Safety recommendation
HSIB recommends that NHSX expands its work programme addressing the challenges associated with interoperability of information systems used in healthcare to include transfer of information between the NHS and independent sector in support of safe care delivery.
Response:
We read with great interest the report from the Healthcare Safety Investigation Branch (HSIB) regarding the surgical care of NHS patients in independent hospitals. We were deeply concerned that patient care had been compromised as a result of unclear channels of communication between the NHS and the independent sector. It is clear that the robust data flow and sharing of clinical information between health and care organisations across sectors is a prerequisite to being able to provide high-quality patient care. NHSX is committed to supporting local NHS and care organisations to digitise their services, and specifically, connect the health and care systems through data and technology.
Within NHSX, programmes of work are currently underway to improve the flow of data between secondary care trusts and community-based services within Integrated Care Systems (ICSs) - with a view to expanding to interoperability between ICSs over time. In this work, we agree that the independent sector must not be regarded in isolation, but rather as a key component of the ICS in which they sit. This is of particular importance, given their evolving role in supporting the NHS to provide timely care to NHS patients (including urgent NHS elective surgical care, and the delivery of cancer pathways).
To underpin this, we will continue to support providers across the health and care sector in the adoption of Fast Healthcare Interoperability Resources (FHIR) standards, in order to optimise the sharing of information between IT systems used in health and care. We recognise that these endeavours pose questions of cybersecurity, information governance (IG), and clinical safety, which must be addressed if true system-wide interoperability is to be achieved.
Given the operational pressures the health and care system continues to face, national strategic priorities are likely to be revisited over the coming months. A greater emphasis on the evolving role of the independent sector would be well-received, and would serve to galvanise our efforts, and the efforts of other organisations and arms-length bodies (ALBs), in achieving true system-wide interoperability.
Response received on 21 January 2022.