Digital Health’s review of the year, 2017

What a year 2017 has been in the world of digital health. It was a year you couldn’t avoid with AI, the ICO and CQC looming large.

It was a year that saw digital health apps like GP at Hand and Evergreen Life hit the UK mainstream, and come under scrutiny; and the year that NHS IT made international headlines for all the wrong reasons with Wannacry.  It was also a year Global Digital Exemplars and the new NHS Digital Academy began to find their feet.  Join us for the romp that is the Digital Health review of the year   

The year kicked off as it was set to continue with Global Digital Exemplars in the news.  For much of the year GDEs loomed large but the money had yet to catch up, resulting in increasingly twitchy CIOs and finance directors.  In February an additional four acute global digital exemplar (GDE) trusts finally been confirmed by NHS England, after being revealed in trusts’ board papers.

The announcement brought the tally of acute GDEs up to 16, after the initial 12 were announced in September. The extras were: Cambridge University Hospitals NHS Foundation Trust; Imperial College Healthcare NHS Trust with Chelsea and Westminster NHS Foundation Trust; Newcastle upon Type Hospitals NHS Foundation Trust; Alder Hey Children’s NHS Foundation Trust.

March saw the mental health global digital exemplars  revealed by NHS England in the Next Steps on the NHS Five Year Forward View. While the report didn’t disclose how much money the trusts will receive, nor the timescale, prime minister, Theresa May, announced in January that each trust would receive £5 million, to be matched in each case with local funding.

This compared to the £10 million promised to each of the acute GDEs, again to be matched by local funding, that was promised in September last year.

Also in March, one of the biggest stories to break was the Information Commissioner’s Office (ICO) raising concerns about TPP, over an “enhanced sharing” function in its SystmOne electronic patient record system.

The ICO’s worries centred on principles 1 and 7 of the Data Protection Act. These relate to fair and lawful processing of data, and to data security –  as a result, warned the ICO, many thousands of patients’ GP electronic records may not be compliant with Data Protection Regulations on fair and lawful processing.  The ICO began a  review.

In April the CQC, the health and social care regulator, cracked down on potentially unsafe online prescribers that fail to carry out adequate identity checks or to review a patient’s medical history.

The 8 May General Election left the country with a significantly weakened minority government, but inadvertently boosted the chances of Northern Ireland getting a national shared record system, after the Democratic Unionist Party were told to bring their big truck round the back of the Bank of England.

Concerns about data sharing were soon overshadowed by developments on May 12. That date that will forever be remembered as one of the most historic healthcare IT disruptions the NHS has yet faced: Wannacry. The global cyber-attack crippled parts of the NHS. While it was not targeted to the NHS, it revealed far more needs to be done both locally and nationally to help trusts prepare for such attacks.

A subsequent National Audit Office report (in October) explained simple measures could have been taken to protect the NHS from the global cyber-attack.

NHS Digital admitted it could have been better prepared and was let down by poor communications.

In the same month, Beverley Bryant announced she was leaving her position as NHS Digital director to join become chief operating officer (COO) of health software supplier System C.

In what became a theme for the year, private online video GP consultation service Push Doctor found itself in hot water after a Care Quality Commission (CQC) investigation found it to be delivering unsafe care.  The regulator’s report into the online service Push Doctor found the service to be neither safe or effective.

Since last October the CQC has been providing more scrutiny for digital health services, and several of the reports into different service providers found significant gaps in their compliance with clinical safety regulations on areas including prescribing and record keeping.

The ICO was in the news again in July, this time finding the extremely high-profile pilot between a London NHS trust and Google’s DeepMind artificial intelligence arm failing to comply with the Data Protection Act.

In a keenly anticipated ruling, the ICO announced that the Royal Free NHS Foundation Trust failed to comply with the Data Protection Act when it provided details on 1.6m patients to Google DeepMind.

The investigation found several shortcomings in how the data was handled, including that patients were not adequately informed that their data would be used as part of the test.

The CQC was also at it, having condemned another digital healthcare provider as unsafe, not well led and ineffective. It found issues with Pharmacy 2U’s patient identification, prescriptions and asthma care.

July also saw the extremely popular Digital Health Summer Schools held in Manchester, which included the launch of a new network for nursing  digital leaders; the first joint Summer School NHS Hack Day; and a fantastic attendance and contribution from Irish CCIOs and CIOs.

Also in July came news of ambitions to use the GDE and accompanying fast follower programme to fundamentally change how NHS trusts buy IT systems, potentially removing the need for future procurements.

