Patient-centric policy means better healthcare

"Integrated care has to be the future" - my thoughts exactly. But on this occasion, not my words. The message was delivered by Baroness Hanham, Chairman of health sector regulator Monitor, at a recent Westminster Social Policy Forum event.

She called for urgent change to better co-ordinate health and social care services at patient level and warned that this essential step is taking too long to become a reality.

Joined up care means putting all of us as patients first - co-ordinating care and sharing our information, particularly as we move from one service to another. Putting patients first means care plans can become more tailored. This in turn should result in more effective treatment and/or prevention and therefore fewer hospital admissions - an outcome that is better for patients and better for an NHS under pressure.

Baroness Hanham's words were welcomed by many. Interestingly, the call to action was also accompanied by a criticism of those "standing in the way" of progress by resisting working together. I say interestingly as I don't believe standing in the way is really the issue. A much bigger problem, in terms of making joined up care a reality, comes from standing still.

Yes, there may be those who for some reason are deliberately opposed to collaborative working within the NHS but I think this is a minority group. In most instances, it is more likely that healthcare professionals and the teams they work with - GPs, nurses, consultants, A&E practitioners, pharmacists - are stuck. They want to move forward but feel they are unable to because of obstacles in their way.

A faster route to co-ordinated healthcare is therefore to look at these obstacles and identify common solutions rather than focus on who is or isn't implementing change fast enough.

I recently blogged about what I consider to be one of the biggest hurdles facing healthcare professionals looking to work more collaboratively for the good of the patient - fear of legal ramifications.

It's not surprising this fear exists. After all, in caring for us, healthcare professionals are privy to our most personal details and that is a huge responsibility.

Greater education around advances in data security and risk mitigation has a vital role to play, but there is also a need for a simplification of information governance. This would ensure that healthcare professionals, whichever strand of the NHS they work for, are confident they can securely share our information when it is in our best interests as patients.

There are many other practical and logistical hurdles that are leaving NHS services 'standing still' in the race to deliver joined up care.

Lack of a common tactical framework for one. Different services and practitioners have very different tactical motivations for the how they record and use patient data (and indeed what data they ask for).

For example, A&E practitioners may be under pressure to manage queue times and so will record the minimum data they need to see people quickly, safely and efficiently. GPs are also under time pressure, but are assessed (certainly in terms of the way they are paid) by the depth of data they record and the care they give as a result. Unsurprisingly, this leads to significant variations in data type, depth and coding systems, making data sharing that much harder.

Siloed funding is inextricably linked to this. Different tactical motivations are, in part, driven by distinct variations in the type, level and sources of funding that NHS services receive. Without a top-down alignment of policies regarding funding, it is difficult to break down barriers.

There is also a need for IT system suppliers to work towards enabling different systems to work hand-in-hand - removing digital hurdles to secure data sharing. This is already starting to happen, with the result that healthcare is safer and more efficient and often a great deal more convenient for the patient.

But without addressing some of these other stumbling blocks facing healthcare providers 'standing still' will not change to 'moving forward'. To me, there is a common theme running through all of this - the need to adopt a patient-centric policy.

What would this look like? It would mean funding that is driven by patient outcomes rather than service outputs; data capture and care plans based on the 'entire patient journey' rather than individual components; IT systems that allow a rich information seam to follow us as we move between different care providers. Crucially, it would include a simplified information governance structure to give healthcare practitioners the reassurance that sharing data to support joined-up care is a priority that won't come back to bite them.

I'm not saying it is simple. But it is what is needed and, in my view, it is the fastest way to making sure joined-up care becomes a reality and doesn't remain a theoretical aspiration.

This article was written by Chris Spencer.

The original article can be read on The Huffington Post.