NHS: Electronic Patient Record Systems

Question

15:29:00

Asked by

To ask His Majesty’s Government what plans they have made to complete the rollout of electronic patient record systems to NHS trusts which have not yet implemented them.

My Lords, NHS England has supported over 160 trusts with digital transformation, including the implementation of electronic patient records. Currently, 91% rollout of electronic patient records has been achieved, with work under way to provide tailored support to the remaining 19 trusts that do not yet have an electronic patient record.

I thank the Minister for that informative Answer. As she will know, the rollout of electronic patient records is just the first step towards full digital maturity, which will allow systems to share data across the system, not only for patient care but for research data that can help with preventive care. Can the Minister tell us more about what specific, targeted assistance those trusts that have not yet reached digital maturity are being given to ensure that they are digitally mature, whether they have the technology but are not yet using it to full capability or they need better technology to achieve full EPRs?

I first acknowledge the role that the noble Lord, and the noble Lord, Lord Markham, played when they were Health Ministers. They both drove this agenda forward. I am grateful for that. The tailored support includes a number of activities to install, upgrade and optimise electronic patient records to meet the standard that the noble Lord is aware that we need to meet. I am sure that he is aware of the What Good Looks Like digital framework. That is an assessment of how digitally mature a system is. It gives guidance but also highlights where intervention must take place to bring it up to the right standard, which we would all want to see.

What progress is being made to improve the flow of patient information between trusts, which at the moment is poor, contributing to NHS inefficiency and hampering the timely treatment of patients?

The noble and gallant Lord is right. Your Lordships’ House will be aware that, of the three main shifts that will be amplified in the 10-year plan, this plays very well into not only analogue to digital but the move from hospital to community, and sickness to prevention. The noble and gallant Lord is right that we need digital capability across aspects of not just the NHS but social care. We are developing various aspects, including the federated data platform and single patient records. We are engaging with the public and stakeholders to understand their views about the use of health data so that we can get it absolutely right.

My Lords, Oracle Cerner and Epic, the two electronic patient record systems that the NHS is purchasing, running to billions of pounds, were designed primarily for the US healthcare system and have not been significantly customised for the NHS. This is leading to a serious lack of alignment with the requirements of the British healthcare model. What assessment have the Government made of this issue and how confident are they that value for money and improved outcomes can be achieved, given that these systems have not been tailored specifically for the NHS?

There are huge gains to be made in digitisation, which I know that the noble Lord shares my view on. It is crucial that we get it right. I assure him that procurement processes are carried out as we would always expect them to be and that we are satisfied that the right provision can be made.

My Lords, does my noble friend agree that any reluctance to share records or data is very rarely on the part of the patients but instead is usually on the part of the systems and the professionals? Patients are always astonished that the records are not shared between their GP and the hospital, and less still with social care.

My noble friend is quite correct. The report of the committee that my noble friend chaired said that one of carers’ greatest frustrations was repeatedly repeating information to all the various aspects. The point about ensuring that there is digital maturity, and that various parts of the NHS and social care can get up to that and beyond, is crucial. This is the way that we are going and it will produce far better outcomes, not just for patients but for those who care for them.

My Lords, patient flow through a hospital is a critical factor in avoiding delayed discharges, which is a major issue. We know that electronic bed management systems can play a major part in helping to reduce bed-blocking. What steps are His Majesty’s Government taking to ensure that more hospitals have that technology and that timescales are set for achieving full rollout?

The noble Baroness is quite right about the benefits. The electronic patient records programme provides a 4.5% reduction in length of stay, as well as a 13% lower cost in admitted patient spells, so there are great benefits as well as better productivity and outcomes for patients. Electronic patient record coverage is forecast to be at 96% of trusts by March 2026, and the remaining 4% of NHS trusts will be advanced in their plans for an electronic patient record. I emphasise that we are proactive in actively supporting hospitals and trusts to get to the right place.

My Lords, I draw the House’s attention to my registered interests. Patients who are managed in research-active environments frequently have better clinical outcomes. For an environment, be it in the community or in the hospital, to be research active, it must be able to collect patient data; electronic records are therefore essential. Beyond that, there is a necessity to curate those data and present them in such a fashion that they can be used meaningfully and rapidly to drive our nation’s research effort and benefit all citizens. What plans do His Majesty’s Government have, as they move forward with the 10-year plan, to ensure that that area of development is properly funded?

Research and data are absolutely key to the 10-year plan and the shifts that I referred to earlier. I also draw the noble Lord’s attention to the data security and protection toolkit. It is an online assessment tool that allows organisations to measure their performance against the National Data Guardian’s 10 data security standards. I know there is a question among some members of the public about this, but perhaps I could, overall, reassure the noble Lord that we see data as key to research. I certainly agree with his comments about outcomes for patients being better.

My Lords, if the Minister is looking for a current successful case history, I recommend Bedford Hospital. I was referred to the external clinic on the 20th and tested for X, Y and Z. A bed was found for me at 2 am. I had four nights in Bedford Hospital, since when I have had three different departments, all of which had full details from my GP and the other departments involved. Not only that but I happened to go to the Moorfields clinic which is attached to it—it is external—which had them as well. So, there is a good case history.

The noble Lord is an exemplar when he describes the quality of care and the joined-up approach of the data and information relating to him. I am delighted to hear that Bedford Hospital was so good to him. I am sure it will appreciate him sharing that with your Lordships’ House, and I add my thanks too.

My Lords, as part of the tailored support that the Minister spoke about earlier, can she explain about the cybersecurity provisions? The ransomware attack on Synnovis last June meant patients’ blood groups were unable to be matched, so there was a call-out for O-negative blood. Patients transfer between the devolved nations of the UK, between Wales and England, and across the border, to a lesser extent, between Scotland and England. Is she having discussions about United Kingdom-tailored cybersecurity support for these rollout systems?

We regularly liaise and work closely with the devolved Governments. More than £338 million has been invested in cyber resilience to date. In March 2023, the department published the cybersecurity strategy for health and social care, which runs until 2030. This is an area of huge importance, as the noble Baroness identifies, and one we continue to press.