The Commissioning Review reporter Lalah-Simone Springer had a chat with Tim Kelsey, NHS England’s Director for Patients and Information to debunk myths around changes to the IM&T infrastructure while working out his vision for the NHS
The Commissioning Review reporter Lalah-Simone Springer had a chat with Tim Kelsey, NHS England’s Director for Patients and Information to debunk myths around changes to the IM&T infrastructure while working out his vision for the NHS
Lalah-Simone Springer: Hey Tim, nice to meet you! I’ve got a few questions I think our audience would be interested in, so let’s just jump in.
First of all – what’s your vision for primary care?
Tim Kelsey: I want us to build a world-class primary care service in general practice, building trust between medical doctors and the local community. At NHS England we help doctors to be much more active in delivering a higher standard of customer service. We want to deliver better outcomes for patients by giving them better information and helping to support them with better technology.
This is about enhancing the role of the primary care physician rather than changing the fundamentally important service that primary care offers.
L: But hasn’t the introduction of clinical commissioning groups changed the role of some GPs at least?
T: I don’t think so, actually, I think it’s very important that we have local clinicians leading commissioning, that’s a fundamentally good idea. I’ve met with many commissioners and general practice providers – and some who are both – and they’re very able to distinguish between their roles.
I think this is a turning point for the health service. We’re saying that local doctors should take responsibility – and they should want to take responsibility – for commissioning local services, while we as NHS England, want primary care to develop and improve as much as it can.
I don’t see any issue with having the GP as both commissioner and provider; I think it’s the right thing to do.
L: Moving on to Choose and Book – some have said it’s going to be relaunched with no fundamental changes, but I’ve also heard it’s going to be on a whole other platform – could you clarify?
T: Choose and Book is in many ways a fantastic system. To be able to book appointments against the entire national cohort of provider institutions is quite an extraordinary achievement. But for historic reasons it hasn’t achieved universal take-up among GPs – there had been all sorts of problems with quality of data in relation to appointments.
So what we’re going to do is relaunch the service, it’s not going to be called Choose and Book anymore it’s actually going to be called e-Referrals – that’s the working title at least.
The idea is to restate the offer of a digital referrals system to GPs and encourage them to make more use of it but also to make it much easier for patients to access the system themselves.
L: Will there be other options, or will GPs have to start using the relaunched Choose and Book?
T: Over time it will become mandatory that providers both in primary and secondary care should move to paperless referrals, but I’m very confident that once clinicians and practice managers realise that a paperless system is easier to use and better for patients then people will not need to be forced to use it, they’ll very much want to use it.
The number of GPs who offer the service has risen very significantly, and also it’s now in the contract that GPs start moving towards that service for patients, and also it’s a requirement of the NHS England mandate that all patients that should have online record access by March 2015.
L: So, what changes will primary care expect to see once more technology is in use?
T: In terms of primary care, a combination of better data and better technology will make it much more focused on the patients who need services most. It will help them to support patients who might otherwise just end up revolving through hospitals unnecessarily, because they will be able to identify people more accurately.
Things like the online primary care strategy will really support primary care physicians – and not just GPs by the way, but primary care managers too, to make better use of their own time, really supporting the people that need the help most.
L: Generally speaking, do you think there’s support from the frontline to make these changes?
T: I think we’re in danger of casting the clinician somehow as resistant to change, but my experience has been that the vast majority of clinicians – maybe not all of them, but the vast majority – want the opportunity to have better engagement, information and technology to improve their own services.
But this is a big change. We’re on a journey and it’s very much about developing, together with clinicians, a very clear view of how we’re going to make the information revolution happen in primary care.
My job is to do that in a way that will always be led by clinicans, because that’s the way we make it sustainable.
Tim Kelsey, National Director for Patients and Information, NHS Commissioning Board, will give two addresses at the Commissioning Show, which will be at London ExCeL on June 12-13.
