The government’s newly launched information strategy for health and social care is an early example of how major policy will be made under its reformed system, according to the Department of Health.
Details of the long awaited strategy were revealed by hsj.co.uk on Sunday and it was published on Monday. It includes some objectives – for example that all patients should be able to access their GP record online by 2015 – but little about implementation.
National director for efficiency and improvement Jim Easton told HSJ it was right not to include implementation detail in the strategy.
“The strategy is one of the first things which shows how we’re going to see big, serious, important things transacted in the new world,” Mr Easton said.
He said it shows the centre will “concentrate on vision and standards” and acknowledged it did not cover “how, over time, the levers and incentives will be used to make it happen”.
Mr Easton said a subsequent NHS Commissioning Board implementation plan, probably published next year, will fill in that detail.
But he said it was likely the levers would initially include “encouragement, support, identification of great practice” and then “end up – when you’re clear about something being a requirement – with performance standards and contracts”.
In relation to technology, the strategy says national bodies will set standards for health records and systems and gradually enforce them locally. Mr Easton said that move – in contrast to the national programme for IT, which tried to specify computer systems – responded to what the service wanted.
The information strategy says little on implications for staff numbers. The DH’s impact assessment for the policy estimates that access to GP records will save nearly £2.5bn by 2020, mainly by reducing GPs’ time talking to patients.
Mr Easton said it would not mean reducing clinical staff. He said: “The strategy supports our broad game plan on workforce, which is to protect the number of clinical professionals we have now. We just need to free them up to do the job better [and] see more patients.”
Mark Duman, chair of the Patient Information Forum, which develops and campaigns for better information for patients, welcomed the strategy. However, he called for “more emphasis on training of professionals to fully support patients in shared decision making”.
He added that without “dedicated funding” from commissioners for information services, “we will continue to have patchy and inequitable provision”.
Where now for advice services?
The information strategy has dodged the long-running question of the future roles of NHS Choices and NHS Direct.
Several reviews in recent years have recommended merging the organisations into a single service. NHS Direct, whose main task has been to run a clinical phone service, is expected to change significantly in coming years because local 111 services – for which it is competing to win contracts – will replace much of its work. NHS Direct is currently an NHS trust.
The strategy says: “There will be a single comprehensive online ‘portal’ provided by government from 2013, as a link to trusted information on health, care, support and public health” – a service similar to the current NHS Choices website at nhs.uk.
However, officials have not yet decided on the name of the new service or who will run it. Jim Easton told HSJ there the portal’s “branding” and “where it sits in the system” were “live work”, although there was not a timetable for a decision.
He said: “It will be settled. This is the new system trying to make sure key objectives are landed in the place which will make them best happen. It is not a tussle for control.”