.
The third was a “time gap” where there is a danger patients will be ignored if clinicians do not have the time to listen to them. Mr Hunt said NHS England will help GPs by bringing in a single payment system, stopping “pointless” referrals from hospitals back to GPs, making all practices paperless and abolishing fax machines.
A fourth priority will be to deliver a “patient centred system” by continuing to explore choice in maternity, end of life care and the rollout of personal health budgets.
His final suggestion was to tackle the “culture” that stops doctors and nurses from speaking out if they see mistakes taking place.
He added: “We must accept that there will always be mistakes and sometimes those mistakes will have tragic consequences but the overwhelming patient interest is in open and transparent culture that learns from those mistakes and stops them being repeated.
“Patient interest is served not just by eliminating variation between hospitals but within them as well. A patient centred system cannot justify mortality rates 15 per cent higher for those admitted on a Sunday compared to those admitted on a Wednesday.”
HSJ annual lecture: Hunt defends plan for 'Ofsted style ratings' of CCGs
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Public do not trust NHS with personal data, admits health secretary