Lord Darzi’s Independent Investigation of the National Health Service in England generated plenty of headlines ahead of the Budget and the launch of a consultation on next year’s 10 Year Health Plan.

The eminent surgeon and former Labour health minister concluded that the NHS “is in serious trouble”; although he also argued the service has “strong vital signs” and can recover with the right “repair.” One area for “repair” that should have received more attention than it has is the payment mechanisms the NHS uses.

Lord Darzi points out that “over the past decade there has been a significant shift away from activity-based mechanisms,” such as Payment by Results, in favour of block contracting. His report suggests this may have hit productivity.

“With block contracts, providers are funded for their efforts rather than their outputs,” he writes. “It is perhaps not a coincidence that the drop in clinical productivity metrics for the urgent and emergency pathway is nearly double that for outpatients and elective surgery, since it remains on block contracts” (while non-elective care hasn’t).

Aligning policy and financial flows and incentives

Lord Darzi is not the only NHS leader interested in financial flows and incentives. Responses to the October Budget and the launch of a consultation on the 10 Year Health Plan that is expected in January also focused on the need to align reforms with financial flows and incentives.

While health and social care secretary Wes Streeting seems to be aware of the issues. In post-Budget comments, he told the BBC: “We have got to improve productivity – and ask some hard questions about where money goes in the system.”

And in an earlier article for the Health Service Journal, he mused that: “Some would like a return to more activity-based ‘payment by results’ tariff, and the idea of extending this to preventative care interventions has been floated.”

Accurate coded data

Before we consider what changes the policy makers tasked with responding to the investigation might consider, it’s worth noting that any payment mechanism requires good data. In healthcare, that means accurately coded data.

Prior to COVID-19, acute trust drivers for accurate clinical coding were to ensure their activity, income, and performance indicators – such as mortality rates – were correctly reported. In particular, these relied on the accurate recording and coding of patients’ chronic conditions and comorbidities.

During the pandemic, when more money went into the service and more of it was distributed through block contracts, there was less focus on the link between coding and income. However, this has become important once again with the reintroduction of activity-based payments to incentivise hospitals to reduce waiting lists.

What many trusts have found is that the depth and accuracy of their coding has declined. Indeed, some are finding their data suggests the complexity case mix of their patients is less now than they were before Covid-19 – which is very unlikely to be the case.

Reasons for concern over the depth and accuracy of coded data

The accuracy and depth of coding may have declined for a number of reasons. During the pandemic, clinical coders shifted to working from home and many have never returned to the office – if they still have an office and their trust has not repurposed it as clinical space.

Working from home isn’t a problem in itself, but clinical coders may not have access to all the systems they would have on site. Instead of working from a full set of notes, for example, they may be working from a discharge summary – and there are well-known issues with the timeliness and completeness of discharge summaries across the NHS.

There has also been a change in electronic patient record systems. The Frontline Digitisation programme is moving trusts from paper and first-generation systems to full EPRs. This should deliver benefits to clinical care and flow, but it can take trust teams time to adjust and find the data they need.

It’s important that trusts pinpoint and address these issues, so they can make sure they have the accurately coded data they need to hold effective negotiations with commissioners for work that is still covered by block contracts or to secure the income to which they are entitled under the reintroduction of payment for activity.

Incentives and drivers for change

There is also that bigger picture on re-introducing direct incentives to deliver more work and support reform. Although, in the short term, changes are likely to be limited. The reintroduction of activity-based payments for emergency and unplanned work would be a significant change that would need careful planning.

It’s more likely that policy makers will look at the introduction of new incentives, perhaps rewarding trusts for carrying out specific checks, tests or procedures, on something like the model of the quality and outcomes framework in GP surgeries.

There could also be more experimentation with payment for pathways. This is already being used to a limited degree. For example, there is a maternity pathway for which trusts are paid for antenatal care, the delivery, and post-partum care.

This could be extended to other areas, although it’s complex because it requires alignment across the NHS, from primary to secondary and sometimes tertiary or specialist services. From a data perspective, that’s challenging, because it requires accurately coded data at each point, with the ability to link activity across different services.

Paying for integrated, preventative care?

The really big, long-term idea could be for local healthcare economies to receive a capitated budget to deliver wellness and health services for their entire population. This was one direction that sustainability and transformation partnerships could have taken when they were introduced a decade ago.

In principle, it would provide incentives for integrated care systems to shift the focus of their attention away from performance managing trusts and towards joining up services and focusing on prevention, to avoid expensive hospital trips and interventions whenever possible.

However, it would be difficult to set up. As things stand, there are real questions about whether the system has the necessary data to profile populations and target interventions appropriately. When these questions come up, there tends to be a lot of focus on how IT systems can be integrated to generate the data required.

There’s less focus on making sure that the data in those IT systems is of good quality. Yet accurate coding would be key to such a fundamental shift in the way that healthcare is organised and paid for, and it would require investment.

Accurately coded data matters today, for productivity, and the future

Meanwhile, trusts need accurately coded data for all sorts of reasons. Accurately coded data allows them to monitor quality and mortality. It allows them to hold more effective negotiations with their commissioners.

It also allows them to claim the income to which they are entitled under activity-based payments, incentive schemes, or integrated pathways. Judging by the Darzi review and other, recent, policy discussions, more areas of activity are likely to be covered by these in the future, so accurately coded data will become even more important.

If some of the big picture shifts on incentives and financial flows are enacted, it will be essential for everybody in the system to know who is being treated and for what. Accurate coding will be key to getting that right.

Maxwell Stanley’s part

Maxwell Stanley is the leading clinical coding specialist in the NHS. Our solution undertakes a targeted and automated identification of individual admissions with potential coding errors and missed comorbidities that impact on performance metrics and income.

If the NHS does indeed return to a more activity-based payment model, Maxwell Stanley can help trusts to assess the accuracy of their coded data, ensure it’s correct and give them confidence in that data going forward, ensuring accurate income for the complexity of activity undertaken.

