News in brief 

Labour manifesto fails to focus on IT: The Labour Party has launched its manifesto for the upcoming general election, promising a more integrated health and care system, but not one that will make more use of IT, reported eHealth Insider (EHI). The manifesto says the party will “rescue” the NHS by creating a ‘time to care’ fund paid for by a mansion tax, by repealing elements of the Health and Social Care Act 2012, and by capping the profits that private companies can make from NHS work. The Liberal Democrats have promised to open up access to GPs by using phone and Skype appointments in their manifesto, according to EHI. The party is the only one of the big three political parties in England to mention alternatives to traditional, physical appointments in its plans to “ensure easier access to GPs”, which seems, unexpectedly, to have become a hot election issue. Meanwhile, the Conservative Party has promised to continue the NHS transparency agenda and to give people “full access” to their electronic health records in its manifesto, reported EHI. The health section of the manifesto has more continuity with the party’s last manifesto. The 2010 manifesto promised an “information revolution” for the NHS, “by making available detailed data about the performance of trusts, hospitals, GPs, doctors and other staff” so that people could see “who is providing a good service and who is falling behind.” The 2015 manifesto says that since then the Conservative-led coalition has put new data onto the NHS Choices website and implemented the friends and family test.

NHS finance problem being ignored, says former boss: The NHS is facing a “substantial financial problem” which politicians are ignoring in the election campaign, the former head of the service says. Sir David Nicholson, who retired last year, told the BBC the NHS in England was accruing large deficits which would become “crystal clear” later this year. But he said instead of talking about how to address these, politicians were focusing on expanding services. He said the situation caused him “very great concern”. In an interview for BBC Radio 4’s Today programme, Sir David – who ran the NHS in England for eight years – said that because there was an election period, the NHS was unable to publish the latest report on its financial position. But he said it was “pretty clear in the NHS that there is a substantial financial problem, particularly in the hospital sector”. 

NHS cash crunch to hit after UK election: The succeeding government will be under direct pressure to insert more money into the NHS to avoid a disaster, according to an analysis by the Financial Times (subscription required). The study reveals that hospitals have fallen far more deeply into the red than has been publicly acknowledged. The NHS will not publish its final accounts for 2014-15 until after the UK general election. George Osborne, the chancellor, announced a further £2bn for the NHS for 2015-16 in last year’s Autumn Statement. But NHS hospitals argue that less than half of that is “new money”, while the remainder is reserved for spending on services outside hospitals. After years of attempting to meet savings targets, hospitals are now struggling to find new ways to save money. The NHS economic regulator Monitor reports that in 2014-15 the actual level of efficiency achieved was nearer 2.5 per cent.

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IBM and Apple want to share how you are with others: IBM has launched a health unit to make sense of the wealth of data created by the boom in fitness trackers and apps, reported the BBC. Watson Health aims to create “a secure, cloud-based data sharing hub” that can feed analytic technologies, it said. It could provide diagnoses or health alerts which could also be sent to doctors, carers, or insurers for example, with the user’s permission. IBM has teamed up with Apple and wants to launch “new employee health and wellness management solutions”. The company says it is buying two firms to help with its goal: Explorys which has one of the largest healthcare databases in the world and Phytel that works with digital medical record systems to reduce hospital readmissions and automate communications. IBM says it wants to provide “individualised insights and a more complete picture of the many factors that can affect people’s health”.

Patient opinions heard: Extra funding will allow people to share their experiences of the NHS online and make an important contribution to improving services, Scottish health secretary Shona Robison announced. Patient Opinion, an independent, not for profit social enterprise, allows patients to share their experiences, both positive and negative, of health services via its website. Health boards are then able to respond and use this feedback to make changes to improve services. Health boards will receive a share of up to £180,000 from the Scottish government each year, until at least 2017, to continue using the website to the best effect. All health boards respond to experiences shared on the website and since it was introduced in 2011, more than 100 changes have been made to services across Scotland in response to feedback. 

Campaign aims to involve nurses in NHS procurement: NHS Supply Chain, the Clinical Procurement Specialist Network and the Royal College of Nursing, have created the Small Changes, Big Differences campaign, according to Supply Management.​ It aims to make savings and promote patient safety by providing interactive tools and sharing best practice to harness knowledge and expertise in the NHS. The campaign contains a toolkit with best practice guidelines giving information about how to get the most out of working with procurement teams, and proposals on how to take action. There are also instructions to help nurses implement the campaign in their trust, and case studies of trusts that have reduced spend. The campaign follows a survey of nurses on their purchasing practices, which identified a need for them to work more closely with their trust procurement teams. More than 80 per cent of nursing staff believed money could be saved in their organisation. Mandie Sunderland, chief nurse at Nottingham University Hospitals NHS Trust, said: “As the individuals at the heart of this process, we as nurses are in the best possible position to influence it.” 

