Recommendation 4

HM Government · verbatim extract Accepted

The first issue relates to information sharing standards, which underpin interoperability between systems. In England, the obligations of data controllers towards each other and users of the care system are covered by a range of statutes and regulations such as the Health and Social Care Act, Data Protection Act, and common law, with statutory bodies such as the Department of Health and Social Care and NHS England (‘NHSE’) charged with setting and enforcing standards. The key challenge is to clarify and improve how these duties are to be discharged and to assure conformance to relevant standards. The Health and Social Care Act imposes duties on care providers to conform to relevant information standards published by NHSE or the Secretary of State. Currently this duty requires providers to give “due regard” to standards. To support improvement in the delivery of standards and interoperability, as committed 11 we have published a draft strategy in Spring 2022 which sets out the work we will do with health and care services to support the development and implementation of a range of standards, final publication is expected in Winter 2023. As noted in our response to the Hewitt review, we have been working to support interoperability in the interim, including by launching the Standards Directory service and publishing an information standards roadmap, which details standards that are required for implementation and planned for the future. The second, and larger, issue highlighted by the Select Committee report was on the variation between NHS organisations in terms of digitisation. In this sense, interoperability can take two forms: interoperability across local systems (e.g., primary, community, acute, social care etc.) and interoperability between institutions using the same class of IT systems. On the former, we are meeting our national targets, and in some instances excelling. Our ambition is for all trusts to meet our core digitisation standards, including for 95% of trusts to have electronic patient records (EPR) by March 2025. 12 EPR coverage nationally is 88% and is expected to increase to 91% by December 2023. We are investing £2 billion in digitising and connecting the frontline for secondary care, which will be matched further by local systems. Where feasible, we’re encouraging systems to explore ICS-wide solutions to support integrated care (convergence). We are providing targeted funding and support to NHS trusts to help them “level up” to a core level of digitisation; trusts that are less digitally mature will get more funding and support than those that are more digitally mature. More than 50% of care providers currently have a digital social care record, up from 40% in December 2021. Last year, we invested almost £50 million to support digitisation, including making more than £35 million available to Integrated Care Systems (ICSs) to support care providers to adopt digital social care records (DSCRs) and other care technologies that help improve the quality and safety of care, or support people to remain independent at home for longer. We will invest a further £100 million over the next two years to ensure people, providers and the wider health and social care system are able to realise the benefits of digitisation. To further address potential variation between ICSs, as part of the What Good Looks Like programme, digital maturity assessments will give health and care organisations a baseline, so they know where they are. This will enable more targeted support for those organisations that need it. Digital maturity assessments will be updated yearly to track progress on their journey to achieving what good looks like. Every Integrated Care Board in England has also been supported to acquire and implement a basic shared care record to address record sharing between general practice, acute care, secondary outpatient care, mental health and social care. In the most mature areas, such as across London, 55,000 professionals access the multi-ICS shared care record 1.3 million times a month. Our priority for the coming year is to establish a national federated network of Shared Care Records so any authorised professional will be able to access the records of patients regardless of where they live in England. In parallel with the development of local shared care records, the long-standing Summary Care Record continues to be available for those who do not currently have access to their local shared care record – e.g., community pharmacists and some paramedic services. Around 90% of the registered practice population in England (58 million) have a summary care records with additional information. In terms of interoperability between institutions using the same class of IT systems, we are also encouraging systems to explore ICS-wide solutions to support integrated care. As part of our Frontline Digitisation support offer, we are working to build an England-wide community to share lessons learnt, improvement