The post Change to NHS Payment Mechanisms: Accurately Coded Data will be Needed to Deliver Them appeared first on .

The focus of this was moving away from episodic care to a more holistic approach to healthcare and support needs, one that considers the entire individual, including their emotional, social, and psychological well-being in addition to their physical health.

Ten years later, there are now 42 Integrated Care Boards (ICBs) in operation across the country. Yet we are still to see a truly connected process for staff on the ground, and for patients receiving treatment.

Primary care, Secondary Care and Social care all have a distinct role in the patient pathway when they are living with a serious long-term condition. These services should be interdependent and work in harmony to provide seamless and effective care.

However, the current model is still characterised by fragmented and siloed operations. With some ICBs serving populations of more than three million, gaps in these areas can have far-reaching consequences including miscommunication, and shortfalls in patient management and care.

The introduction of the ICBs structure provides the right foundations for integration, but to achieve truly integrated holistic healthcare, tailored to the unique needs of each patient, there is still a need to apply innovation to create a completely joined-up approach.

Technological Enablers of Holistic Healthcare

Technology is a critical enabler of integration, it connects health and social care providers, improves interoperability and data sharing supports care coordination, and connects tools that can empower patients. As Lord Darzi’s independent investigation into the organisation claimed, the NHS is ‘in the foothills of digital transformation.’ He called for a ‘major tilt towards technology to unlock productivity.

With the Prime Minister pledging to put this into practice, we are likely to see conversations around NHS innovation shift to areas that assist the integration model and preventative care.

The Continuing Healthcare Process (CHC) is just one spoke on the wheel of holistic integration, but it is a clear example of where there is potential for improvement through digital integration. The CHC process is designed to offer those eligible with funding and support for ongoing care, but the traditional decision-making process can be slow, admin heavy and confusing for patients and their families. This can add additional stress and frustration for them at an already challenging time.

Platforms are available that can streamline the complex processes involved in CHC, ensuring that healthcare professionals and patients, have real-time access to essential information. By digitising workflows and integrating them with existing health and social care systems, we will see enhanced efficiency, reduced administrative burdens, and timely, accurate decision-making. This enables improved patient outcomes and a more seamless, co-ordinated approach to managing long-term care needs.

Social Prescribing is another holistic approach to care that complements the integration of health services. It involves referring patients to non-clinical services to address their social, emotional, and practical needs. This could be anything from community groups, connecting patients to financial management support, and exercise memberships.

Both examples demonstrate the value of holistic care supporting the benefits of integration. For example, if a GP or a specialist within a hospital recommends social prescribing services, the symptoms of their condition could be reduced, meaning they are less likely to need to revisit urgent care in the future.

Digital solutions or platforms play a significant role here too; by enabling healthcare professionals to see a patient’s history across all their health service touchpoints and link them to the right service for their needs more easily.

A Collaborative Culture

Achieving integration requires more than just technological solutions; it necessitates a cultural shift towards collaborative care. Healthcare professionals across primary, secondary, and social care must embrace a team-based approach, recognising the value each sector brings to patient care.

Ongoing training and development are essential to equip healthcare providers with the skills needed to work in an integrated system. While different systems can work collaboratively in a practical sense, it will take time for a collective shift in mentality away from more traditional siloed ways of working.

While there are digital platforms on the market that allow information sharing between the NHS and social care providers and enable patients to be directed towards holistic care that meets both their medical and social needs – the existence of such platforms won’t work without a team embracing change and with an embedded collaborative culture.

Decision-makers and those in senior leadership must play an active role in the development of such a culture. That involves developing a collaborative vision, with clear steps to take it forward and excellent communication of the benefits to patients. From there a new mindset will take shape.

Meeting the needs of the population

The population in the UK is growing year on year, with demographic shifts and ever-changing needs. Integrating health services across primary, secondary, and social care is pivotal for sustaining our healthcare service.

Integrated and holistic healthcare really lies in the hands of care providers delivering the initiatives that support every patient in every stage of their care journey and sharing the right information with the right people across the organisation. But, without technology to facilitate smoother admin operations and promote easier collaboration between all care settings, these initiatives could fail to get off the ground, or patients in desperate need of the services could slip between the cracks.

The journey towards integration is challenging, but it is indispensable to herald in a new era of holistic and integrated healthcare.

By Rob De Felice, Business Development Director at IEG4

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While we can’t expect these recommendations or investment commitments to act as a silver bullet to tackling the immense pressures on service providers, it does present a significant opportunity to make inroads in the vision for a more digitally enabled neighbourhood health service. But only if the critical role of data is recognised in these plans from the outset and throughout.

Untapped data

Access to NHS data is largely untapped and underutilised currently. There are initiatives such as NHS England’s Frontline (EPR) Digitisation programme and the Federated Data Platform that are changing this – by creating the right infrastructure for safe and effective data sharing. In turn enabling commissioners and providers to surface it for clinical, operational, financial and research purposes in safe and secure environments.

However, there are some critical milestones during these digital transformation projects that aren’t always considered – or considered too late in the process – and can lead to delays and additional costs. And subsequently impede the pace and scale at which the NHS can achieve Wes Streeting’s big shift from analogue to digital.

For example, a trust’s EPR deployment involves assessing, migrating, integrating and archiving millions of patient records, which are often sitting in disparate and siloed legacy systems. Not reviewing and agreeing how to tackle these issues at the beginning of the project can lead to lost data, poor quality migration, costly setbacks to EPR plans, and delays to a trust’s operational reporting, such as Referral to Treatment (RTT). It can also create the need to call in tiger teams at short notice, which can lead to additional and unplanned costs.

Therefore, the data roadmap needs to be baked in from the outset – rather than treated as a consideration part-way through.

Taking this more strategic, long-term approach also prompts IT and delivery teams to consider how data management can underpin the trust’s wider operational plans, such as service continuity during a cyber security attack. For example, there are ways for clinicians to read archived patient notes even during an outage that affects the EPR. However, the right data architecture needs to be configured before go-live for this type of preparedness to be effective.

