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A network to support the new models of care with information governance

For the new care model vanguards and the integrated care pioneers, who are redesigning care on an industrial scale, information Governance (IG) has the potential to be a major headache. In this blog, Geraint Lewis, Chief Data Officer at NHS England, discusses the launch of a new collaborative network aimed at ensuring that IG becomes a tool to improve health and wellbeing rather than being perceived as an irritation or a barrier to good work. 

Information governance. Seven syllables that can instantly strike a sense of dismay, despair or despondency into the heart of anyone who wants to improve how their NHS service is organised and delivered.

Like many people, I have mixed feelings about IG. On the one hand, it clearly has a vital role to play in ensuring that NHS services obey the law of the land and in reassuring patients that the NHS will look after their confidential information carefully, fairly, and securely. On the other hand, however, there is a widespread view that IG in England has become too Byzantine in its complexity and that in practice, it is too risk averse and too inflexible to meet the modern needs of patients and clinicians.

This network will be different.

The IG professionals working with me to launch this new network are, to a person, determined to change the face of IG for the better. Our collective aim is to be open, straightforward and helpful. We want to ensure that the vanguards and pioneers feel empowered to take a sensible and proportionate approach to privacy and confidentiality. We’ll do this firstly by challenging some of the myths associated with IG but also by holding national bodies to account where their guidance is outdated or unwieldy, or where we hear that they are not being responsive enough to the new requirements of the service.

Backed by the Information Governance Alliance, the IG network will support the vanguards and pioneers by promoting the use of national tools, such as privacy impact assessments, and by refining and promoting local materials, so that sites do not duplicate work that has already been done by their peers elsewhere. We will listen carefully to the vanguards and pioneers to identify where there are problems that we need to resolve and to see where more support and advice is needed.

Like its sister network for population health analytics, which we launched a few weeks ago, this will be a supportive and collaborative network. Rather than issuing yet more reams of guidance, we will focus instead on co-developing frameworks, checklists, flowcharts and templates. Our guiding principle will be to simplify processes and to provide a consistent approach to IG.

The new network is being hosted on an online platform called the futureNHS collaboration. It includes chat areas for the vanguards and pioneers, which will be complemented by a rolling programme of Webex presentations, Q&A sessions and face-to-face meetings. In order to help members of the network navigate their way around the platform, we have organised it according to the structure developed last year by colleagues at the Local Government Association. They found that pioneers were using data and information for six purposes (see below). The platform will therefore include individual pages for all six purposes, each of which will include materials and links to relevant resources, plus a dedicated chat area.

  1. Sharing information electronically (integrated digital care records)
  2. Care coordination, planning and delivery (supporting the coordination of care across providers)
  3. Risk stratification for case finding (identifying those at risk of an adverse event)
  4. Tracking outcomes across a pathway of care (tracking particular cohort groups, irrespective of care setting)
  5. Developing alternative payment models (including capitated budgets)
  6. Understanding current and future population needs (strategic and commissioning needs analyses)

Ultimately, the purpose of this network is to empower the IG representatives of each vanguard and pioneer to achieve the aims of the NHS Five Year Forward View. But while the primary aim is to support these people, if you are working on a similar initiative, such as a primary care home or test bed, or if you are otherwise keen to help, we would really welcome your input. Please contact england.ignetwork@nhs.net for details about how you can get involved.

Geraint Lewis

Geraint Lewis is the Chief Data Officer at NHS England and an Honorary Clinical Senior Lecturer at University College London. He trained in medicine at the University of Cambridge and holds a Masters degree in Public Health from the London School of Hygiene and Tropical Medicine. Geraint began his career in acute and emergency medicine, working at hospitals in the UK and Australia over an 11-year period.

After completing his higher specialist training in public health medicine, he was appointed Senior Fellow of the Nuffield Trust (an independent health policy think-tank), then as Senior Director for Clinical Outcomes and Analytics at Walgreens in Chicago, before returning to the UK to take up his current post.

