Head of NHS Scotland says doctors key to IT projects

Doctors are playing a key role in the development of IT systems in Scotland and will continue to do so in future, the chief executive of NHS Scotland has pledged.

Dr Kevin Woods told the Scottish Parliament’s Health Committee that one of the key messages from NHS Connecting for Health in England was the necessity of clinical engagement.

He told MPs that NHS Scotland had attached much significance to making sure that leading doctors play a key role in the development of systems and said a “change board” had been set up with the Scottish chief medical officer as chairman.

He added: “That will ensure that clinicians are centrally involved in everything we do.”

The emphasis on clinical engagement was reinforced by Stuart Bain, chief executive of NHS National Services Scotland, who told the committee that in Scotland there had been a willingness to engage with clinicians and people who deliver health care.

He added: “In some parts of England, there is a sense that there is a very centrally driven, IT-dictated solution. Many clinicians down there are not using systems such as Choose and Book because they were not part of their development. They are not sold on those systems as a means of providing the kind of health care that they want to deliver, in the way in which they want to deliver it.”

Bain claimed that Scotland had tackled clinical engagement in a very positive way.

He added: “We have engaged with many clinicians and systems and have thought about how we want our health service to be run. We have then thought about how we will enable that through the development of IM&T, data and information and have tried to tie all that together.”

Scotland is committed to developing a single electronic health record (EHR) and Dr Woods told the Scottish Parliament’s health committee that NHS Scotland has created a new e-health strategy board at national level. He told MPs: “We have reached a few important conclusions. One is that it is unlikely that any one supplier can deliver the full range of what we need.”

Dr Woods added that NHS Scotland was trying to procure a set of products rather a simple single system and believed that it could exploit many of its current systems.

One of the core strands of the e-health strategy is the procurement of a national Picture Archiving and Communication System (PACS). Woods told MPs that the bulk of implementation of PACS will take place in 2007 with one large site, the Western General Hospital in Edinburgh, going in 2008. The original target for full roll out of PACS was June 2007 but Woods said “protracted negotiations” over the contract had created the overrun into 2008.

Scotland also aims to introduce a national software system to support patients’ journeys through accident and emergency. MPs heard that the new system has been installed in six board areas, Lanarkshire, Grampian, Forth Valley, the former NHS Argyll and Clyde area, the Western Isles and Highland, with five other boards in the final stages of implementation or in implementation discussions. Five boards, Tayside, Fife, Lothian, Glasgow south and south Ayrshire have elected not to implement the national system.

Charles Knox from the Scottish Executive Health Department told MPs that those areas were undergoing compliance checks to make sure they met the standards set for the national system.

Dr Woods added: “If at all possible, we do not want to waste investment if a system retains the kind of functionality that we are talking about. Sometimes we say that the new strategy that we are working with is not about—to use the jargon—rip and replace. We want to build on the things that work where they work but ensure that they comply functionally with the additional systems that we will put in, to ensure that we have a complete set across Scotland.”

Knox told MPs that NHS Scotland was talking to all the home countries about interoperability including access to the emergency care summary (ECS), currently available to all out of hours providers north of the border.

He added: “We are working towards a position where if a Scot down south or someone up here on holiday lands in the accident and emergency department, the hospital can get to their emergency care summary.”

He told the committee that “serendipity is involved” as the English have “had to reduce their ambition” for the amount of information that goes on the spine so that the proposals are now similar to the ECS, making transfer of data easier.

He added: “We are not so far advanced on the European level, as we are not talking about specific integration measures, although work is being done toward a common data definition of a European health record. We will participate with the Department of Health in talks at a European level about a common record.”