Information key to improving NHS, says Francis report
7 February 2013
Accurate, useful and relevant information is the lifeblood of an open, transparent and candid culture, according to Robert Francis QC.
His inquiry report makes almost 30 recommendations about how information can be used to transform the NHS — and how doctors should play a full role in this.
Mr Francis says: ‘All professionals, individually and collectively, should be obliged to take part in the development, use and publication of more sophisticated measurements of the effectiveness of what they do, and of their compliance with fundamental standards.’
In his report, Mr Francis says there are about 270 healthcare databases covering the UK, England and Wales, or England only; this rises to more than 1,000 if Scottish, Wales and Northern Ireland databases are included. There are a further 104 clinical databases.
He says it is crucial that the information that is collected is appropriate, accurate and verifiable, and it can be interpreted and used correctly by NHS staff, managers, regulators and patients.
Mr Francis says patient confidentiality and security should be paramount but suggests that conventional means of NHS record keeping look increasingly outmoded and inefficient in the age of portable media devices and instant internet access.
He adds: ‘In a world in which most adults are now accustomed to operating bank accounts remotely, and dealing with other aspects of their daily lives in this way, the time has surely come for similar facilities to be developed for patients.’
BMA council chair Mark Porter said there needed to be an urgent shift by the NHS towards a more open and transparent approach that valued learning from mistakes and put the patient experience at the centre.
He added: ‘We need good systems and data to enable clinical teams to spot problems early on — and make things better.’
The way forward
The report recommendations include:
- Common information practices, shared data and electronic records — there is a need for all to feed performance information into shared databases for monitoring purposes. Electronic patient information systems should allow patients user-friendly, real-time and retrospective access to their records, and a facility to enter comments. Systems must be designed by healthcare professionals, in partnership with patient groups, to ensure both are engaged in the process and to ensure the accuracy, utility and relevance of the system
- Patients should be followed up after discharge and asked about the services they received
- The NHS Information Centre should develop a means of publishing more detailed breakdowns of clinically related complaints
- The NHS Information Centre should collect statistical information about serious untoward incidents, and make the details publicly available in the same way as other quality-related information
- Healthcare providers and their healthcare professionals should develop and maintain systems that give them real-time information on the performance of each of their services against patient safety and minimum quality standards; and of consultants and specialist teams in relation to mortality, morbidity, outcome and patient satisfaction. This should be informed by the medical royal colleges
- For each specialty, a programme of development for statistics on the efficacy of treatment should be prepared, published and subjected to regular review
- It should be the professional duty of all healthcare professionals to collaborate in the provision of information required for such statistics.
Read more about the information and data recommendations in the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, Volume 3, Chapter 26.