What does IT have to do with the patient? This is the question many people ask when they see the government spending billions of pounds of taxpayers' money on IT systems that are yet to make a significant impact on patient care.
There is widespread scepticism amongst NHS staff and patients alike; staff often see IT as disrupting rather than improving the delivery of care and patients worry about what will happen to their health care information and who will be able to access it if it is stored electronically.
The poor roll-out of the government's National Programme for IT is largely to blame for this disillusionment. Despite its benign intentions, it is five years behind schedule and at least £500m over budget.
Local NHS trusts have lost control of implementation costs after taking on one-size-fits-all systems chosen by the government, not the trusts.
Worst of all, patients are unclear about where and how their information is being held and the centralised structures of the programme leave them with little grounds for flexibility and choice.
As Conservatives we want to reaffirm the potential for IT to deliver significant benefits to NHS patients in a way that maximises choice for both local NHS services and their patients. We want to support the NHS in becoming more productive so that both patients and taxpayers get the best possible deal.
When he welcomed the review, David Cameron made this very point: "As patients, we want to know we're getting the best possible care; as taxpayers we want to know we're getting value for money: technology, well-applied, can create opportunities for both in a decentralised NHS."
So how do we embrace IT in a way that supports both NHS staff and their patients? The first step will be store all patient healthcare information locally and centre it around the patient – something which the government's national database of patient records fails to do.
In a localised vision of IT, information will follow the patient as they make use of different NHS services so that the outcome of their treatment can be measured and recorded effectively: this will require information to be collected and stored at the point of care and yet to be interoperable with the rest of the information generated along the care pathway – regardless of where the patient is treated.
Our proposal for a catalogue of accredited systems will ensure that trusts can guarantee that the information their chosen IT system stores is compatible with that stored by the patient's GP or another trust where they have received treatment.
Not only do we believe that NHS trusts should be able to choose an IT system that is best suited to their patients, we want patients to have greater control over their healthcare information. It is the patient who is best placed to assess who should access his or her health record and when.
We must, of course, achieve the right balance between safeguarding the integrity of health records by guaranteeing their accuracy and reliability and involving the patient wherever possible.
This is why we have launched a nationwide consultation on how much control patients want over their health records and why we have pledged to store health data away from a monolithic central database.
Every patient should have the right to view their health record and we are consulting on whether there is scope for patients to contribute to records by adding comments and extra information on their health if they choose to.
What is not yet decided is how patients might access this record (for example through an electronic card or over the internet) and who might provide the system to facilitate this access – does the patient want to choose a provider from a range of suppliers or would they like their record to be held on a system chosen by their GP? We want patients, doctors and nurses to have a say in these decisions.
What we are very clear on though is that we don't want any one single provider or private company to have control over patient records – instead, the patient will have the choice over how they access their information.
Healthcare data helps doctors do their job and helps our NHS become more efficient by improving patient care – it is important that we prioritise security at the same time as enabling patients, taxpayers and dedicated professionals to get the most out of our NHS.
Labour's National Programme for IT went wrong because it used patient information as a tool for the state rather than as a tool for empowering the individual service-user to receive better healthcare. We want to redress the balance so that the ultimate objective of our NHS is achieving better patient outcomes for all. That is what the Conservatives have pledged to deliver in government.
* To take part in the Conservatives' consultation on patient control of records, please send your views to evidence@healthitpolicyreview.info
