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3 The challenge
NHS Scotland delivers many patient contacts with many staff in many locations, with each contact requiring a record. Making these records and other useful information available electronically will make patient care more informed, safer, and independent of where the patient makes contact with the NHS.
To illustrate this, the diagram below shows a patient's journey through cancer-related services. Even though simplified, it demonstrates the extent of hand-overs of care and the multiple 'silos' of patient information which can result. Moreover, if these silos are pieces of paper in cabinets then essential communication becomes even more difficult.
A 'paper-light' NHS Scotland will offer fast, local and reliable access to patient services through the use of appropriate technologies. Achieving that will require investment and systematic change in the way we work, right across the service. Where IT systems do exist, they are often ageing, sit in silos, vary between NHS Boards and are mainly administration focused as opposed to helping healthcare professionals get access to the information they need to provide the most effective help to patients. We have already successfully implemented initiatives such as SCI Store, SCI Gateway and the Emergency Care Summary which help us to join systems and share information but we need to move further.
An attempt to move to this new world in a single bound, even if achievable, would take a number of years and would be disruptive. NHS Scotland has to date chosen to approach this vision step-by-step; by building on what we have already successfully achieved, carefully addressing risks and resources to gain benefit from our effort as we go. The investment plans over the next three years will balance changes intended to provide immediate benefits to patient care and meeting today's challenges with steady progress toward a longer term vision.
Patients and their carers also need information. If we want to support patients to take more responsibility for their health, then they need more ready access to their personal health information, guidance on its interpretation and its potential to support improvement in their well-being.
Added to these challenges is the fundamental need for robust information governance as part of a wider information assurance 2 strategy. This is about making sure appropriate information is available when it is needed, accessed only by those who should have access to it, and that it is correct and up-to-date. We need to assure ourselves that we have balanced arrangements which support both duties of confidentiality and the interests of patients in receiving safe and effective care. These arrangements must carry the trust and confidence of both patients and healthcare professionals.
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