Wide ranging proposals aimed at making the NHS fully digital by 2020, including new regulatory powers and allowing patients to write in their care records from 2018, have been revealed.

The Personalised Health and Care 2020 blueprint, which aims to put technology at “the heart of the NHS’s future”, was developed and published by the national information board, which includes senior figures from the Department of Health, NHS England, regulators and other arm’s length bodies.

This latest attempt to digitise the NHS builds on the Department of Health’s 2012 information strategy and the “ambition for a paperless NHS by 2018” announced by health secretary Jeremy Hunt in 2013.

As well as proposing that regulators take action over NHS organisations not meeting standards, particularly in relation to patients’ records, the document says all levels of the NHS workforce will be up-skilled in informatics.

Tim Kelsey

Tim Kelsey said Jeremy Hunt’s ambition for a paperless NHS by 2018 would be met

NHS England national director for patients and information Tim Kelsey told HSJ: “What we are saying is that interoperability and safe digital record keeping is no longer a voluntary, amateur sport. It’s got to be the heart of the future of the healthcare system.”

The document’s full title is Personalised Health and Care 2020: Using Data and Technology to Transform Outcomes for Patients and Citizens, a framework for action.

Its large range of new proposals include:

  • All patient and care records to be digital, real time and interoperable by 2020.
  • Clinicians in primary, urgent and emergency care and other key transitions of care contexts will be operating without the use of paper records by 2018.
  • Patients to have access to their hospitals, community, mental health and social care services records by 2018.
  • Commissioners and providers must, by April 2016, publish their own “road maps” for how their organisations will have developed interoperable digital records and services by 2020.
  • The Care Quality Commission will take performance on the new IT data quality standards into consideration, as part of its regulatory regime from April 2016.
  • Patients to be able to write comments into their records from 2018.  
  • NHS England will bring forward plans, and test through regional pilots, the integration of the NHS 111 service with NHS Choices and other services.
  • A longer term vision for the development of a faculty for health informatics for doctors and a federation for informatics professionals for non-clinicians.
  • The NHS is to make a fresh push to encourage GPs to prescribe the use of apps and other digital tools, as previously reported.

Mr Kelsey added: “By June 2015 we will give guidance to the NHS which will specify what we want bodies which are both commissioning and providing NHS services [to have] in relation to their adoption of digital record keeping.”

The document says a new set of indicators will be published by October next year, which hospitals will be expected to either meet, or outline plans to meet them.

These metrics “will be taken into consideration by the Care Quality Commission as part of their inspection regime and by Health Education England with regard to training accreditation [from March 2016],” the document adds.

The timetable suggests Mr Hunt’s ambition for a paperless NHS by 2018 will be missed. However, Mr Kelsey insisted the health secretary’s aims would be met.

He said: “NHS England committed that a third of A&E departments would have access to summary care records by March next year. That has already been achieved.

“In this document we say that by 2018 all urgent, emergency and primary care context will need to have achieved interoperability. And by 2020 all contexts [will have to achieve interoperability]. There is no delay in [the 2018] target.

“The target that we announced when we talked about a paperless NHS by 2018 related to out of hours GP, A&E and ambulances and those will absolutely be achieved by 2018.”

Mr Hunt has always described the date as an ambition rather than a target. However in his speech on the subject in January 2013 he said that by April 2018 “digital information [should] be fully available across NHS and social care services”.

He added: “It is crazy that ambulance drivers cannot access a full medical history of someone they are picking up in an emergency – and that GPs and hospitals still struggle to share digital records.”

National tech blueprint sets greater role for regulators