IT experts question HES expansion plans

NHS IT directors have questioned whether most hospitals can get the IT in place to allow a hugely expanded Hospital Episodes Statistics dataset to be extracted by April 2014.

Last month, NHS England launched a consultation on its proposal to require a greatly expanded HES dataset to be provided electronically from the beginning of the next financial year.

The HES expansion includes the regular extraction of tests and results, investigations performed and medications prescribed, as well as nursing observations.

The data will be sent to the Health and Social Care Information Centre.

Daniel Ray, director of informatics at University Hospitals Birmingham NHS Foundation Trust, told EHI that most trusts would struggle to hit the 2014 target.

Birmingham uses an e-prescribing and communication system that has been developed in-house over a number of years.

“In my opinion it’s something hospitals should’ve been submitting for years. It’s not going to cause us any problem – we could submit the data required tomorrow – we’ve been reporting on that data internally in the trust for three years,” Ray said.

“However, most organisations don’t have the technology in place. They do not have an e-prescribing solution, for instance, so they are going to have to implement that.

“Then you’ve got to change culture and implement that. In short, most organisations are a minimum of two to three years away,” he said.

Ray questioned whether data definitions and standards are being given necessary consideration.

“There’s a massive amount of work that needs to be done to be able to compare this data,” he said.

However, he added that he felt positive about the way it would transform research and assessment of judging whether a hospital is ‘good’ or ‘bad’.

His views were echoed by Christine Walters, associate director of IM&T at Pennine Acute Hospitals NHS Trust, which is in the process of implementing e-prescribing across its four hospitals, in a project that should be complete next March.

“It makes sense to get as much data generated as possible, and share it, but most trusts aren’t going to have the information they are looking for so how long it’s going to take before it’s useful, I don’t know,” she said.

“We don’t do nursing observations electronically. We’ve got the capability to do electronic forms right now, so we’re just going to have to replace the paper. It’s just more work. We’re going to have a think about building it into our work load.

Walters said she would prefer to spend scarce resources on improving clinical systems and their use, instead of focusing on getting ready for data extractions.

“We already have enough to do and it’s another job we could do without. But if someone dictates that we have to do it, it will just have to get done.

“If it helps support integrated patient care, that will be worth it,” she said.

In an interview with EHI last month, NHS England chief data officer Geraint Lewis said NHS England expects trusts to start sending data in April 2014, but is aware that most hospitals will not be able to achieve this.

“They will need to work with local commissioners on improvement plans so they can start sending in data on the same level as the best hospitals,” he said.