'Political bravery’ required to keep the NHS ‘the most open health system in the world'

Tim Kelsey was made the Cabinet Office’s executive director of transparency and open data in January, after occupying a similar position while on secondment from McKinsey.

While still at the management consultants, Mr Kelsey co-authored a lengthy essay on how the publication of healthcare data can drive service quality. The other author was Nico Henke, the highly influential head of McKinsey’s European healthcare group.

The article claims: “The NHS is, in some respects, the most open health system in the world. For example, it is still the only system that routinely publishes comparative outcomes for all hospitals. However, introducing transparency has not been easy for the NHS. Four important lessons can be drawn from its experience so far.”

It continues: “First, start small – do not wait for perfect data. The NHS has never developed a standardised, linked administrative dataset that could be used routinely in all care contexts and, given current economic circumstances, it is highly unlikely it will do so soon.

“However, the absence of perfect data has not prevented publication. The service began with the data it had, even though it knew the information was somewhat inconsistent and, in some cases, of poor quality. However, the introduction of transparency has helped improve data quality, as once anonymised data became publicly available, coding accuracy improved.

“Secondly, political bravery is required. All UK prime ministers since the mid-1990s have supported the concept of an open NHS, even when the idea was politically controversial and results revealed variations in performance.

“Thirdly, public concerns must be addressed at all stages. The public may not be the initial drivers of change. More typically it is health professionals who use the data to compare performance and drive improvement through peer review. Nevertheless, it is very important public apprehensions, especially privacy concerns, are addressed at every stage of policy development.

“Finally, professional engagement is paramount. Any attempt to introduce transparency will be sustainable only if frontline professionals understand the benefits of the effort and are involved in designing the programme’s rollout.”

• Read the full article: Can transparency be the most powerful drive of healthcare improvement?