Regional opportunities

The move to EPR convergence amongst neighbouring trusts – and at an ICS level – presents an even bigger opportunity for data, as it introduces discussions amongst stakeholders about how to tackle the information silos across a locality, not just within a trust.

London North West Hospitals (LNWH) and The Hillingdon Hospitals (THH) recently achieved this, by collaborating on their EPR to create the largest single instance of Oracle Health in the UK, covering 12 facilities across the Integrated Care System (ICS) and 7 million patient records. Stalis partnered with them to migrate the records from legacy systems and merge the Master Patient Index registrations into a single, shared domain. Having the data readily available for clinicians and operational teams across four trusts has paved the way for more joined-up patient care and streamlined services across the ICS.

This type of digital transformation also means innovations like AI can deliver their true potential at scale. As it ensures good quality clinical data is accessible for predictive analytic tools to validate waiting lists and predict and prevent diseases.

We’re already seeing examples of this at a local level, such as Somerset where the trust is using a case-finding search engine developed by Stalis (in partnership with Predictive Health Intelligence) to help clinicians identify people who might be at risk of developing liver disease. Typically, the symptoms present late, but by using this predictive tool staff can use data already present in clinical systems – such as blood results – to identify those at risk.

Now is the time to give ICSs the tools and support to really expand these pockets of success. However, to realistically do this in the short-term and within the perimeters set by government, we need to think differently about data.

End-to-end data management provision 

In a similar vein to EPR convergence, commissioners and providers should be considering end-to-end data management across a locality. This type of arrangement would cover everything from strategic reviews and readiness assessments, architecture, migration, integration, archiving, population health management and risk stratification (for example, using AI).

It will make the roadmap to integrating operational and clinical data across trusts and ICSs – and feeding validated information into the FDP – easier and quicker. Plus, it will ensure the right infrastructure and data flows are in place to shift from the typical ‘diagnose and treat’ to the desired ‘predict and prevent’ approach to healthcare.

It will also help the NHS achieve economies of scale and mitigate the need for multiple contracts for individual data projects at a local and regional level.

With so much happening in recent weeks, it feels as if we’re at an important crossroads. And we have a tangible opportunity to use the new financial commitments and reforms to take a new approach to data management. One that meets government’s ambitious (but necessary) goals for the NHS, its staff and patients.

By Kate Bryan, Managing Director, Stalis (part of the Egress Group)

The post Why End-to-end Data Management is Key to Government’s Ambitious Plans for the NHS appeared first on .

Clinical professionals and end users were deeply involved in this complex undertaking, from the moment a decision was made to deliver a new emergency department electronic patient record. A comprehensive team managed the procurement, core design and implementation of Miya Emergency across three emergency departments.

This approach enabled rapid and effective progress – and within 10 months of contract commencement, teams redesigned complex clinical workflows, integrated key systems, engaged a full range of stakeholders, and prepared staff in and beyond emergency departments, before a successful simultaneous go-live on a single day.

Delivered on time and within budget, the new system now supports end-to-end patient workflow. It allows teams to capture data for patients coming into the trust’s emergency department, streamlining processes as they are treated, and ensuring seamless data continuity as they move forward in their care – as inpatient admissions, or during discharge back to community.

Paper processes are progressively being removed as Miya Emergency is integrated with other trust digital systems. Automation of once manually intensive tasks, such as data collection for the Emergency Care Data Set, is saving time, and efficiencies are being created as the system generates clinical assessments, forms, referrals, and task creation.

Led by a multi-disciplinary clinical and operational team representing various functions in the trust, implementation successfully took place during the summer at emergency departments in Andover War Memorial Hospital, Basingstoke and North Hampshire Hospital, and Royal Hampshire County Hospital.

Dr Tamara Everington, former chief clinical information officer for Hampshire Hospitals NHS Foundation Trust and now chief medical officer at Queen Victoria Hospital, Sussex, said: “Clinical and operational staff see enormous potential in Miya Emergency to help them work in more modern ways, in support of better outcomes and efficiency. The system works extremely well, providing cross-trust visibility of what is going on in our emergency departments.

“A broad range of people in and around emergency departments – doctors, nurses, pharmacists, operational specialists, and administrative teams, have worked hard together to ensure a successful implementation on time.

“We have had an extremely positive relationship with Alcidion – including engagement from the chief executive, and close communications at every stage with senior clinicians and technical people, allowing us to respond to challenges and design a solution collaboratively.

“This is a very important part of our organisation’s paper-free journey, and work here will also inform progress towards a shared main electronic patient record for all the acute hospital Trusts within our integrated care system.”

Implementation to-date has seen the deployment of a core system, which has been integrated into the trust’s current electronic patient record, and which is already able to communicate important discharge information to GP practices. Additional integrations, including the ability to send patients’ documents into the NHS App, will take place in the new year.

In addition to informing the future regional EPR strategy, the project is also expected to lend lessons to at least one other neighbouring trust that is expected to go-live with Miya Emergency next year.

Dr Paul Deffley, chief medical officer for Alcidion, said: “The complexity of reimagining workflow across not only three busy emergency departments – but across upstream and downstream services within and beyond hospitals walls – cannot be understated. Nevertheless, the team at Hampshire Hospitals has done this in an impressive and collaborative way. Every deployment is different, and we are pleased to have been able to be so closely involved and present onsite to understand and respond to local needs. We also look forward to sharing lessons with other emergency departments and other EPR implementations across the country, at a time when digitisation has once again been thrown into sharp focus.”

Hampshire Hospitals’ operations director (Medical Division) Zena Ludick, said: “Transitioning to MIYA while maintaining extremely busy emergency departments was no small challenge; this change impacted all members of our ED staff and also required departments throughout the trust to prepare and respond. As well as considerable planning ahead of the transition date, a full contingency response team met regularly throughout the switch to MIYA and this was supported by Alcidion.”

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While the new money has been welcomed, they want to see the detail of how it will be distributed and a strategic focus on enhancing infrastructure and digital capabilities to improve productivity and outcomes. Read more from Highland Marketing’s market leading clients.

