Lord Darzi pledges IT review

A review of England’s NHS IT modernisation programme to ensure it “delivers real clinical benefits” is promised in health minister Lord Darzi’s interim report on the health service published yesterday.

Lord Darzi, a practising surgeon who joined the Department of Health’s(DH) ministerial team in Prime Minister Gordon Brown’s new government, says he will be considering the best way forward in the second stage of his review.

He says the National Programme for IT has created an opportunity to make a step-change.

“The national infrastructure established by the National Programme for IT has connected every hospital and GP surgery to a common secure network. Clinicians should benefit from access to digital x-rays and scans – Picture Archiving and Communications Systems (PACS),” Lord Darzi says.

“But I believe more work is now needed to ensure that the Connecting for Health programme delivers real clinical benefits, and I will be considering in the second stage of my review how best to achieve this.”

The DH has stoutly resisted external calls for a review of its IT agency, Connecting for Health (CfH) and Lord Darzi’s report will be seen as a U-turn by the CfH’s critics. However it falls short of pledging a root-and-branch review and appears instead to signal an adjustment of the £12billion IT programme and a re-focusing of its work.

Smart use of technology is a strong theme in Lord Darzi’s review. A £100m innovation fund is to be created by the DH to help the NHS develop and deploy hi-tech healthcare such as medical devices and diagnostics.

The fund will be controlled by a new Health Innovation Council, to be chaired by health minister, Lord Darzi, with participation from bodies including NICE, the Wellcome Trust and the Office for Strategic Coordination of Health Research.

The aim of the fund is to persuade the NHS to acquire, adopt and spread cost-effective technologies; it was announced as part of Lord Darzi’s interim report on the ‘Our Health, Our Future’ review.

Lord Darzi said: “I want to see the UK become a world-leader in pharmaceutical and medical technology research and development, so NHS patients have access to the best innovative treatments and services.

“The new Health Innovation Council will provide leadership and advocacy with key decision-makers in the NHS on the benefits to patients, the NHS and the country, of adopting cost-effective new technologies and models of care.”

In his interim report, Lord Darzi reports his initial findings from speaking to over 1,500 NHS staff members and reading over 1,400 letters. He has also taken part in a series of debates and webchats.

The aim of the report is to help the NHS deliver the highest quality care for all and to do this Darzi says that greater influence must be placed in the hands of local NHS staff and others working in partnership across the service, based on the best available evidence, using the latest technological innovations and responding to the needs of local communities.

On technology, he writes: “We need to build an NHS that is able to harness the tremendous benefits that can flow from new treatments and technologies such as these as swiftly as possible.

“But effectiveness is not just about making use of the very latest treatments and technologies. It is also about ensuring that patients receive well co-ordinated and integrated care.”

The new Health Innovation Council, he says, will act as “the overarching guardian for innovation from discovery through to adoption, holding the Department of Health and the NHS to account for taking up innovation and helping overcome barriers to doing so.”

As well as more technology, he also called for better information to be provided, to encourage patients to exercise their right to choice.

“There is a wealth of information already available but it is not normally directly comparable and not benchmarked in a systematic way. For example, while I record the clinical outcomes of the surgery I undertake, the data is not regularly benchmarked against that of other surgeons carrying out similar work. There are individual

examples of excellent practice, such as some clinical audits, but these are isolated examples. This is a significant hindrance to progress.

“Establishing a clear framework and standard ways to measure results will allow us to demonstrate the high quality of what we do, and identify what is needed to sustain and improve that high quality. Any framework will need to be comprehensive, rooted firmly in the recurring questions about their care that people tell us are at the forefront of their minds, but also scientifically valid and clinically relevant.”

The government’s chief medical officer, Professor Sir Liam Donaldson, has been asked to develop a standard quality framework and proposals for systematic measurement against this framework and Professor Sir Bruce Keogh, the NHS Medical Director, has been asked to advise on how best to implement it within the NHS.

Mark Walport, director of the Wellcome Trust said: “A greater focus on health innovation is good news for patients in the NHS. The new Health Innovation Challenge Fund, jointly funded and administered by the Wellcome Trust and the Department of Health, will provide much needed resource to support the development of innovative technologies, devices and clinical procedures.

The interim report has been welcomed by the trade unions. Karen Jennings, Unison’s head of health, said: “It will mean a lot to staff in the NHS that Lord Darzi has recognised that they are creative and can be on the cutting edge of innovation given the opportunity. This is a very different message from the mantra that the private sector has the monopoly on creativity.

“In order to make greater progress the idea of setting up a new Health Innovation Council with funding to make change happen is a good one.”

However, the Conservatives said the announcement was rushed out, as part of the government’s pre-election manifesto.

Shadow health secretary, Andrew Lansley, said: “Bringing forward Lord Darzi’s finding so soon is yet another example of this government using our NHS as a political football.”

Health secretary, Alan Johnson, said: “I am pleased to welcome the interim report that Lord Darzi is publishing today. This report draws on evidence of good practice from this country and around the world. It is the start of developing the next stage in the NHS journey.”

Links

Our NHS Our future: NHS next stage review – interim report

 Linda Davidson