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The bigger picture

Making health services more patient-centred and supporting frontline staff is driving many of the changes in information and communications technology in the NHS. Jane Hobden assesses how iCSP fits within this scenario.

Imagine it's 2010. By this time, the government says, the NHS will be a more streamlined, open organisation with patients having far greater access to information, able to view their healthcare records via the internet. What's more healthcare professionals will be able to access and share information, enabling them to analyse NHS use or produce risk predictions systems for primary care trusts. The result? Delivering services more effectively than ever before as they are designed to meet the clients' needs.

The big question is whether this vision can become reality. The government is certainly putting money where its mouth is in terms of providing a robust information technology (IT) infrastructure. In what it says is one of the world's biggest ever civil investments in information and communications technology (ICT) and the biggest in the NHS, the government has invested £2.3 billion over the last three years, and awarded contracts for local service providers worth £6.2 billion over the next seven years. This money will fund a whole raft of changes in England being developed by the National Programme for IT (NPfIT). These include the care records service, the choose and book system and the electronic transmission of prescriptions (see box on page 18).

All these changes will profoundly affect the way physiotherapists and other health professionals work, says CSP project manager Nigel Senior, the architect behind iCSP. Nigel sees the system as playing a key role in helping physios to manage the broader ICT changes coming on-stream - not least in building their confidence in using information technology. 'Using iCSP will instill a 'can-do' attitude towards IT, and will show how IT can bring real benefits to them,' he says. In this time of rapid change, Nigel sees iCSP as an opportunity physios should seize as a means of making their work easier. The system is designed to be easy to use, enabling physios to access targeted information quickly, to share their knowledge and to offer each other support.

'For instance', he explains, 'if a paediatric physio is working with a child who has a condition of which they have little experience, at the press of a button, they can contact 1,000 other paediatric physios and tap into their expertise.' iCSP will also enable physiotherapists to share experiences about how the new NHS systems are being implemented, and to get help on specific difficulties, for example, on adapting systems to a specific way of working. Useful support resources such as training or guidance notes can also be shared.

The sort of world physios will inhabit in 2010 is one where access to information regarding best practice or innovative practice will be essential. Pen Robinson, former CSP director of member networks and relations has been involved in advising the NHS on the IT needs of allied health professionals (AHPs) for a decade. She believes the new technology means physiotherapists can swiftly access key information and the latest evidence they now need for their work, for instance, researching the Cochrane library via the National Electronic Library for Health. And while the array of new ICT systems can seem daunting, support should be in place, with training being provided by all NHS employers.

Continuing professional development (CPD) is also an area where iCSP can play a vital role. As well as accessing details of newly published research and good practice, iCSP enables users to contribute content and interact with peers, for example, sharing research findings or starting or responding to a discussion. A user can then use contributions of this sort as evidence of CPD. As Nigel Senior explains: 'The system enables users to view all the contributions they have made to the different networks and sections of iCSP.'

Access to a computer remains a big issue - and one on which the success of the changes is dependent, says Pen. Currently the situation is mixed, and though improving, some staff still have only minimal access to a computer. The NHS should also be investing in palm top computers, allowing community based health professionals to input data while working.

Margaret Hastings, AHP information development officer for Scotland, echoes her concerns. She is acutely aware of the need to ensure technology fits the needs of physios. She notes 'tablet' personal computers, with drawing and annotating abilities, would equip physios to draw charts and carry out other tasks while away from the office. However, she adds changes must be backed up with quality training to build confidence and skills in using technology.

Margaret has been involved with the Kerr report, about the future direction of healthcare in Scotland, and the use of ICT to help manage long-term conditions. The report stresses the importance of a healthcare system that promotes self-management and preventive care, and information being shared between patients and professionals and across different organisations.

In terms of the changes that lie ahead, she believes physios need to embrace working with ICT. Pen concurs: 'Within every trust there should be someone leading on this area. Find out who they are and get involved - it is only by becoming involved physios can get things to work to their advantage.' The same is true for iCSP - it's only by getting involved physios can see how IT can work for them.

A national electronic information spine

NHS care records service: every patient will have a central electronic record, giving authorised health professionals and patients secure, easy access to medical and care records. The record will identify essential details and any care and treatment clients have received, plus patient contact with all care providers. Gradually being rolled out over the next few years, the system becomes fully operational in 2010.

Choose and book: this system allows patients who need referring to a consultant or other practitioner, to choose the time, date and place of their first hospital or clinic outpatient appointment. They will be able to book the appointment on the spot, while they are with the GP, or later, either online or through a telephone booking system. The system is currently being introduced.

Electronic transmission of prescriptions (ETP): prescriptions issued by GPs and other prescribers will be transferred electronically to the pharmacist chosen by the patient. The intention is to make the service more convenient for patients, and pharmacists, armed with more information, will be able to offer more tailored advice. Better knowledge of patient's medication histories will also mean improved patient care.

Picture archiving and communications systems (PACS): PACS can store, distribute and display digital images such as electronic x-rays and scans. Images can be immediately distributed across several NHS locations. Forming a key part of every patient's care record, the images will also be stored centrally. Benefits for patients include more effective care with clinicians and care teams working together across locations, and faster access to medical imaging services and results. N3 - the national network: this is a new high-speed broadband network replacing the private NHS communications network NHSnet. Underpinning the other reforms, the result is faster, more efficient services for patients with online access to records, and visual images when needed. Specialist care will also be more widely available through remote diagnosis without patients having to travel miles to specialist centres.

Contact: a centrally managed email and directory service provided free to NHS organisations in England. Quality Management and Analysis System (QMAS): an IT system giving GP practices and primary care trusts objective feedback on the quality of care they deliver.

Further info: Connecting for Health website


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