The current Westminster penchant for speeches with applause lines but without details has reached DH…
Update: NHS Digital has now published some details – which are utterly underwhelming when compared with the Secretary of State’s hyperbole. “Use the NHS number” and “upgrade from ICD-10 to ICD-11” is not the radical changes Secretary of State appeared to suggest. Although with the promise of registers, we might dust off the amendment we suggested to the Lefroy Bill (which mandated NHS numbers by law) in 2014.
We will update this document when NHS Digital published the document that should have appeared at the same time.
- Data: “We are supportive of … Data Trusts” – does the SofS/DH have so little confidence in the NHS getting data right that he/it is supportive of stripping the NHS of that governance role?
- DH blindspots: “We will know we have achieved our goals when”… does not mention patients other than suggesting they use apps for self-care…
- Privacy: There is no reference to the duty of confidence every clinician is under to their patients (it instead points at the Data Protection Act)
- Google: The obligation on all systems to use FHIR interoperability removes the figleaf behind which DeepMind insisted on data for all patients in the Royal Free for 5 years.
- Google: It also proposes outlawing the monopoly line in Google’s standard contract that forces users of the Streams app to only connect to DeepMind’s servers. It is unclear whether that line will survive the lobbying it is about to receive.
- Amazon: Case study 7 is as true as leaving a note on the fridge, but there are other effects of giving Amazon/Alexa such information. Facebook’s new Portal offers the same functionality, and will explicitly be used to target ads at users.
Below quotes can be attributed to Sam Smith, coordinator of medConfidential, which works to improve uses of data and technology in the NHS.
The NHS knows what good working technology like, but to get there, you can’t just turn A&E off and on again and see if helps.
Mr Hancock says “we are supportive” of stripping the NHS of its role in oversight of commercial exploitation of data. That should be a cause for widespread concern. If Matt thinks the NHS will never get data right, what does he know that the public don’t?
The widely criticised National Programme for IT also started out with similar lofty vision. This is yet another political piece saying what “good looks like”, but none of the success criteria are about patients getting better care from the NHS. For that, better technology has to be delivered on a ward, and in a GP surgery, and the many other places that the NHS and social care touch. Reforming procurement and standards do matter, and will help, but it helps in the same way a good accountant helps – and that’s not by having a vision of better accounting.
There’s not much detail in here. It’s not so much ‘jam tomorrow’, as ‘jam… sometime’ – there’s no timeline, and jam gets pretty rancid after not very long. He says “these are standards”, but they’re just a vision for standards – all the hard work is left to be done.