Wales thinks big in tough times

The NHS Wales Informatics Service has issued an ambitious information services strategy that focuses on supporting health services in a time of austerity.

The strategy, which was issued for consultation earlier this week, argues that the national approach to developing IT that the country has pursued over the past five years has delivered significant benefits.

But it says it is now necessary to take account of the ‘Together for Health’ five year plan for the NHS in Wales, significantly reduced resources, and the advent of new cloud and consumer technologies.

Together for Health is based on shifting a significant amount of work from hospitals to community services and the third sector, and the new strategy focuses on supporting this and on encouraging self-care.

Yet it says that in future NWIS will be expected to deliver on “less than 1% of the public service budget.”

“Good progress has been made by international standards [and] gives Wales a world-class platform for scaleable future innovation,” the strategy says.

“[However] austerity means that new systems to manage demand and improve efficiency are needed now… [as are] new systems to transform the care process across Wales.”

The strategy says that when the Wales’ IT programme, Informing Healthcare, was drawn up, the 15 trusts and 22 councils in the country each had their own IT systems, which rarely worked together.

It says the programme focused on delivering an “essential, safe common platform” for modern healthcare, focused around creating a new network for Wales, a single health record for every Welsh resident, common administration and clinical systems accessed through a Welsh Clinical Portal, and modern referral and discharge systems.

However, it says there is now a need to go further. So, the strategy says that although GP information is already being shared with emergency and out-of-hours services, there is now an urgent need to provide an integrated view of the whole health record to authorised users.

It says this will be achieved by focusing on turning the 100m documents generated by the NHS in Wales each year into “a usable record” to which specialist systems can contribute without having to be integrated with each other.

It says that to achieve this different systems will have to generate documents in the same way, and that a new document management service will be needed to store and transmit them to different parts of the health and social care system.

Alongside this, the strategy says an integrated view of the patient’s journey is required, building on the work that has already been done to create booking capabilities within the Welsh patient administration system, Myrddin.

Although this has been rolled-out to most health boards, significant services – such as NHS Direct and out-of-hours services – do not use Myrddin; so “the use of the system will be expanded to cover all patient contacts with the health service.”

Other innovations will include the wider use of guidelines for referring and treating patients, extending the integrated view of records approach to social care and third sector services, and making more use of modern telecommunications to deliver support and services to patients in their own homes.

Finally, the strategy says that a “modern business intelligence function” will be set up to support health and social care, to drive improved efficiency and outcomes.

“The delivery of this strategy will demonstrate that Wales can deliver a modern health and care service to citizens supported by the same technology that they are increasingly using day to day for other purposes,” it concludes.

“Overall, the approach means we will be able to continue to make progress during the economic downturn.” The health and social care strategy for enabling integrated information services until the end of October.