Sarah Wilkinson took over the helm at NHS Digital, replacing Andy Williams as the new chief executive.  Previously the CIO at The Home Office, with responsibility for the delivery of all technology services for Counter-Terror, the UK Border, Visas and Immigration, Asylum and Policing, she remains a woman of mystery yet to make a public speaking appearance.

Wilkinson still snaffled the title of second most influential woman in UK IT. She received the accolade in Computer Weekly’s annual ‘50 Most Influential Women in UK Tech 2017’ list, the only woman from the health and care sectors on the list.

August also saw the surpise announcement of NHS England’s first national CCIO Keith McNeil announcing his resignation after 13 months in the role. Prof McNeil, who sealed his reputation as national CCIO with an iconic rendition of ‘I come from the land down under’ at the 2017 Summer School, hopped on the plane back to Oz take up an assistant deputy director general role at Queensland Health and chief medical information officer at Queensland.

Applications for a replacement national CCIO, who will chair the NHS National Information Board, be a Board Member of NHS Digital, and work collaboratively with NHS Improvement, Public Health England, Care Quality Commission and NICE, closed on 14 November.

Dr Joe McDonald, chair of the CCIO network wants to see the role “beefed up” and be put on a level with the head of the US Office of the National Coordinator for Information Technology.

With conference season came new promises were made in September. Big ones too. Health Secretary Jeremy Hunt, who defied the odds by remaining in post for a another year, promised every NHS patient access to their records through an app. He said patients should be able to use an app to access their medical records and book a GP appointment by the end of 2018.

The promised app, expected to be the latest incarnation of the NHS England-led NHS.uk national patient portal, would also enable patients to “express their organ donation preferences”, “express their data sharing preferences”; and access support for managing a longterm condition.

On that note, the redeveloped NHS.uk was due to go live on 30 September this year as stated in NHS Digital’s latest board papers remains missing in action. It is intended to provide a national portal to digital patient services, including personal health records.

TPP, providers of the SystmOne EPR which is widely used in primary care, previously told Digital Health News the company is working with NHS Digital to give patients access to their GP record via NHS.uk.

Watch this space next year!

September was also the launch of the NHS Digital Academy, in a high-calibre, ivy league, virtual leather patches on jackets tie-up between Imperial, Edinburgh and Harvard, designed to create a paradigm shifting, step-changing revolution in the way the NHS develops digital leaders.  Starting 2018, the £4 million NHS Digital Academy programme  over three years aims to train 300 digital leaders.

October started with Matthew Swindells,  NHS England’s director for operations and information saying the NHS compares unfavourably with the best internationally.  Swindells said “the best hospitals in the UK, in terms of using IT, are mediocre by international standards”.  He said the aim of the GDE programme was to narrow this gap.

In October the new new chief executive of the NHS Digital Academy Rachel Dunscombe announced the academy will no longer be exclusively for digital leaders from GDEs and their Fast Followers.

Back in August, the Irish Health Service Executive CIO Richard Corbridge announced his resignation. This month saw him officially taking up his role as CIO at one of the largest trusts in the UK, Leeds Teaching Hospitals. He was with HSE for three years and said decision to leave was very much based on the opportunity in Leeds

The month also saw the controversial app, GP at Hand launch. The ‘free’ NHS service, powered by Babylon, promised to cut waiting times by allowing patients to book appointments and talk to their doctor through their smartphones.

It was met with questions, including from one Digital Health reader, who said: “If you visit the site you find that, unlike any other NHS practice, they appear to be picking low-risk, non-complicated patients.”

Three days after the launch, an emergency motion was called for a halt on online consultations until there is ‘clear evidence’ that it is beneficial to patients.

The emergency motion was passed at the Conference of England Local Medical Committee’s (LMC).

At the end of November, the Academy opened its doors for selection into its first cohort of 100 students.

Digital Health was one of the delivery partners behind a new Building a Digital Ready Workforce online consultation on the future needs of health informatics staff, led by Health Education England, which more than a 1,000 NHS IT and informatics professionals took part in.   Findings of the consultation will be published by Digital Health in January.

Late this month Digital Health reported that NHS England will in January invite trusts to become Local Integrated Care Record Exemplars, with Digital innovation Hubs to follow

The official call for invitations are expected to take place in January and will focus on accelerating integrated care records projects that directly support patient care and care coordination.  Like the previous hospital and mental health global digital exemplar (GDE) programmes, the focus be on those with existing relatively mature record sharing programmes.

And as the year ends rumours swirl of a new Enterprise Wide Agreement in the offing with Microsoft.

Phew, those were just the highlights.  It’s been a busy year when its felt like the pace of developments has accelerated.  Enjoy the Christmas break and Digital Health News will be back in the New Year.