Jeremy Nettle, chair of the Highland Marketing advisory board

“The big question for this Budget was whether the Chancellor would stop the bleeding in NHS and social health care or whether she would apply a sticking plaster. It turns out the answer is a bit of both.

“Rachel Reeves announced a headline £22.6 billion for day-to-day spending over the next two years, which is very welcome. But some of that money will be consumed by existing deficits and the increase in employer’s National Insurance costs, unless the health service can deliver the 2% productivity, efficiency and savings target that all departments have been asked to hit.

“The government is also investing around £1.5 billion in beds, surgical hubs, modern scanners and AI to increase capacity and tackle waiting lists. Again, this is welcome. But we don’t know how the money will be allocated between beds, the development of polyclinics, and med tech.

“Overall, this was an interesting stab at addressing NHS and social care challenges. My concern is that the NI changes will have unpredictable effects and there is too little ring-fenced investment in the IT infrastructure that many organisations desperately need, both to deliver holistic patient care and to drive the productivity and efficiency savings the government expects.

“Away from the Budget, there was some positive news in the form of new legislation to try and kick-start the sharing of patient data within health and social care. I have always maintained that is more dangerous for patient records not to be shared than to be shared, so let’s hope this encourages that mindset!”

Jonathan Hinchliffe, delivery director, St. Vincent’s Consulting

“The Autumn Budget’s commitment to NHS technology and digital infrastructure is a positive step in the right direction. With over £2 billion earmarked for NHS tech, this funding has the potential to make a real difference in both patient care and the everyday experience for healthcare staff.

“Expanding the NHS App, implementing Electronic Patient Records across all trusts, and strengthening cybersecurity aren’t just upgrades—they’re essential for creating a more connected, resilient, and efficient healthcare system.

“The 2% productivity improvement target through digital initiatives is also encouraging. By streamlining admin processes and reducing the pressures on NHS staff, it paves the way for healthcare teams to focus more on what matters most: caring for patients. We’re looking forward for further detail from the secretary of state in the coming weeks!”

Assad Tabet, senior vice president healthcare and life sciences, UK&I and Europe, Mastek

“For me, the biggest surprise is that the government plans to raise taxes by £40 billion and to put more than half of that into the NHS.

“Chancellor Rachel Reeves is hoping that if she ‘fixes the foundations’ the NHS will deliver more capacity and improved productivity to get waiting times down and access up. But to achieve that, the service will need to invest in technology and invest in the right way.

“There will continue to be money for the big, national programmes to deliver electronic patient records, the Federated Data Platform, and the New Hospitals Programme. And, hopefully, we will start to see benefits from that over the course of this Parliament.

“However, what I hear from policy makers and IT leaders is that we need investment in basic connectivity and infrastructure, both to improve efficiency and to consume modern technologies such as generative AI. We also need to invest in less invested areas.

“Previous attempts to shift from analogue to digital have focused on big hospitals. We need to focus on other sectors, including social care, if we are also going to deliver the shift the government wants from hospital to community and treatment to prevention.”

Jane Rendall, UK and Ireland managing director for Sectra

“The budget’s focus on NHS diagnostic technology is extremely important. The government has rightly singled out an investment priority to level up NHS scanning capability and capacity.

“In practice, this resource deployment must happen closer to the people who need it the most. Providing diagnostic capability in places convenient to patients: in their communities, by their communities, and in ways that the hardest to reach citizens trust, will help more people engage with diagnostics and screening.

“More scanning capacity is only part of the answer. We need to leverage every piece of technology out there, for everyone, not just a chosen few. This doesn’t only mean multi-million pound modalities, but simple wearables in the home that feed the diagnostic picture.

“And we need flexible, ongoing investment to harness emerging technologies – such as AI that not only supports a diagnosis today, but that can predict 20 years into the future. Even now, new AI is emerging to support early detection of osteoporosis, that might prevent someone presenting to A&E years down the line with a hip fracture, and suffering the consequences of immobility, morbidity or mortality.

“Combined with advances in genomics, we can build on momentum to break down diagnostic boundaries, using technology to change what integrated diagnostics looks like, in ways that abandon blunt tools and generic treatment journeys, in favour of getting patients on the right pathway sooner – better for patients and for the NHS.

Jamie Whysall, principal, head of health, Netcompany

“This was an eagerly anticipated Budget, but the Chancellor’s speech was lacking in detail when it comes to health. There were some big headlines, but we will have to wait a few days to find out how much of the ‘£22.6 billion for the NHS’ will go on National Insurance and existing commitments, and how much will be new money.

“The decision to announce £3.5 billion of capital spending is welcome, because the NHS has been starved of capital for facilities and technology. Again, though, we will have to wait for detail on how it will be spent.

“The government’s decision to highlight investment in new scanners makes political sense, but what we need is a fundamental shift towards investing in technology to drive transformation. That means good digitalisation as opposed to digitisation of the existing systems and a focus on reducing the burden on the frontline and join up services for patients.

“It also means linking investment to these outcomes. I think the government will get ‘more bang for its buck’ if it focuses the resources that are available on a few trusts on an ‘invest to save’ basis and then rolls out the best ideas. Show the shift from analogue to digital can support the shift from hospital to community and treatment to prevention, and then make sure it is adopted at scale.”

Dr Mark Ratnarajah, practising NHS paediatrician and UK managing director for C2-Ai

“The budget won’t fix the NHS alone, say ministers. So, what will? It’s not just about 40,000 more weekly appointments, what’s really needed is reformed ways of working, according to health and social care secretary Wes Streeting. He’s right.

“Fuelled by new insights from technology, some of the most impactful novel ways of working already exist in the NHS today. But they remain sub-scale. We have seen groundbreaking ways of managing waiting lists and acting for those most at risk: with compelling impact on A&E attendance, patient outcomes, reduced harm, complications, and waiting lists themselves.

“Insights generated could underpin decisions on how to design and deploy new surgical hubs for example, based on new understandings of the risks and dynamic clinical needs of individuals at-scale across local populations.

