Giles Wilmore, Director of Quality Framework and QIPP, Department of Health, discusses the NHS Information Strategy at The King's Fund's NHS Information Revolution conference.

1. Developing the Information Strategy
The King’s Fund Information Revolution Conference
12 October 2011
Giles Wilmore, Director of Quality Framework and QIPP

2. Introduction
• We are currently developing a new information strategy covering the
NHS, social care and public health.
• This will be informed by the consultation on Liberating the NHS: An
Information Revolution and by the work of the Future Forum group co-
chaired by Jeremy Taylor and Professor David Haslam, reporting later
this year.
• Vast possibilities – but also daunting barriers.
• Whilst the direction of travel is broadly clear, there remain significant
complex issues to resolve and real questions about how best to make it
happen.
• Today is a fantastic opportunity to share our thinking to date and work
through some of the thorny issues with you.

3. The vision
• Equity and excellence: Liberating the NHS
– putting patients at the heart of everything, to make a reality of ‘no
decision about me without me’
– achieving outcomes that are among the best in the world
– empowering clinicians to deliver results
• Liberating the NHS: An Information Revolution
– people have the information they need to stay healthy, to take
decisions about and exercise more control of their care, and to
make the right choices for themselves and their families;
– people are able to see an accurate record of their care, which is
available to them electronically, and use it as a basis for interacting
with their care providers;
– information is liberated from a closed, bureaucratic system in order
to serve patients and the public, and to help drive better care,
improving outcomes, fostering innovation and facilitating
the better use of resources.

4. This demands a significant culture shift
• to patients and service users being active participants in
their care
• to information which is based on the patient or service user
consultation and on good clinical and professional practice
• to a focus on meeting the needs of individuals and local
communities
• to a culture characterised by openness, transparency and
comparability
• to a range of organisations being able to offer service
information to a variety of audiences
• to an approach in relation to digital technologies, where we
connect and join up systems.

6. Key themes from the consultation
• Ensuring that the information revolution benefits everyone
• Information for improved outcomes including service user feedback
• The need for information to be linked across health, social care and also
public health
• Information for professionals
• People’s control of and access to information held in their own care
records with clear governance and consent models
• The need for clear routes (or channels) to information including clear
online signposting
• Information to support choice, to help people live healthier lives and to
help patients to care for themselves
• Information for autonomy, accountability and democratic legitimacy,
including proposals for information ‘intermediaries’ and how information
drives research
• The need for clear information standards across health, public
health and social care.

7. Current progress
• A substantial programme of work is underway to address these
themes and to shape specific policy options for ministers to
consider.
• The broad direction of travel is clear, but there are a series of
areas where we need to test the practicalities of implementation
and consider what pace and scale of progress is achievable.
• There are six key areas where we hope to get your input
throughout today and beyond:
1. information for shared decision-making and choice
2. patient control of records
3. recording data accurately at the point of care
4. sharing data effectively and securely
5. transparency and the information market place
6. channel shift.

8. 1: Information and support for shared
decision-making and choice
• Do we know enough about the types of information people
need and want for different types of choice, and how they want
to access it?
• How do we ensure the information available is kept up to date
and responds to trends in the choices people want to make?
• How can we tackle information inequalities and avoid some
communities being disempowered by difficulties accessing and
using information effectively?
• What should our digital channel strategy be?
• Should we simplify the ‘front doors’ to the NHS?
• What information should remain the responsibility of the
centre to provide?

9. 2. Patient control of records
• How are professionals, GPs initially, encouraged, incentivised
or required to offer this service to their patients?
• Should we take a phased approach, initially focused on, eg,
long-term conditions?
• How do we encourage people to trust and use radically
different ways of accessing services?
• Who will build and supply the systems to deliver electronic
access to the record and associated functionality?
• How will this be funded and do we know that commensurate
efficiency savings can be made?

10. 3. Recording data accurately at the point of
care
• How do we shift ingrained working practices and cultural
barriers to make this vision possible?
• How can we support organisations to ensure that the right
information and IT systems and capability are in place and
supported locally to capture information in this way?
• How can we effectively police the use of a single set of
informatics standards and consistent data coding?
• How can we reassure the public that their personal data will be
held securely and confidentially, and that only anonymised
information will be used for secondary purposes?

11. 4. Sharing data effectively and securely
• What kind of consent system will we need for sharing personal
data with other professionals (eg, GPs sharing their patients’
records with social workers)?
• How can we reassure the public we will avoid errors of identity
and lapses in data security as we move their information more
freely round the system?
• How do we ensure that locally procured or upgraded systems
can connect with each other effectively and securely?
• In a resource-constrained environment, how can we
demonstrate the longer-term cost effectiveness of health and
care organisations making such investments?

12. 5. Transparency and the information market
place
• What, if anything, do we need to do to stimulate a market of
information intermediaries?
• What kind of differential approaches are needed for different
types of intermediaries – eg, voluntary organisations,
research organisations, organisations providing analytical and
interpretive services to the NHS?
• What role should the state play as an information
intermediary?
• What will be the role of local authorities in relation to social
care and public health information?
• How can the public be assured that information about public
services is reliable and trustworthy?
• Who is responsible for ensuring information is accredited or
kite marked, or will the information marketplace self-regulate?

13. 6. Channel shift
• How can we best facilitate and support the use of digital and
new technology to deliver more responsive care and better
value for money?
• Where are the greatest benefits?
• What are the key barriers to overcome?
• How do we most effectively learn from and build on current
innovations and best practice?

14. Next steps
• We expect the NHS Future Forum to produce a further report
around December.
• They are focusing especially on how to overcome the cultural
and practical challenges that have limited progress in the past.
• Aiming for Information Strategy publication this winter, informed
by the Future Forum work and by discussions including this
conference.
• The NHS Commissioning Board will be working with
stakeholders to develop a more detailed implementation plan for
the NHS elements of the strategy after it has been published.