The NHS information technology (IT) and social care review 2009: a synopsis.

BACKGROUND: England's National Health Service information technology (NHS IT) has been much criticised in a number of major governmental and non-governmental reports. The author was requested to write a review of NHS IT to help formulate policy. OBJECTIVE: To identify what had worked and should be continued and what was unhelpful and should be dropped from NHS IT. METHOD: Iterative process of debate with a committee of experts. RESULTS: The theme areas which emerged were: • the central importance of the record to serving individual patient care, and that this should be top priority • development of systems should be carried out as close as possible to the front-line clinicians who use them • standards and frameworks are useful centralised functions; whereas imposing detailed technical solutions across large geographical areas is unlikely to succeed and should be abandoned. CONCLUSIONS: IT should be seen as a clinical tool in health care, developed to meet the needs of patients and front-line clinicians.

Registration and regulation of health informatics professionals in the UK National Health Service.

Whilst good health informatics can contribute directly to the delivery of effective patient care, bad informatics can kill. The UK is establishing a regulatory body to register health informatics specialists who can demonstrate that they meet agreed standards of professional practice: the UK Council for Health Informatics Professions (UKCHIP). UKCHIP will also manage the introduction of a Code of Conduct (based on the IMIA Code) and processes for continuous professional development, appeals, and removal from the Register. The challenge has been to design a process that provides a suitable structure for all informatics staff, including records, coding, audit, library and knowledge management, ICT, systems, information management and clinical management specialists. The contention is that this inclusive model of regulation has international applicability.

Validating national informatics policy--the importance of operational consensus to influence positive developments.

The National Health Service in England faces reorganisation of services on a very regular basis. In 2002 a 'Long Term Review of Health Trends', commissioned by the Chancellor of the Exchequer indicated the need for a substantially larger investment in informatics to support the delivery of better healthcare overall. Subsequent to the issue of this report, the Spending Review confirmed an investment of pound 2.3 Billion (approximately $3.7 Bn) for the period to 2005 for NHS informatics, subject to performance. This paper describes the actions taken by the national representative society (the British Computer Society Health Informatics Committee) to ensure that the views of those in the field were taken into account in facilitating the best possible outcomes from this investment. In addition, the initiative established has confirmed the ongoing priorities for involvement in health informatics, regardless of professional role, in support of healthcare. The outputs and insights gained from two years of this initiative provide useful points for thought about health informatics and health management in other countries and under different models of care to that of the NHS in England.

Health informatics needs regulation and registration to add value recognition.

Education is only one step towards being recognised as 'fit' to carry out an operational role in informatics to support health at any level. For many years there has been little real 'brand image'. Although significant bodies like IMIA and the BCS welcome a wide range of professionals, there is still confusion over what the discipline really means and does. In order to become a mature profession in the health domain, particularly in the UK, it is necessary to operate a registration process that recognises both qualification and competency, and the responsibility to keep skills and knowledge contemporary. This paper describes the steps taken to establish a registration and regulatory body to maintain high quality professionalism in operational care delivery, academic and commercial organisations in the health domain. The concepts described have resonance internationally.