EPR divergence in a local area ‘will not be supported’ under HSLI


Sustainability and transformation partnerships will be expected to standardise clinical IT systems across the local health economy as part of the £412.5m Health System Led Investment programme.

A prospectus for the programme, which was shared exclusively with Digital Health News last week, reveals that projects which risk increasing the diversity of IT systems within an area will not be favoured within the NHS England-led initiative to bolster provider digitisation.

It specifically states that sustainability and transformation partnerships (STPs) will be expected to support a move to a standard electronic patient record (EPR) system across all organisations in a geographic patch.

The document reads: “Investment in solutions that would result in the divergence of services, systems or infrastructure across the local health and care system should be avoided, unless a compelling rationale can be made. Specifically, EPR divergence in a local healthcare system will not be supported.”

It emphasises “there should be a focus on standardising IT solutions across health systems to simplify data sharing, ease staff movement between providers and reduce the total cost of ownership”.

Under the Health System Led Investment (HSLI) programme, STPs will be allocated a set amount of cash for developing local provider digitisation plans.

While the investment agendas will be set by STPs, it will be down to individual health and care organisations to spend the funds.

The requirement of EPR standardisation suggests something of a departure from the ‘national support, local decisions’ attitude which became more prevalent following the disastrous National Programme for IT (NPfIT).

Interoperability standards will also be a key requirement of STPs and Integrated Care Systems (ICSs) under the Health System Led Investment (HSLI) programme.

Health systems will be expected to “ensure provider organisations comply with national interoperability standards designed to enable the effective sharing of data across care settings.”

This includes the promotion of open APIs that enable the sharing electronic patient health records, and the use of consistent sets of terminology and diagnostic codes such as SNOMED CT.

By December, STPs will need to ensure that providers have enabled delivery of Open APIs using CareConnect profiles, “or have locally agreed plans in place to do so.”

The prospectus, which also revealed plans for fresh waves of GDEs, goes on to suggest that NHS England will provide key interoperability priorities that provider organisations will be required to work towards, under the direction of STPs and ICSs.

This includes the sharing of structured basic observations; sharing of structured dates and schedules; sharing of structured basic pathology information; sharing of medications that are machine readable and interoperable; and use of the NHS number at the point of care.

HSLI funding will be doled out to the 44 STPs in phases, with 25% given in 2018/19, another 25% given in 2019/20 and then the final 50% handed over in 2020/21.

At a national level, £104m is available in 2018/19, £92.4m in 2019/20 and £261.1m in 2020/21.

STPs have between 1 September and 5 October to submit their final investment proposals.

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