The new NHS: Only the fittest will survive and flourish

Published: 1-May-2013

Exploring how security and privacy will be key to the NHS meeting the challenge of becoming paperless by 2015


In this article KURT LONG of software supplier, FairWarning, explains why reputation means everything as healthcare providers start to compete in the new NHS marketplace. He also argues that within the reformed NHS landscape only the strongest will survive

The NHS is currently undergoing a transformation, which once completed will make way for a new, leaner and more efficient healthcare landscape.

This is a tectonic shift in the history of the NHS: the rules of engagement are changing and as a consequence only the strongest, most agile and financially viable organisations will survive

With limited financial resources, and having to meet the growing needs of an ageing population, many NHS trusts are struggling and some have gone into administration, such as South London Healthcare NHS Trust, with more expected to follow suit.

While many refuse to accept this and fight to keep the current status quo, the fact is that these irrevocable changes will happen. The Government, having to reduce its own deficit and cutting back in all areas, no longer has the financial means to bail those trusts out, nor to prop up a healthcare system that is no longer viable.

A commercial market

Current reforms, including the introduction of GP commissioning as well as meeting the government’s £20billion efficiency target over the next four years, mean that NHS trusts are now operating in a more competitive environment. I would go as far as arguing that the healthcare environment is becoming a commercial marketplace, with various providers competing against each other.

This is a tectonic shift in the history of the NHS: the rules of engagement are changing and as a consequence only the strongest, most agile and financially viable organisations will survive.

Visionary healthcare providers have already understood that in order to meet budgetary mandates, as well as respond to new competitive market-place dynamics, they have to embrace the Government’s ambitious digital plans of a paperless NHS by 2018

In order to succeed in this new emerging NHS, healthcare leaders must encourage a shift in their organisation’s culture, which needs to be more tuned to the commercial world. Providers must put in place a sound economic plan that will provide them with a cost structure that not only enables productivity, but also creates revenues. Importantly in the context of the Francis Report into the Mid Staffordshire NHS Trust, providers need to demonstrate leadership and provide the workforce with a vision to attract and retain the right people.

Visionary healthcare providers have already understood that in order to meet budgetary mandates, as well as respond to new competitive market-place dynamics, they have to embrace the Government’s ambitious digital plans of a paperless NHS by 2018.

They understand that there is no alternative option but to adopt electronic health records as this is their only chance to fundamentally reduce the cost structure in which they provide their services, while improving care for patients and helping to tackle the challenge of an ageing population and increasing incidence of long-term conditions. Those visionary providers have also acknowledged that key to the success of the paperless NHS vision is the tenet of privacy and security as a fundamental underpinning to protect the reputation and integrity of their brand.

Reputation management

In other words, to stay competitive and flourish in this new market where reputation is everything, NHS healthcare providers have to learn to manage, promote and protect their brand. Reputation is a precious and fragile asset, quickly and easily damaged by media coverage of any failure. Rebuilding a lost reputation is a slow and difficult process and it is therefore essential for providers to safeguard their reputations and maintain the trust of patients and the confidence of clinical commissioning groups in order to compete for their ‘business’ with other NHS and non NHS health providers.

With more information stored and shared electronically, and with patients fast becoming discerning consumers of healthcare and taking a more active role in making use of their own health records, patient privacy becomes more of an issue. In fact privacy has become the cornerstone of electronic healthcare

At the core of a good reputation is the respect of certain values and principles such as integrity, transparency, accountability, security and privacy. In a world that is increasingly becoming digital, security and privacy are mandated business assets, tied to the reputation and the quality of how a business is run.

With more information stored and shared electronically, and with patients fast becoming discerning consumers of healthcare and taking a more active role in making use of their own health records, patient privacy becomes more of an issue. In fact privacy has become the cornerstone of electronic healthcare.

The healthcare providers who will succeed in the new NHS, where electronic records and patient-focused commissioning are the norm, will be those who introduce best-in-class privacy and data protection measures. Our experience in the US and Europe demonstrates that those providers who have the best privacy plans in place are always those who are the most successful.

A blueprint for privacy

Privacy issues are best dealt with on a strategic, holistic and planned basis rather than piecemeal or in response to crises. By working to a blueprint it is possible to stay ahead of the curve – compliant with present and forthcoming regulations and providing security standards which give confidence to patients, clinicians and commissioning groups.

It is vital that healthcare leaders put plans and processes in place to ensure that information is secure against unauthorised access and modification. Responsibility for data protection needs to be given to specific named staff and all staff have to be trained and competent in privacy issues.

Those providers that see implementing best-in-class privacy measures as crucial will be able to deliver effective and efficient care, attract patients and secure contracts. Those who do not will be dangerously exposed in a healthcare market where reputation means everything and where only the strongest will prosper

Practically, healthcare systems need to be designed and organised with security to fit the nature of the personal data held and the harm that may result from a security breach. Information must be monitored for inappropriate accessing and automated privacy monitoring has to be introduced as it addresses the problem very effectively by providing fast, effective, resource-light and automated comprehensive auditing. In order to be fully effective though, this requires healthcare organisations to insist that vendors supply fully enabled audit logs within their IT systems.

Privacy underpins success

Forward-thinking healthcare providers such as NHS Scotland are already moving ahead at some pace to deploy privacy enhancing technology and procedures. The rest of the NHS needs to follow this lead as it moves towards creating comprehensive electronic records. This can be achieved by drawing on the experiences of providers in healthcare markets such as Scotland, the US and other parts of Europe that have already travelled this path.

Those providers that see implementing best-in-class privacy measures as crucial will be able to deliver effective and efficient care, attract patients and secure contracts. Those who do not will be dangerously exposed in a healthcare market where reputation means everything and where only the strongest will prosper.

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