Deborah Gilpin – Principal Consultant for Health

The NHS is constantly evolving. One of the greatest transition periods ever is proposed.  The recently published white paper ‘Equity and excellence: Liberating the NHS’ (July 2010) describes what Andrew Lansley, Secretary of State for Health, refers to as a ‘Bold vision for the NHS’.

Whilst describing wholesale change, Mr. Lansley’s vision does not start afresh. Many of the core principles are established on relatively recent and existing reforms: breadth of patient choice; emphasis on quality standards and excellence in performance; and the concept of self-governing foundation hospitals are cornerstones of the proposals. The specialist knowledge gained over the past decade is not thrown away but built on and enhanced.

What is new is the sheer pace and extent of change. The abolition of (Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs), with the move of commissioning responsibilities from these organisations to GPs, creates a structural change and shift in responsibilities that has PCT leaders warning of the potential of chaos during the transition period.  Although the Royal College of GPs chair, Steve Field, states that the opportunity for GPs to “take centre stage in the running of the health service” is one that GPs have long been waiting for, many other GPs are frankly scared, or even disinterested in the thought of commissioning – considering it a specialist management task rather than an area of medicine. 

It is this specialist management task that makes the availability of timely, quality information so vital to the success of the proposed reforms.

These new GP Consortia will have a fundamental requirement not only for timely access to quality information, but they will also need the means to review and interpret detailed practice and patient level information. The challenges they therefore face will not only relate to the quantity of data, and its accuracy, but also he sheer complexity and fragmentation of data sources.

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