Bryant puts paperless future on CCGs

Clinical commissioning groups have overall responsibility for delivering a paperless NHS by 2020 and will manage any funding made available to support this ambition, NHS England has said.

Speaking at the NHS Expo in Manchester today, Beverley Bryant, director of digital technology at NHS England, said the definition of paper-free is that all patient and care records will be digitally interoperable and real time by 2020.

CCGs will need to submit digital roadmaps by next April, showing how they will achieve this within their defined geographic area.

Bryant said CCGs have been chosen to lead on the roadmaps because they are best placed to manage the health economy and drive a focus on interoperability.

“We accept some CCGs don’t have the capability to do this so they might be heavily reliant on their commissioning support unit.

“That is perfectly alright as long as the CCG takes responsibility,” Bryant said, adding that CCGs may also choose to use private sector companies.

As reported in Digital Health News last month, Bryant told the Expo that NHS England has been working on business cases to go to Treasury to support the digitisation programme.

No funding has been confirmed, but NHS England hopes to create a “meaningful use technology fund” to support the delivery of the digital roadmaps.

“It’s complicated, because it’s our providers that need to deliver this job as primary care is already 100% digitised,” Bryant told her audience this morning.

“But rather than channelling this down the provider route, by going to CCGs, they have got to do it in an interoperable way.”

NHS England has now released the guidance on creating the roadmaps that it promised over the weekend.

This confirms that the roadmaps must be in place by April next year, and lay out how “the local health and care economy” will “achieve the ambition of being paper-free at the point of care by 2020.”

Bryant said the first thing CCGs need to do is define their footprint. A template on the NHS England website will help them describe which providers are going to be covered by their roadmap.

“By the end of October, please tell us: ‘Who’s in your gang?’” she said. CCGs will then need to start work on their governance arrangements to allow NHS England to monitor and track progress.

By November, CCGs and healthcare organisations will need to report back to the centre on where they are now in terms of their digital capabilities.

This will inform a new ‘digital maturity index’ that will focus on the usage of systems, rather than systems deployed. The results will be made public next March.

“We need to create a benchmark and we need to measure progress,” said Bryant, adding that NHS England has been working with colleagues in the United States on how they measure the ‘meaningful use’ of systems deployed.

Thirty CCGs and trusts have helped to create the questionnaire that providers will need to fill out. Bryant said CCGs will need to take overarching responsibility for what is reported and there will be audits to make sure that what is recorded matches reality on the ground.

Planning guidance released at the end of this year will incorporate templates and further guidance for CCGs to write their roadmaps, which will be published in June 2016.

Bryant said NHS England will not tell CCGs what to do, but it is keen to support and work with organisations.

She also warned that it was “not ok” for healthcare organisations to do nothing, and that they should be honest with the commissioning board if they felt they lacked the expertise to define their current digital capabilities or create roadmaps.

She also said all systems bought in the future need to be interoperable across organisational boundaries so CCGs and providers should focus on buying software with open APIs.

NHS England’s director of patients and information Tim Kelsey also spoke at the Expo this morning.

He confirmed the commitment to end the use of paper records at the point of care in health and care services by 2020, that was first set out in the latest NHS IT framework, ‘Personalised Health and Care 2020’, which is meant to support the ‘Five Year Forward View’ to save £22 billion by 2020-21.

He also confirmed the intermediate stage of healthcare being paper free in primary, urgent and emergency care services by 2018, and said NHS England would be promoting some specific measures to encourage the uptake of healthcare IT.

These include support for the use of barcoding to track medical equipment, drugs and blood, and to make sure they are 'positively matched' to the patient at the bedside. The Department of Health already requires GS1 UK standards to be used for such systems.