NHS Technology Strategy

1. NHS Technology Strategy 25th May 2011 Rory Davidson, Technology Office, Department of Health Informatics Directorate

2. Context • Being developed as part of the Informatics Transition Programme based on drivers from the White Paper, Information Revolution Consultation and the Information Strategy. • Will set a direction of travel for informatics that will guide future informatics procurement based on principles of local leadership, open standards and interoperability rather than massive central programmes. Technology must become the enabler and not the obstacle to innovation across health and social care for the NHS and its partners.

3. Scope • The scope of this NHS Technology Strategy covers areas of information technology that support or have the potential to support the delivery of health and wellbeing for citizens and as such is aimed at the whole NHS:  • The strategy will define the key principles and technology areas that are required to support this change - and where necessary make detailed statements about specific technologies; • The strategy aims to create alignment in key technology areas while ensuring competition and choice; • Pragmatism and achievability is critical for each strategic area - therefore in addition to the long term vision, roadmaps will be defined with one, two and four year planning horizon; • The strategy will make statements about the direction of travel for key national services and core infrastructure items.

4. Information Revolution • Patients accessing and controlling their records • Information for patients • Information Governance • Patient feedback and measuring how we are doing • Sharing information across boundaries and the need for standards • Recording information electronically at the point of care • Accessing information to deliver care • Clinical leadership including education and skills

5. Business drivers & principles • Business Drivers • Patient control & access • Better outcomes & quality • Information to support care • Market driven innovation • Efficiency & cost reduction • Transparency & accountability • Local empowerment • Principles • Connect all • Modularity • Open service interfaces • Re-use • Technology lifecycle • Layered Technology Architecture • User centred design & safety • Use of open standards • Green IT Strategic Aims • Foundation • Network infrastructure • Care worker identity management and SSO • Patient identity management • National Services • End User Devices • Enablers • Interoperability • Business intelligence • Cloud, hosting and software as a service • Game changers • Patient access and control • Telehealth & Telecare • Collaboration and mobile working • Open Source, Information and cyber security

6. Technology Outcomes • Provide key enablers for a market for patient facing applications • Service interactions e.g. symptom checking, booking online, advice online, medical results, repeat prescriptions amongst others • Personal Health Records • Telehealth • Facilitate pragmatic & effective interoperability • Lower the bar for entry to new suppliers • Allow current ones to innovate more • Enable ‘connect all’and Any Qualified Provider • Remove boundaries to the flow of information • Free information ‘locked’ into closed systems • Support cross community interactions • Allow the organisation to evolve without system ties • Enable broader use of ubiquitous technologies • Real-time information flow from point of care • Virtual presence to mitigate staff resource shortages • Shorter solution implementation lifecycles But we must maintain focus on the key clinical and patient benefits that these enablers support

7. Equality Under the Equality Act 2010, the Department must have due regard to the impact of its proposals on equality. We would be grateful for your ideas on potential opportunities and issues for the Technology Strategy on equality. • The Equality Duty (Equality Act 2010): • Eliminate discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act; • Advance equality of opportunitybetween those who share a protected characteristic* and those who do not • Foster good relationsbetween people who share a protected characteristic and those who do not • The 9 Protected Characteristics are: age; disability; gender reassignment; pregnancy and maternity; race; religion or belief; sex or sexual orientation. 7

8. Strategy Evaluation Under the HM Treasury guidance “Magenta book” the Departments policies, programmes and projects must be subject to comprehensive but proportionate evaluation of differing options to achieve its objectives. If they are not they cannot be approved for implementation by Ministers. • We would be grateful for your assessment of the market drivers and rate of change over time to establish and ideally quantify: • The Counterfactual - what would happen in the NHS and for patients anyway as a result of market forces if the DH took no additional action? • How successful any ideas discussed would be in: • achieving the objectives from your perspective as a stakeholder. • creating additional value for patients and the NHS to justify all additional costs to the taxpayer. 8

9. Strategic Aim Questionsfor discussion & feedback

10. Network Infrastructure We can already see that the NHS needs to work with and share information with Social Care. In the future, it will need to work with more organisations that are not currently connected to the N3 national network. • Does there need to be wider N3 connectivity to other networks? • How does the market move to more effective network aware development? • Does the group think that there is value in using alternatives to N3, including the Internet as part of the wider NHS network?

11. Identity Management The aim of the strategy is to provide overall direction to the NHS on how best to use existing Identity investments, to manage Digital Identity and ultimately enable the NHS to provide Care Workers with simple, secure and efficient access to the information they need to do their jobs without compromising security or governance controls • How can we build upon the existing National Identity to enable its use in all 850 (or more) individual organisations in all contexts (from the desktop, through to national applications and extended use)? What issues do we need to address? • Would use of the Government single citizen identity (IDA) be seen as a benefit to what is likely to become a more complex and densely populated online world for the NHS – does it make sense to re-use this work in an NHS context? 

12. Common & National Services We are moving from a ‘replace all strategy’ to a ‘connect all strategy’ so we are trying to identify what is common services if any are needed to support that model. • What common or national services are required to support the future NHS? • Do we have any unnecessary services at the centre or are there some important ones missing that would be needed to support connect all? • Is it appropriate to make national services more accessible – e.g. to more types of organisation, a wider variety of applications, a wider group of professionals involved in patient care? If so how should we protect the services and data in this new world?

13. End User Devices As consumerisation becomes more relevant in the NHS, NHS organisations will need to manage this influx of new devices alongside the existing infrastructure. • How can we enable the use of a variety of consumer devices through a clear separation of presentation, application and data concerns? • Is it practical to define an NHS standard application environment for use across all organisations?

14. Interoperability Interoperability is key in a ‘connect all’ strategy, providing the glue that allows data to be shared and systems to work together where appropriate. • How can we provide a framework for the facilitation of interoperability standards, driven by the market, and what would this look like? • Should we enrich ITK to access common/national services? • How can we move to better content abstraction and architectural layering?

15. Cloud – Hosting and Software as a Service The Government ICT Strategy – Smarter, cheaper, greener published in January 2010, described a requirement for the G-Cloud or Government Cloud. The objective is to enable different public sector organisations to share ICT infrastructure allowing disparate hardware to be brought together and used to deliver increased flexibility and responsiveness to prevailing business needs. • What are the situations where infrastructure as a service should be used and are appropriate? • Where would software as service be useful and appropriate for the NHS?

16. Patient access and control The aim of this strategy is to provide an environment, in which access to information, control of records and capability for patients to manage their personal health records can be made available in a safe and confidential way. This should be primarily through market innovation with national support for standards and use of shared tools where required • How do we promote innovation in patient facing applications? • What does patient control of personal health information mean? • What could be done to minimise the risk to implementations who forge the initial paths in to this area?

17. Telehealth & Telecare • Is the level of market and consumer penetration sufficient to meet the timeframe of the developing problem? What are the current barriers to it rolling out further? • However, these have failed to be rolled out, do we know why? How can we prove we are not flogging an already dead horse? How do we allay cynicism?

18. Collaboration & Mobile Working Collaboration and Workforce Mobility are about enabling NHS Care Workers to perform common duties in a seamless manner and enabling innovation through improved cross organisation collaboration and working. A recent mobile health worker project undertaken as part of the Transforming Community Services Programme demonstrated increased efficiency and significant cashable benefits resulting from reduction on admissions and referrals • How can we enable workforce mobility in local organisations? • How can we provide knowledge management tools to capture best practice in informatics across the NHS?

19. AOB & ENDCONTACT DETAILS:Rory Davidson, Technology Office, Dept. of Health Informatics Directoratemail: rory.davidson@nhs.net