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David Hancock

Healthcare Executive Advisor, InterSystems

Greater integration of NHS IT systems is crucial if the health service in the UK is to deliver more joined up care for patients.


With many hospitals, clinics and healthcare units having different systems, integration and interoperability are paramount with the introduction of the new NHS structure of integrated care systems (ICS), where the health and care sectors will work in closer partnership to deliver a holistic healthcare approach to patients.

A core element of this is the utilisation of the electronic patient record (EPR) and building a shared care record, making the medical notes of individuals available at whatever point they access the NHS.

Major NHS transformation

Healthcare IT expert, David Hancock, explains the current NHS transformation is happening because “the way it has been organised in the past is not able to solve the problems of today.”

“Now,” he continues, “we need to be focussing on prevention, and on how people can remain healthy, in order to do that, care needs to be rooted far more in the community. We need to be able to treat the care system far more holistically, integrating primary care, community, acute and social care.”

The Health and Social Care Bill going through Parliament will create 42 ICS across England – made up of GPs, community trusts, acute trusts, mental health trusts, local councils for social care and the charity and the voluntary sector – to improve population health and reduce health inequalities.

This, combined with the shared care record, he adds, will deliver a clearer, longitudinal patient centric view across health and care systems, with better treatment and greater continuity of care.

Shared care records

Hancock, who is Healthcare Executive Advisor with InterSystems, explains how the software company is supporting the NHS to deliver that.

One example, in the large rural county of Lincolnshire, with health challenges in managing the disparate – and often elderly – population, the shared care record has transformed how the population is being treated. That has led to innovations such as the use of neighbourhood teams – groupings GPs, community and social care – to look after specific patients, such as the frail elderly.

Digital transformation is making this joining up of care more possible with the shared care record accessible for healthcare professionals via an internet browser, with no need for specialist software or hardware.

We need to be able to treat the care system far more holistically, integrating primary care, community, acute and social care.

Pockets of computerisation

A broader challenge, however, is that NHS units are still reliant on paper, while others have pockets of computerisation. Integration technology specialists, InterSystems has the capability to extract data from those systems and make it relevant to users, as well as work with customers to digitise their operations.

“Different organisations have different needs because nobody is starting from the same place,” says Hancock. “But all see the benefit of having something more integrated where systems talk to each other and give an overview of patients.”

With hospitals under pressures from the pandemic and staff shortages, InterSystems has helped many – such as North Tees and Hartlepool Hospital – to “progressively migrate” to an integrated EPR, rather than undergo an immediate switch. “To progressively migrate is something which is increasingly being appreciated across the NHS,” he says.

Accessible care plans

The shared care record enables healthcare professionals to work more efficiently and means that patients do not have to keep repeating themselves and be assured the person treating them has their latest medical information. The facility also allows for care plans for patients – such as for strokes – to be shared across multi-disciplinary teams.

A next step from the vertical integration of GPs, community and mental health care services is the horizontal integration of acute hospitals to enable them to work together as a provider of collaboratives and create economies of scale, or specialise in certain areas, such as hyper acute centres for stroke and collaboration around reducing the waiting list for operations.

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