New report claims, Cloud-based data storage solutions crucial to enhancing NHS services: The healthcare industry can offer more efficient customer care and communication through the use of cloud-based data storage solutions, reported Building Better Healthcare. The report by Frost & Sullivan claims intense pressure to reduce healthcare costs has affected the state of the healthcare system, leaving an open door of opportunity for the IT industry. The traditional model of patient-centric care is progressively giving way to member engagement and authorisation, which in turn has opened up opportunities for healthcare providers in the unexploited health and wellness sector. The big data trend is pivotal and numerous IT vendors have responded by developing cloud-based solutions for the healthcare industry. The amount of big data needed to provide better and more cost-effective care is best handled in the cloud. The capacity, flexibility, and pricing models offered by cloud service providers resonate well with the healthcare industry. Tonya Fowler, customer research director at Frost & Sullivan said “by providing use cases and demonstrating ROI, the IT industry can expand the scaled use of mobile and remote technology solutions as part of care delivery and patient/provider workflows.”

e-Referral Service ‘live on 15 June’: On the 15 June the new NHS e-Referral Service will go-live as part of plans to replace all paper-based referrals, reported eHealth Insider. The Health and Social Care Information Centre (HSCIC) has confirmed the new date in spring 2015 after a delay in November. The HSICIC said the delay was down to the need for “significant test, assurance and defect resolution activity” to be completed. The new service is considered a key breakthrough towards a paperless NHS by 2018. The HSCIC website said the “new electronic referral service will improve the quality of the referral experience for patients and better support for clinicians and administrative staff.” The HSCIC says the e-Referrals Service will build on the successes of Choose and Book and will include enhanced functionality and usability. “We have spoken to more than 2,500 stakeholders and they have told us about some of the functionality they would like to see from a future NHS e-referral service,” it says. Former NHS England chief executive, Sir David Nicholson, said last year that the main difference between the old and the new service is that “anyone can refer to anyone”. It will allow patients to book their own follow up appointments electronically and be given alerts and reminders of when to book.

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Value of apps and wearables questioned: The potential for smartphone apps and wearable devices to have an effect on health outcomes has come under question in an article published by the BMJ, reported eHealth Insider. The article by Des Spence, a GP from Glasgow and former BMJ columnist, highlighted a lack of evidence to back the use of these personal health tools as part of a wider healthcare plan. While Spence acknowledged that most of the tens of thousands of health apps currently available are “harmless (and likely useless)”, he suggested risks lie in their use alongside wearable devices, such as fitness tracking wristbands. Spence was challenged in the BMJ by Iltifat Husain, editor of healthcare app review website iMedicalApps.com. He said: “The naysayers will argue that healthy people shouldn’t use health apps because there’s little evidence of benefit or that they may lead to unnecessary anxiety, meaning more work for primary caregivers. But apps have been around for more than ten years, on PDAs [personal digital assistants], and have been shown to improve outcomes and health”.

Safe staffing levels have not improved, say nurses: Safe staffing levels have not improved on hospital wards in the last 12 months, despite government claims of increased nursing numbers, a survey of more than 5,000 nursing staff has revealed. The annual Unison survey, carried out during February revealed that 45% of respondents felt there were not adequate staff numbers to deliver safe and dignified care, reported National Health Executive. On top of this, nearly two-thirds reported that patients missed out on care due to understaffing, while around 50% reported not having enough time with each patient. Christina McAnea, head of health at Unison, said: “We have carried out this survey for the past four years and it is deeply worrying that little has changed. Staff are still not able to see all their patients – despite working through their breaks and doing lots of unpaid overtime. Demands on the NHS are at an all-time high, but despite the government’s promise, the NHS is operating in a financial straightjacket. With not enough money to fund adequate staffing levels, nurses and midwives are running themselves into the ground as they struggle to keep the health service going.”

Accenture looks set to take over NHSmail: The Health and Social Care Information Centre has confirmed that Accenture is its nominated preferred supplier for the NHSmail service, reported eHealth Insider (EHI). The HSCIC narrowed the field to BT and Accenture in December last year, and then asked both to provide more information. The NHSmail contract is estimated to be worth between £120m and £350m. No details have been released about the systems that Accenture will be using, but EHI News understands that NHSmail will remain on a Microsoft Exchange platform, with an additional offer to use Microsoft Lync, an integrated directory, diary, and messaging system. NHSmail was launched in 2002 as a national directory service and an email address for life for NHS staff. It was one of the first, national services to be delivered after the launch of the National Programme for IT in the NHS. It remains the only NHS email system accredited with ‘official sensitive’ status and backed by medical organisations for the exchange of patient identifiable and sensitive information.