A fellow of both the Royal College of Physicians of London and the UK Faculty of Public Health, Geraint is the lead author of the postgraduate textbook Mastering Public Health and has published over 40 peer-reviewed articles in journals in including Health Affairs, JAMA, Milbank Quarterly and the BMJ. Geraint was a 2007 Harkness Fellow in New York, during which time he received the National Directors’ Award at the U.S. Department of Veterans’ Affairs. In 2008 he was the “overall winner” of the Guardian Newspaper’s public service awards. In 2011, he was awarded the Bradshaw Lectureship of the Royal College of Physicians of London. Previous recipients include Sir Liam Donaldson, Dame Sheila Sherlock, and Sir Magdi Yacoub. More recently, he has served as an external adviser to the World Bank, and he leads the Care Model Design work-stream of NHS England’s New Care Models Programme.

5 comments

  1. Kassander says:

    ” We will listen carefully to the vanguards and pioneers to identify where there are problems that we need to resolve and to see where more support and advice is needed.”
    ==
    And where do we Patients & Public fit in – where & when do our elected representative enter the ‘co-production’ exercise?

    • NHS England says:

      Dear Kassander,

      Thank you for your comment.

      The principles of patient engagement are at the heart of the new care models. The support the national programme provides to the vanguards has been developed in response to the vanguards’ needs – patients and the public shape the vanguards, which in turn shapes the programme that supports them.

      One of the national workstreams providing is “Empowering patients and communities” – working with the vanguards to enhance the way in which they work with patients, local people and communities to develop services, and to increase the activation and engagement of individuals and communities in their own health and wellbeing.

      A number of practical examples of how patients and the public fit in can be found below:

      1) Modality MCP (Birmingham & Sandwell) has recruited volunteers to support the health of local communities. Modality has trained hundreds of local people from a range of ethnic and social backgrounds to help others from within their communities to take practical steps to improve their health. Their role includes helping to identify people at risk of developing long-term conditions such as diabetes or heart disease and promoting healthier lifestyles. They also raise awareness of key risks to health, such as cancer and tuberculosis (TB), and help identify new cases of dementia by giving a basic cognitive (mental ability) test during home visits. More information can be found at http://www.modalitypartnership.nhs.uk<http://www.modalitypartnership.nhs.uk>

      2) Manchester Cancer Vanguard has engaged people affected by cancer to work with the Macmillan User Involvement Team (MUIT) to develop and carry out the selection process for the new members of the Team. Two new Macmillan User Involvement Managers and a Programme Support Officer were recruited. One of the Managers will be fully dedicated to the Greater Manchester Cancer Vanguard, whereas the others will focus on the involvement opportunities within Manchester Cancer.

      3) North East Hampshire & Farnham PACS recruited 80 Community Ambassadors as part of their Happy Healthy at Home work. Community Ambassadors have helped to increase participation in GP Satisfaction Survey from 20 to 102 in a week. They helped develop program engagement plans, provided views on draft new PC plans and review of community beds. Community Ambassadors were chosen for their relevant knowledge, skills and experience with volunteers ranging from computing professionals in the private sector, to retired local councillors, through to an elderly lady with Alzheimer’s who is supported by her care worker. More information can be found at: http://www.happyhealthyathome.org<http://www.happyhealthyathome.org>

      Kind regards,
      NHS England

  2. Jayne Andrew says:

    Dear Geraint

    I have read the above with interest. I work in the NHS as a Operational Delivery Networks’ Director for three Clinical ODNs: South Yorkshire Major Trauma, North Trent Adult Critical Care and Northern Burn Care ODNs. Each ODN comprises of a number of NHS provider Trusts. We develop Network-wide clinical guidelines, protocols and policies which are often delayed in their implementation due to each Trust having to take them through their own governance arrangements. I am wiritng to ask if the work you are doing would be helpful in streamling this process for the networks.

    I look forward to hearing fro you.

    Many thanks

    BW

    Jayne

    • NHS England says:

      Dear Jayne,
      Thank you for your comment. Please could you email england.ignetwork@nhs.net where we can discuss your particular circumstances.
      Kind regards,
      NHS England

      • Jo Smart says:

        Dear Geraint,

        I am the manager for the South West Neuromuscular ODN and this is an issue faced by all ODN’s. IG across organisations regarding clinical guidelines and protocols as Jayne mentions above but also when trying to collect data across organisations.
        Would it be possible to keep all ODN’s in the loop on this please.

        Many Thanks

        Jo