“Such ways of working could deliver widespread impact across the country. But what needs to happen to achieve that? Do we now need accountability for inaction, as much as action, around adoption? Do we dare ask such questions?

“Today’s promise of additional money isn’t a golden ticket. But this budget could be an important date that brings with it opportunities for the health sector: to properly examine what needs to be done nationally and locally, and to be brave enough to stop activities that add little value to allow for innovative practices that increase productivity and patient benefit.

“We need more than a focus on innovation and the latest pilot, to scaling what the NHS knows works, so that we can fix problems right now, rather than waiting the course of one or more parliaments to make this happen.”

Dean Moody, healthcare services director at patient entertainment provider Airwave Healthcare

“The budget announcements on funding for the NHS are to be welcomed, but we need to see the detail of how and where this is to be spent, to ensure it’s going to be spent wisely and that it helps tackle some of the huge inefficiencies within the health service.

“There’s a constant national focus on the NHS, reflecting patient demand, frustration and expectation. Now with the Budget announcements, and in the wake of the Darzi review, it feels we have a momentum to make proper progress on new ways of delivering patient care supported by new technology and AI.

“There needs to be priority on developing approaches to care delivery though that resolve inefficiencies such as the lack of personalised medicine, and then evaluating which is the technology to best support that.

“Capital investment that helps repair and overhaul our health infrastructure is also to be welcomed, and brings hope for wider future development of our health environments where patients have easy access to technology that better supports, informs and educates them about their care.”

Allan Elborn, managing director, Fujifilm Healthcare UK

“It is reassuring to hear that the Government understands the need for additional NHS funding at this critical point, with the announcement of an additional £22.6bn funding for the day-to-day health budget.

“While this additional funding is of course welcomed, with the current challenges faced by the NHS as identified in Lord Darzi’s report, we must simultaneously keep focus on identifying funding efficiencies, improving education, harnessing innovative technologies, and supporting the workload of clinicians delivering care throughout the NHS.

“For instance, AI-enabled scanners remain a hot topic but, ultimately, the functionality of these machines needs to ensure a better experience for patients and clinicians. Funding should also consider further innovative solutions available to enable the NHS to achieve their aim of community first.

“Fujifilm is seeing impressive results from a trial in South West England that takes scans into people’s homes, so they don’t need transport to hospital nor to be admitted unnecessarily; reducing waiting times in A&E and freeing up ambulances for emergency calls.

“We look forward to working closely with the Government to support an NHS that is fit for the future, through the 10-Year Plan and beyond.”

Dani Langson, European commercial director, Probo Medical

“At Probo Medical, we are encouraged by the UK government’s commitment to invest £1.57 billion in the Budget for health diagnostic systems. This strategic allocation of increased budget is a significant step forward to strengthening the foundations of the NHS.

“We believe the enhanced funding will enable investment into more high-quality imaging systems, resulting in an increase in appointments and procedures. Most importantly, the investment will facilitate faster and more accurate diagnoses, improving patient care and addressing the rising demand that hospitals face daily.”

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Just last month, a cyberattack that impacted several London hospitals including King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust resulted in over 1,000 planned operations and 3,000 outpatient appointments being postponed. According to the founder of the UK’s National Cyber Security Centre (NCSC), this might not be an anomaly, thanks to the NHS’s outdated IT systems and lack of basic security practices.

Just like the infamous 2017 WannaCry attack, the incident serves as a reminder of the importance of data protection for healthcare organisations. With budget concerns and talent shortages rife throughout the sector, it’s easy to see why implementing robust cybersecurity strategies can slip down the priority list, however in today’s digital landscape, it is a necessity.

A costly business

Research released last year revealed that three in four (76%) healthcare organisations around the world have experienced a successful ransomware attack and two thirds (65%) have experienced data loss from other types of attack. almost half (43%) of those organisations consider data security as their primary risk. This comes ahead of economic uncertainty (39%) and the adoption of emerging technologies like AI (32%).

A cyberattack has the potential to destroy any business. When it comes to the healthcare industry, especially the UK’s National Health Service (NHS) which services a large portion of the population, an attack feels more personal. Its impact is widespread and unavoidable. At a base level, cyberattacks can disrupt medical services and cripple hospital operations. This is because, when systems are down, essential patient information is inaccessible. This can delay medical procedures and compromise patient care. It can also increase the risk of medical errors and negatively impact treatment outcomes.

Beyond this, cyberattacks also frequently result in hefty financial costs. Sometimes this is in the form of immediate ransomware payments, however, any prolonged downtime and recovery following an attack could also have an impact. In the healthcare space, it can be even more tempting to pay off the attackers, due to the sensitivity of the information they manage to get hold of.

Another implication which isn’t always considered is the impact a cyberattack will have in terms of patient trust. A cyberattack in which malicious actors manage to access sensitive data can lead to a loss of confidence in an organisation’s data safeguarding abilities and can seriously damage its long-term reputation.

Safeguarding the health industry against the inevitable

In today’s digital age, the question is not if a healthcare organisation will face a cyberattack, but when. With that in mind, those in the health sector must be ready to mitigate the effects and recover quickly. Here are some ways in which health organisations can improve their safeguarding and protect data from attackers:

• Implement a data backup and recovery plan designed for the safeguarding of essential health data and ensure business continuity. Backup processes should capture all critical data and be executed at regular intervals. Coupled with a swift recovery process, data backup and recovery help minimise downtime and ensure business continuity when data is lost due to malicious activities.
• Invest in cyber awareness training. Develop and implement an ongoing cyber awareness programme to educate the entire organisation on the latest cyber threats and the policies to avoid them. The programme should be continually updated to reflect emerging threats and remain a critical line of defense in identifying and thwarting potential cybercrimes.
• Deploying advanced security technologies like firewalls, anti-malware tools, and intrusion detection systems that use AI and machine learning for predictive threat analysis and response.
• Regularly stress test and break systems to identify where the weak points are. Often organisations – especially within the public sector – implement security strategies and then wait until an incident occurs to see whether their framework is effective. With the regularity of attacks in the current landscape, this cannot adequately anticipate the scale at which breaches are attempted.

