Only one in six local NHS innovation and efficiency schemes explicitly mentions adopting or extending the use of new technologies, HSJ analysis reveals.
The finding comes in the week health secretary Jeremy Hunt altered his four “key priorities” to highlight the need to facilitate a “technology revolution” in the service.
In a blog for the ConservativeHome website Mr Hunt said the NHS should not “put its head in the sand with respect to technology,” emphasising the importance of joining up IT systems to integrate care, particularly for patients with long term conditions.
HSJ understands the health secretary believes much wider use of technology is essential if the NHS is to meet its £20bn quality, innovation, productivity and prevention challenge. However, the latest regional tracking of primary care trust clusters’ savings programmes, released to HSJ under the Freedom of Information Act (see box below), shows that just 51 out of 317 local QIPP workstreams have one or more technology milestones.
The finding that the vast majority of initiatives make no mention of technology suggests that it is not integral to most clusters’ QIPP programmes.
Where there are milestones relating to technology, the introduction of telehealth services is most commonly mentioned, often in rural areas, and generally as part of a wider initiative to improve care for those with long-term conditions.
Some areas plan to bring in performance dashboards or risk-stratification tools, in order to improve understanding of the local health economy.
In Norfolk, commissioners plan to mandate the “consistent use” of patients’ NHS number through provider contracts by February 2015, while those in Surrey hope to bring in an electronic referral system for cardiology services from March 2013.
The tracker also reveals some technology milestones are behind plan. Somerset’s telehealth pilot was described as having a “limited impact on saved admissions and in-year savings [and] no impact on service”.
In Buckinghamshire, the introduction of a “tele-dermatology” service for use in primary care slipped from July to October. Similar slips were reported on projects in South Yorkshire, and North Yorkshire, where telehealth was not leading to the predicted falls in acute activity.
NHS Commissioning Board director for patients and information Tim Kelsey said: “One of the most important strategies we have to improve outcomes for patients and the effectiveness of health and care is to unleash the power of information and technology in a way we haven’t really done in the past.
“It has got to be one of the key levers for delivering QIPP in the future and my role is to make a reality of the data and technology revolution in the NHS.”
Sir John Oldham, national QIPP lead for long-term conditions, said: “You need to change the system first - and alter the way people are working - and put the kit in second.
“QIPP plans up to this point have been about changing the way people have been working. Now is the appropriate moment to think about how you can bring technology in, in a big way.”
Forty per cent of local QIPP initiatives now rated amber or red
Forty per cent of local efficiency initiatives were rated amber or red on the NHS Commissioning Board’s quality, innovation productivity and prevention tracker at the midpoint of 2012-13.
HSJ’s analysis of the latest version of the tracker reveals that of the 317 QIPP workstreams being driven by local commissioners, 60 per cent, or 191, were green. In total, 29 were red and 97 were amber.
Between quarters one and two of 2012-13, 63 workstreams saw their ratings worsen and only two saw them improve.
The ratings for all seven of the Arden primary care trust cluster’s workstreams slipped over that period; all are now rated red.
Meanwhile, the following clusters all had deteriorating performance
in four of their initiatives: Bedfordshire and Luton; Lincolnshire; Norfolk and Waveney; North Essex; Staffordshire; Sussex; and West Mercia.
Overall, only 12 out of 51 local areas’ QIPP plans were rated green overall. Twenty-two were amber, and 17 were rated red.
The tracker also reveals that commissioners have identified new potential savings. At quarter two, local QIPP schemes were expected to yield £5.2bn between 2012-13 and 2014-15, up from £4.5bn three months earlier.
This accounted for 55 per cent of the total QIPP savings expected over that period.