GE Healthcare: We’re leaving the hospital EMR business: GE Healthcare confirmed at HIMSS 2015 that it is to leave the hospital electronic medical records business. Jon Zimmerman, general manager of clinical business solutions at GE Healthcare, said: “We are working closely with Centricity Enterprise customers to help them transition to a solid and effective acute care EMR.” The hospital-focused Centricity Enterprise product produced approximately 5% of total electronic medical records revenue. In 2013, Centricity products were thought to generate close to $300m, making GE Healthcare a distant sixth in EMR vendors. That was more than $100m behind fifth-place athenahealth that year, according to Medical Economics. But the gap was reported to have grown since then.

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Opinion:

How safe is our public data in the internet of things?
The internet of things may bring greater efficiency, but security is a real risk. On the Guardian’s Public Leaders Network, Kate O’Flaherty examines how public bodies need to prepare for a surge in online data.

“According to the government, 14bn objects are already connected to the internet, 40m of them in the UK. By 2020, it could be as many as 100bn worldwide. This huge surge in the amount of data being shared wirelessly is increasing both the opportunities and the risks for public services.

“Making more objects “smart” can increase efficiency by paving the way for public services such as internet-enabled bins and traffic lights. But the potential for data breaches in the public sector will only get worse with the adoption of the internet of things. It is a major concern for the public sector because of the sensitive and personal information it handles, such as NHS patient records. 

“Exposing even more publicly held data on individuals could be devastating. Private medical records might reveal information such as mental health issues that could impact people when they apply for jobs; data might be used by hackers to bribe individuals in ransom attacks; and there are potentially deadly implications if hackers tampered with, or deleted important medical information, such as blood type.

“Not all aspects of security are alien to the public sector. Some elements of this new IT world, such as the necessity to report a breach, will not require much adjustment. Public bodies such as the NHS are accustomed to reporting breaches.” 

The road to digital healthcare: championing the NHS, cyber evolution
The healthcare sector needs to celebrate its cyber successes if it is to succeed in creating trust in a digitised system, says Chris Wysopal, co-founder CISO and CTO, Veracode.

“‘Digital by Default’: this is a phrase that has been used widely across many parts of the public sector. Yet, despite the notable benefits of digitisation, the question of data security has proven challenging.

“In no sector is this more prevalent than in health, where the government’s care.data programme continues to experience teething problems. Last year, the NHS Watchdog raised nearly 30 questions about the programme, specifically around how general practitioners (GPs) would be able to comply with the Data Protection Act. These kinds of concerns will need to be thoroughly addressed before the programme is implemented.

“Bring Your Own Device (BYOD) or Choose Your Own Device (CYOD) have become indispensable in some healthcare environments, yet cyberattackers target vulnerabilities in mobile apps with increasing regularity. It is imperative that hospitals and NHS trusts take the required steps to secure this extended perimeter.

 “It’s not all doom and gloom, though. The UK health sector has been increasingly responsive to the threat that cyberattackers pose. Veracode findings show that some NHS trusts and hospitals are not only increasing their cybersecurity budgets, they are also spending it smartly to keep new and emerging risks at bay.”

Power to the people: signs off
In the medium term new forms of coordination and change will come faster from patients and carers than they will from organisations and politicians, writes Patient Opinion founder Dr Paul Hodgkin in his final Power to the People column on eHealth Insider.

“For centuries, the relationship between patients and their health care providers has been a one-way street in which doctors and organisations held all the cards: it was patients who were information poor, who lacked resources, and who were much more vulnerable,” he says.

“These imbalances of information, power and vulnerability have shaped medicine since Hippocrates. But our networked world is beginning, slowly, to change this. This goes way beyond the fact that patients and carers now come highly informed.

“Today’s patients have access to significant new resources. Not those controlled by the system, but those created by patients themselves: the forum, the voice in the night from the other side of the world saying ‘have you tried this?’ and, increasingly, the ability to share your bio-data and your life experiences with your community of fellow sufferers.

“These new resources are created by the lower transaction costs of the loosely coupled, but intelligently communicating, crowd of ‘people like me’. This is not ‘co-production’ – which is what those people called patients are still supposed to do to help the system. It’s much more like hacking healthcare from the bottom up, from the outside.”

 

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In this week’s blog Rob Benson says politics should champion health technology for the people before the professionals.

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