The widespread adoption of joined-up electronic patient records and advanced communications technologies is vital to ensuring that hospitals across the UK can adapt to future care needs, according to a new report.
The need for change is clear. The time has come to take action. Those working in the NHS have a responsibility to lead this change, supported by the organisations that represent them and empowered by national policymakers
The Future Hospital Commission has published its Future hospital: caring for medical patients document, which makes 50 recommendations for creating a radical new model of care designed to encourage collective responsibility for the care of patients across professions and healthcare teams.
Set up in March 2012 by the Royal College of Physicians, the commission is an independent body tasked with identifying how hospital services can adapt. It recommends new ways of working across hospitals and between hospitals and community services, supported by financial and management arrangements that give greater priority to caring for patients with urgent medical needs. This means aligning funding and incentives across the health economy to ensure that acute services are appropriately supported.
And a key part of this vision is the adoption of innovative technologies, the report states.
It calls for the development of ‘systems that enable hospitals to become the hub of clinical expertise and supporting technology for the local population, particularly in relation to diagnostics and treatment’.
It states that this can be supported by the development of:
- iShared referral pathways and care protocols across the system to support integrated working with health and social care partners. This would be underpinned by rapid, relevant sharing of information, mechanisms for rapid admission and referral, and effective arrangements for enabling patients to leave hospital with support where necessary
- Information systems that bring together all relevant clinical information, including that from primary and community care, mental health, social and hospital services in one electronic patient record (EPR). Immediate access to this comprehensive EPR is particularly important in the assessment of patients presenting as a medical emergency
Hospitals should also set up in-house clinical co-ordination centres responsible for collating and disseminating information that allows patients’ needs to be matched to the care and service capacity available within the health economy. This should support the joined-up administration of urgent care, out-of-hours systems and hospital-based parts of the medical division.
To achieve this hospitals will have to ‘encourage and support clinical leadership in information and communications technology’, the document adds.
Organisations and professionals involved in health and social care – including doctors, nurses, politicians, hospitals and national bodies – must be prepared to make difficult decisions and implement radical change where this will improve patient care
A spokesman for the Future Hospital Commission said: “The need for change is clear. The time has come to take action. Those working in the NHS have a responsibility to lead this change, supported by the organisations that represent them and empowered by national policymakers.
“Organisations and professionals involved in health and social care – including doctors, nurses, politicians, hospitals and national bodies – must be prepared to make difficult decisions and implement radical change where this will improve patient care.
The comments have been widely welcomed. Dr Justin Whatling, chairman of BCS Health, the healthcare arm of the Chartered Institute for IT, told BBH : “The report outlines the best practice that really ought to be uniformly in place today, and that reflects many of the key themes that BCS Health has been championing in recent years. However, we believe this good work could go much further - the challenges the health system faces requires that we not only perfect the care we deliver, but that we have to radically transform the very processes of care delivery – information and technology have a hugely disruptive role to play in redefining how care services are delivered.”
He added that training hospital staff in IT and information would be key.
“We need to train clinician undergraduates in EPR now,” he added. “Clinicians should be trained to work in multi-disciplinary teams and to use patient information systems for recording of high-quality data and sparking a culture of enquiry to understand and use the data to change clinical practice.”
And in reference to calls in the report for the widespread appointment of chief clinical information officers (CCIOs), he said: “These leaders are a critical connector of informatics and the clinical profession in helping to realise the benefits that information and technology can bring. We need to see more CCIO appointments and we need to ensure they have enough time protected to fulfil the role.
Clinicians should be trained to work in multi-disciplinary teams and to use patient information systems for recording of high-quality data and sparking a culture of enquiry to understand and use the data to change clinical practice
“We have a real opportunity to engage hospital clinicians in joined-up patient care by providing them access to patient information from across the local health economy and ensuring they contribute back to the sharing of this information to make better care decisions. Commissioners will be looking for new models of care that are focused on patient outcomes and this will help hospitals engage in delivering patient-centred services across the care continuum – a theme at the heart of the Future Hospital Commission report.”
But Dr Clare Gerada, chairman of the the Royal College of General Practitioners, argued that the relationship between hospitals and primary care services was vital and largely overlooked in the report.
She said: “The NHS does not start and end with hospitals. We must ensure that general practice - and its potential to transform the way we deliver care to patients - is not neglected as the recommendations in this important document are debated and implemented.
“We hope that this report will provide an essential blueprint that will shape the way care is provided to patients across the health service from the start to the end of their lives, in a way that keeps the NHS safe, sustainable and value for money.”
Other recommendations in the report include the creation of acute care hubs in hospitals, which will focus on improving assessment and stabilisation of acutely-ill patients; improved round-the-clock care with 27/7 consultant presence on wards; improvements in patient transfer and handover; and better education, training and deployment of doctors.
For more details of the report, click here.