eHealth Exchange

20th Nov 2002

Personal review by Rod Ward

The official web site for this conference including slides from the presentations is available at: http://www.partnershipsinhealthcare.co.uk

Reception This event was organised by Enterprise Events "Partnerships in Healthcare" and was intended as avenue for interested parties to meet and discuss current issues rather than a traditional conference. Delegates had registered before the event and selected the sessions, discussion groups and individual meetings they wished to attend, which had been then been prepared for them into a personal agenda, which was available in advance on-line and was included in the delegate pack from the reception desk. This process seemed to work well. The venue at the Queen Elizabeth II Conference Centre, London was easy to get to and provided continuous coffee :-)
Individual meetings and discussion groups, of around 8 people, were organised onto numbered tables, which the correct supporting papers made available by the staff. Some groups leaders seemed much more comfortable with running small group discussions than others. The better ones acting as facilitators encouraging people to introduce themselves and encouraging everyone to have their say. Others either wanted to give an exposition on their pet topic, or just repeated their original questions when the group "strayed" into other areas - which were sometimes more interesting than the original question. tables
ECDL The first discussion group I attended was led by George Davies, National project Manager (ECDL), NHS Information Authority who led a discussion about Basic IT skills in the NHS - Using the ECDL

The table included elearning suppliers and project leaders & IT trainers from NHS trusts. George briefly set out the history, current situation and future developments in this area with some figures for uptake so far (8000 studying & 3500 completed), and data from a small scale evaluation which showed a saving of 38 mins per person per day after completing ECDL. He gave several examples of how this project differed from other NHS/DoH projects saying "this is an investment in people rather than things". Discussion centered around ways of motivating staff and encouraging them, costs and benefits of elearning for this (being delivered by Spring IT training) and how to work with the approx. 25% of NHS staff with absolutely 0 IT skills. George also mentioned the forthcoming voucher scheme available to all NHS staff so that neither individual staff or trusts would have to pay for the on-line materials - although attendance at a test centre to complete the assessments would still be required.

For more on the ECDL in the NHS see:
http://www.nhsia.nhs.uk/wowwi/pages/programmes/ecdl/
http://www.ecdl.co.uk/nhs/
http://www.ecdl.com/
& for the training materials: http://www.course-source.net/sites/nhs/

I then had an individual meeting with a project manager from Surrey Ambulance Service who is currently undertaking her MSc in Health Informatics at the University of Sheffield we discussed ways in which her course could be related to her practice area and the potential of ICT systems in that area of practice. She also helped me in looking at the information and educational needs of ambulance staff. We overran our allotted meeting time and agreed to continue the discussion by email.

The next group discussion I attended was led by Peter Jones Team Leader, Community Mental Health Services for Older People, Chorley, Lancs and addressed "Finding an Information Space for the Multidisciplinary Team!".

His opening remarks set out Hodges' Health Career Model, which led to discussions about the evidence base and the importance of the single assessment process (SAP) & Care Programme Approach (CPA) , and the differing views of patient data required at different times by different professionals with varied roles. An example was given of a project to enable A&E staff to check children on the "At Risk Register" in a safe manner & with up to date information.

Worries were expressed about the profusion of data sets and care episodes.

Further information about Hodges Health Career Model is available from Peter's web site at:
http://www.p-jones.demon.co.uk/
Peter Jones
The 3rd group session I attended considered Development and Change of existing staff skills across boundaries, which was led by Jan Harry, Director of Nursing & Quality Assurance, Mid Staffordshire General Hospitals NHS Trust.

Jan highlighted changes in the need for skills amongst the NHS workforce and changes in professional boundaries involved in workforce planning and capacity planning. The discussion touched on the roles of Workforce Development Confederations and the relationship between their work and care pathways.

Many of Jans issues relate to the DoH Agenda for Change on which there are likely to be some major announcements over the next couple of weeks see: http://www.guardian.co.uk/guardianpolitics/story/0,3605,844196,00.html

This session developed into an interesting lunchtime discussion with Laurence Harrison, Healthcare Programme Manager, Intellect.who introduced me to Prof Terry Young, Chair in Healthcare Systems, Dept of Information Systems and Computing, Brunel University.

Sandy Bradbrook My next session was a more formal "conference type" presentation by Sandy Bradbrook, Chief Exec Birmingham Children's Hospital in the Confidentiality and Consent section, on the new consent forms and procedures which have been introduced to the NHS. He gave a trust eye view on the introduction process and lack of financial support, despite initial evidence showing it takes 6 to 16 minutes longer to complete per patient and potential conflicts with coordinated care. He did emphasise the improvements for patients and relatives of the improvements in the process of gaining consent for procedures and the importance of this in the light of legal changes including the Human Rights Act 1998. he stressed the importance of risk management in this context and concluded that "the protection of patients comes at a cost".
The next speaker was Phil Walker, Head of Information Governance at the DoH Information Policy Unit, and also working with the NHSIA. He considered various aspects of Consent relating to patient information and in particular Gaining patient consent to disclosure . He discussed a balance between society (scientific) benefits of information sharing and individual rights and autonomy. He stressed a principle of patient choice, but highlighted the potential difficulties when this is exercised. Recent consultation has led/is leading to a code of practice for staff, improving communications about these issues with the public and guidance on implementation including temporary support for the changes introduced in Section 60 of the Health and Social Care Act 2001. He promised "Big Things" on information governance coming soon. Phil Walker
Panel
The final event was a panel discussion with Alistair Liddell, Peter Drury, Nick Manson - chaired by Richard Gibbs.

A series of questions relating to Informatics developments in the NHS had been answered by delegates on-line before the events and the panel were asked to make a few comments on these and then respond to questions and comments from the floor.

Nick commented on the tension between the "push" of national projects against the "pull" of service developments. He speculated that political pressure will deliver the IT programme via pus but that there is a need to develop the pull by enhancing the benefits from IT systems.

Peter suggested that local delivery plans need to ensure integration into everyday practice, particularly in relation to the Integrated Care Records System (ICRS) building on work from EPR, EHR & ERDIP. He also discussed the issues surrounding short termism (from trust chief execs) against the longer term investment needed for IT systems and the potential disconnection of NSFs from the IT agenda.

Alistair focused on the need for leadership in NHS IT developments and the need to shorten timescales before developments happen (possibly by breaking them into bitesize chunks and being prepared to take risks & be opportunistic). He also announced that the NHSU development plan and consultation would be unveiled tomorrow see: http://www.nhsu.nhs.uk

The final discussion again touched on the balance between big central initiative and local projects and included suggestions for all nurses to be given lap top for use at home, and ring fencing of IT money.
Final reminders of the importance of this topic to NHS Plan, NHS Modernisation were given with exhortations for all Strategic Health Authorities to achieve full ICRS functionality by the target date of 2008 and the coherence with the whole NHS agenda.

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last Updated: 25.4.03