The ability to deliver effective healthcare services relies on data. It is what enables nurses and doctors to diagnose their patients, it is what ensures that patients are not given medication that they are allergic to, and it is what helps us as a society to develop life-saving treatments and innovations. Unfortunately, attackers know this, and they are not above using it to their advantage.

Whilst facing cyberattacks is inevitable for healthcare organisations, losing data doesn’t have to be. Data protection strategies and cybersecurity tools can enhance defense mechanisms and improve the healthcare industry’s ability to respond promptly to emerging threats.

By Oliver Norman, Regional Vice President for UK & Ireland at Veritas Technologies

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Wes Streeting wanted ‘no stone left unturned’ when he asked Lord Darzi to examine the current state of the NHS in England. Laudable to be sure – but we need to keep doing this at every level, and dig deeper without burdening busy teams. Here’s why.

Lord Darzi’s independent investigation, delivered in just nine weeks, shed light on the big issues – from access to services, to inequity of investment in the community, longer waits for treatment, cancer performance, and A&E waiting times so long that they have been linked to many thousands of additional deaths each year.

Set against a backdrop of reduced productivity, despite personnel increases, his report signals a need to stop doing things that don’t work, and improve where and how NHS money is spent, to do better for millions of patients.

But how can NHS leaders at every level know where to refocus resources to get the health service back on its feet? How can they gain an ongoing understanding of the real causes of problems – and the right solutions that will fix them? How will they prevent the next scandal ever occurring, fix A&E, safely address waiting lists, and bolster community services in ways that can evidence sizeable impact?

To give the NHS a chance in recovering, we now need to rapidly scale new means to keep turning stones over, in ways that respond to these questions, and that allow the NHS to unearth problems early, act quickly, and measure the effectiveness of new action about to be taken.

Strong calls for openness and honesty – but will the right things be measured?

The need for greater transparency is prominent in the Darzi assessment, as he very rightly calls for greater investment in measurement in “all areas of the NHS”.

Page one of his summary letter to the health secretary argues that to rebuild public confidence, there is a need to be completely honest about where the NHS stands – on which his report provides a snapshot.

But the full range of challenges, across a breadth of services throughout England, has been difficult to quantify, he admits.

Though this can be difficult – evidence from around the world, and in pockets of the NHS, show it is possible.

Media facing critique of regulatory and patient safety measures has come to the fore in recent months. But with a great deal of time already invested in the NHS in measuring services – what needs to change to tell the health service and its patients if ‘good’ is being achieved, and what needs to be done if it isn’t?

Lord Darzi urges each NHS care setting to better measure activity, workforce, and spending to deliver a better understanding of productivity.

Knowing whether we are doing more things with our people and money, will however will only go so far in helping the NHS. What leaders may benefit from the most is a better understanding of quality as they attempt to work through challenges national and local.

Darzi review suggests renewed NHS digital push could drive transparency on quality

As the NHS now strives to move beyond the “foothills” of technology enabled transformation that Lord Darzi describes, it could enhance digital capabilities at-scale to deliver this measure.

Uptake of technology to quantify quality is not new – it is already being used in some of the world’s safest hospitals, to enable a forensic understanding of whether observed outcomes are at least as good, if not better than the expected outcomes for individual patients.

In a relentless pursuit for understanding where quality can be improved, such hospitals have taken a sophisticated approach to understanding the complexity of each patient, calculating the outcome trajectory for that patient, and examining what actually happens. Doing this at-scale, allows teams to identify issues very early when things don’t go as planned, make informed decisions on required remedial action, and understand the effects.

NHS organisations have been using the same underpinning technology for many years – informing service design in ways that have helped to prevent deadly illnesses, reduce hospital acquired harm, and more recently by trusts and integrated care systems to target high-risk patients on waiting lists in ways that improve outcomes, reduce their time in hospital, mitigate avoidable complexity, and prevent them presenting to A&E.

The Darzi report points out that despite many examples of impactful technologies, too many remain subscale. Scaling the technology that pioneering trusts have already adopted, could go a long way to quantifying precisely where and why problems exist – and what to do about them.

If accompanied by a culture that accepts that things will inevitably not always go right, services could show their performance in ways meaningful to the outside world without fear of blame. They can learn and swiftly act, with insight that can inform the need for system-wide interventions in ways that harness collective responsibility before problems escalate into scandals.

Patients could better know with greater confidence if their surgical teams, or maternity wards are safe.

And the action the government now requires, as it seeks to address the big problems, could be underpinned by evidence.

Informing reforms, moving to prevention, targeting community investment

Prevention has long sat on the policy agenda of successive governments. Now could be an opportunity to make it reality. But this will only work if we understand the detail behind changing problems, and behind the prescribed responses.

The additional 14,000 A&E deaths each year, outlined in evidence submitted to Darzi review, is shocking. But might we now ask for every non-traumatic emergency admission in the NHS – why did this happen? And how can we plot trajectories for each patient to prevent this ever occurring – so that they have support needed in the community to manage their wellbeing, their condition, or perhaps their prehabilitation as they await surgery?

This could be part of a wider piece of intelligence, built on perpetual forensic transparency at every level, that could inform precisely where in the community money should be spent to prevent the need for hospital treatment. Rather than resources simply being allocated in greater numbers in the same settings in reaction to spiralling demand, systems might ask how they can use upstream analysis to reform or engineer services around the personalised needs of individual patients, and enhance the effectiveness of heath and care for everyone.

Lord Darzi’s investigation raises many questions. But as the NHS reforms – it has been given license to learn like never before.

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This increased complexity has made an already attractive cyber target even more alluring to threat actors, as they now have more entry points than ever before. With this in mind, there’s no surprise that the same SOTI study found almost three quarters of healthcare workers admitted to their organisation experiencing one or more data breaches since 2022.

