The King's Fund has warned that implementation of the government's long-awaited NHS information strategy raises technical and financial challenges and will rely on the pace and scale of local take up.
"While we welcome the ambition and direction of the strategy, at a time of unprecedented financial constraint, some commissioners and providers will find it challenging to invest in developing information systems rather than frontline services," said Dr Veena Raleigh, a senior fellow at the health think-tank.
"The goal of linking health and social care records is the right one and is vital for facilitating integrated care to meet the needs of older people and those with chronic conditions. However, while there are some outstanding examples of linking records across services to draw on, implementing this on a national scale raises technical and financial challenges and much will depend on the pace and scale of local take up."
Titled, The power of information: putting all of us in control of the health and care information we need, the document says that the success of the strategy depends as much on a culture shift – in the way patients, users of services and professionals think, work and interact – as it does on data or IT systems.
Intended as a 10-year framework to transform information for health and care, and a response to the consultation on Liberating the NHS: an information revolution, the strategy sets out deadlines for changes.
By 2015, all general practices will be expected to enable patients to book and cancel appointments, order repeat prescriptions, and access their records online.
Currently more then 50% of general practices use IT systems that are capable of providing patients with electronic access to their own records, but less than 1% offer this service.
The document also sets out an aim to develop integrated health and social care networks, when technology is available to enable this. It acknowledges that many health and social care IT systems currently have their own 'standards' and do not work together.
"Using digital and online services can simplify the more routine aspects of care, such as booking appointments, requesting repeat prescriptions, or self-assessment for social care," says health secretary Andrew Lansley in a forward to the document.
"The strategy sets out ways to reduce the frustrations we experience, such as repeating or recording the same information many times for different staff, or travelling long distances for services that could be delivered better in other ways."
The document acknowledges, however, that some GPs may decide that they can only provide online access to records from a specific date onward, rather than access to historical information "which may not have been written with patient access in mind".
By 2014 the Department of Health and NHS Commissioning Board will pilot new ways to promote the use of integrated barcode medication administration systems in care homes. The results will inform the planning of wider implementation.
From 2013 a single portal will bring together information and online services currently provided by NHS Choices, NHS Direct online, NHS 111 online content and Healthspace. The plan is that, together with the 999 and 111 telephone services, it will be one of only three main ways for patients to access help and information about health and social care.
In terms of taking the strategy forward, actions such as setting common standards to allow information to flow effectively around the system, will be led nationally.
More detailed implementation planning will be led by organisations including the NHS Commissioning Board, the NHS Health and Social Care Information Centre, and Public Health England.
"This strategy represents a detailed repudiation of the centralised National Programme for IT," said SA Mathieson, a senior healthcare analyst for market intelligence provider Kable. "In future, except for some national infrastructure, it will be up to individual trusts and surgeries to equip themselves, although there will be some financial help from the department.
"Patients should get a much better service online, but the careful choice of 'digital first' rather than 'digital by default' recognises that many NHS users will want to use offline methods for many years to come."
Guardian Professional.
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