We’ve seen this reflected in recent headlines, with the NHS declaring a critical incident earlier this year after it was hit with a huge ransomware attack. This was due to a breach on its partner Synnovis, which led to operations being cancelled and emergency patients having to be diverted elsewhere.

It’s clear that healthcare providers must switch up approaches to better monitor how data is being handled to minimise risk. But what is the current state of play and how can the sector get to the root of the problem? Let’s take a look.

Data Dilemma

Cybersecurity concerns are nothing new to the healthcare sector as it has long been a prime target for hackers, but according to SOTI, the concern is particularly high in 2024 with a third of healthcare professionals noting it their primary worry, up from 17% in 2023.

This growing awareness from employees could be explained by the sector’s desire to digitalise, with staff now needing to rely on more and more apps and devices than ever before.

The data that fuels these devices, from supporting with diagnosis to collating medical details, means the industry is collecting, storing and processing higher volumes of sensitive information than in previous years. All of this is appealing to cybercriminals as it can be sold on the dark web or even held to ransom, so it’s essential that data is protected and that the location and status of devices can be tracked.

The Legacy Battle

While there is a marked increase in digitalisation, healthcare workers are still losing over three hours per week to IT issues, according to SOTI’s study. A common cause being the continued use of legacy systems. Concerningly, almost two thirds (65%) of UK health workers believe their organisations are relying on outdated tools.

Legacy and outdated systems can come from layering complex technologies over many years, and any upgrades are often held back by lack of budget. While a complete overhaul may not be feasible, new technology integration into legacy and fragile infrastructures requires absolute confidence and accuracy with trusted partners to maintain security and compliance, and guarantee no downtime with immediate, real-time optimisation.

When apps and devices are a crucial part of providing lifesaving care to so many patients, downtime is something that the industry simply cannot afford. While it wasn’t an issue from legacy technology, the recent global IT outage was a stark reminder of the impact that any downtime can have on healthcare, as it left many hospitals without the tools needed to provide essential treatments.

It’s also key that organisations can remotely support devices to ensure they are working properly while on the go, and are updated with the latest patches to stay secure, yet one in five UK healthcare providers don’t currently have the capability as a result of legacy tech. Healthcare organisations need to manage their transition away from legacy tech in order to be innovative and to get ahead of potential issues. This can reduce the amount of time staff are spending trying to tackle the problem themselves and free them up to focus on patient care.

Getting it Right

Ongoing technological advancements in the healthcare sector are critical to effectively managing increased use of services and a fast and enhanced patient experience. But it’s essential that providers take a step back and evaluate all risks to ensure that defending sensitive data is central to every decision.

Whether it’s accidental or intentional, data leaks and downtime can have a devastating impact on the essential work that healthcare providers do every day. Our work with Newland EMEA, a provider of mobile computers and handheld scanners to the healthcare sector, strengthens patient care by securing the data scanned and collected on every device. A senior Newland executive recently commented on how doctors and specialists can now fully concentrate on patient care due to the highest possible levels of safety and compliance now being ensured by SOTI.

While it’s key that the healthcare sector doesn’t stunt growth or shy away from the use of AI or other innovations, it’s important that new projects are viewed through a security lens and that legacy technologies aren’t forgotten. At the end of the day, the best security approaches will look to increase visibility across the entire tech stack, use effective management solutions and support response teams while keeping patient care at the core.

By Stefan Spendrup, VP, Northern and Western Europe at SOTI

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Over time, we’ve addressed this by putting “band-aids” in place, like separate pharmacy ordering tracking systems such as the one from PTS. However, the manual burden of accurately tracking everything often leads to incomplete records, with only certain types of items being monitored. As a result, frequent inquiries about the status of medication orders further strain both pharmacy and ward resources. There is also a disconnect once the medicines leave the pharmacy with the porter, as again their whereabouts or who receives them cannot be easily tracked.

More and more hospitals are transitioning from paper-based processes to digital solutions.  However, there are some common misconceptions and barriers that need to be overcome first.

A general misconception is that workflows will become much more complicated or that a new system won’t let people work in the way they want to. For the former, I think it’s a justified concern – most healthcare apps aren’t known for their fantastic user experience (UX), but things are improving, especially when we think of newer entrants into the market (such as Better) who don’t have 40 years of technical debt. UX is now a separate profession; factors like accessibility are serious considerations, whereas once they were just buzzwords.

For the latter, being encouraged to rationalise and streamline processes is actually one of the main benefits. Pharmacy often works on tradition rather than looking at potential improvements; as a service, pharmacy tends to dislike change. Gradually, we accumulate dozens of small exceptions, changes, one-offs, and various other accommodations that all had a valid purpose at the point of conception but have combined to create a very complex and difficult-to-navigate system.

The digital opportunity for pharmacy ordering processes

Electronic prescribing with stock control integration provides the opportunity to fully digitalise this process, reducing transcribing, saving paper, getting rid of lost or illegible scripts, and providing full electronic status updates. Almost every aspect of pharmacy ordering can be streamlined and simplified, becoming just another part of a greater system that fits in with recognised standards such as GS1 barcoding. Systems to track medicine bags with the porters (e.g., RFID tags) already exist and can be readily integrated.

Suddenly, the ePMA system becomes the hub for pharmacy activity – you can see the patients’ prescriptions and doses, amend their treatment, view their medicine reconciliation, pull in summary care record data, send prescriptions electronically and order and track medicines in one view from anywhere with network access. When used with the Electronic Prescription Service (EPS), this can allow fully remote consultations and prescribing and prevent patients from having to come into the hospital. This is ideal in cases where trusts cover vast and remote areas. When combined with GP Connect, seamless data sharing around all hospital episodes becomes possible – a true patient care record rather than an organisational patient care record.

Eventually, every dose, every prescription, every order and every dispense will be centralised and combined with primary care data, forming a comprehensive care record that provides invaluable insights for prescribers, patients, and pharmacies. At this point, the benefits for patients and ownership of their own data become clear.

End-to-end e-prescribing and stock control in action

At South Tees we’ve partnered with Better on integration between their ePMA solution Better Meds and the Helix Stock Control system.

Valuable time is being saved that would have been spent transcribing, orders are fully traceable, and errors during transcribing are being avoided. The stock control system doesn’t have to take into consideration clinical decision support as it’s already validated in Better Meds and users can only dispense medication that has been ordered by authorised staff.  The integration is also enabling a real-time update of everything that’s changed with the prescription which is helping pharmacists prioritise workload.

Following our go-live, we prioritised getting effective reporting out of the ePMA system as early as possible.  It’s a fundamental factor in leveraging our system to improve efficiency.  Real-time visibility of critical or time-sensitive medicines immediately gives a safety net from which pharmacies can act to improve patient care and review where issues are occurring. When combined with ward stock list data, reports like missed doses can provide far more insight than just a ‘gut feeling’ into where things are being missed and why. Using the data available can allow for a very sensitive fine-tuning of stock availability.

Looking to the future

South Tees plans to extend the system’s scope beyond inpatient supply requests and feeding back quantities and dispensed items, as well as utilising other data such as ward stock lists and integrating with further systems, i.e., bag tracking.

As a service, we should strive to advance the ongoing progress of closed-loop prescribing – including deeper integration of various GS1-compliant standards such as Global Local Numbers (GLNs) for locations and Global Service Relation Numbers (GSRNs) for staff.  The implementation and adoption of the Dictionary of Medicines and Devices (dm+d), Fast Healthcare Interoperability Resources (FHIR), and structured dosages have facilitated some progress in making data transferrable.  However, we should extend our focus beyond just medications and start looking at how every entity and action in the system can be made traceable and identifiable across the system and organisational boundaries. The standards to enable this already exist – we just need to start using them.

By Daniel Pugh, Lead Technician for ePMA at South Tees NHS Foundation Trust and Lead Developer for Helix Stock Control

The post The Case for Change – Digitising the Pharmacy Ordering Process appeared first on .

The Overlooked Priority: Healthcare

According to the U.S. Census Bureau, more than eight million Americans move each year. While the reasons for moving vary—such as changes in living situations, purchasing a home, or seeking a new environment—one critical aspect often neglected is healthcare.

The survey highlights that a staggering 91% of Americans do not prioritize healthcare when choosing a new home. Instead, prospective movers focus on factors like school districts, home value, and commute times. Only 9% of respondents considered healthcare options, such as proximity to hospitals or doctors’ offices, as a top priority. This oversight can have significant implications, especially in emergencies or when managing ongoing health conditions.

Regrets and Realizations

The survey indicates that 58% of Americans who moved within the last five years did not consider healthcare options at all during their relocation. This lack of foresight has led to regrets for 1 in 5 of these individuals, with over half (53%) stating they would prioritize healthcare if they moved again. These findings suggest a growing awareness of the importance of accessible healthcare, yet it remains an afterthought for many during the moving process.

The Challenge of Managing Medical Records

One of the most critical yet challenging aspects of moving is managing medical records. The survey revealed that over 1 in 4 (29%) Americans have encountered difficulties transferring health records between providers when switching doctors. This issue is particularly pronounced among those who have served in the military or grown up in military families, with 29% citing the maintenance of medical and vaccination records as a significant challenge.

The chaos of moving can make it easy for important documents to be misplaced or forgotten. Google searches for “How do I find my medical records” increased by 26% from January 2021 to January 2024, underscoring the confusion many Americans face in tracking their health information. Additionally, 35% of survey respondents admitted they do not know where to find all their health records. Among parents, 30% do not have all their child’s health records, and 58% do not know how to access them if needed.

The Impact on Health and Well-being

The neglect of healthcare during a move can have serious repercussions on individuals’ health and well-being. Without easy access to medical records, continuity of care can be disrupted, leading to potential gaps in treatment or missed diagnoses. This is particularly concerning for those with chronic conditions or ongoing health needs that require regular monitoring and management.

And, we know that the stress of moving itself can exacerbate health issues. The uncertainty and logistical challenges involved can lead to increased anxiety and decreased attention to personal health, making the accessibility of healthcare services even more crucial during this transitional period.

Helping healthcare patients manage a move: Recommendations for providers

Given the findings, it is clear that integrating healthcare considerations into the moving process is essential, yet the disruption can significantly impact a person’s healthcare continuity. Providers can take practical steps to help ensure a smooth transition for patients.

First, retaining records to meet retention and release of information requirements is crucial. Simplifying the application landscape can reduce the burden of digging for records releases, ensuring that vital information is easily accessible when needed. An active archive is helpful here. It securely consolidates all historical data and allows for user workflows to access and release records. This allows those old applications to be decommissioned. Second, implementing an easy-to-use patient portal can make records readily available, allowing patients to manage their health more efficiently during and after their move. Having a streamlined, integrated software portfolio can further enable information sharing to a patient portal.

By prioritizing these steps, healthcare providers can help mitigate the negative effects of a move on patient care. Ensuring that records are retained and accessible, streamlining processes, and providing user-friendly digital tools are key strategies in maintaining continuity of care. This holistic approach not only supports regulatory compliance but also enhances patient experience and outcomes during the often-stressful moving process.

There is clearly a significant gap in how patients prioritize healthcare during the moving process. While factors like housing and commute times dominate decision-making, the accessibility and management of healthcare should not be overlooked. As providers, fostering greater awareness and proactive measures can ensure continuity of care and well-being during relocations, ultimately supporting better health outcomes for patients.

By prioritizing healthcare, individuals can avoid the pitfalls of disrupted care and ensure their health remains a top priority, no matter where life takes them.

About the Author

Amy Holmes, Director of Marketing, Harmony Healthcare IT has over 15 years of diverse marketing experience. With early roles ranging from product management to communications and customer education, she quickly progressed to building and leading a marketing team which covered multiple product lines in the dental industry. Amy has guided marketing strategy, communications, demand generation, branding and product management. At Harmony Healthcare IT, she is responsible for all aspects of marketing, helping connect the healthcare market with data management solutions.

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