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For its part, the government is keen to promote growing use of technology in the NHS and in February, the Department of Health and National Information Board announced that IT expert Professor Bob Wachter has begun a review of computer systems across the NHS.
The review will address issues such as electronic health records, as the NHS aims to achieve a paper free health system by 2020, will also consider the experiences so far of clinicians and trust leaders with regards to IT, and will examine current capacity and capability of trusts’ IT systems. It is due to report back in June 2016.
Meanwhile, the first wave of a joint programme called NHS Innovation Test Beds was launched in January. This collaboration between NHS England, the Office for Life Sciences, the Department of Health and the Department for Culture, Media and Sport is designed to modernise care.
Seven different sites around England will pilot new ways of helping particular patient groups including older patients, people with long-term conditions and people with mental health problems.
The pilots bring together local health bodies including clinical commissioning groups (CCGs), hospital trusts, and primary and community care providers with a range of innovative tech firms to use technology to address some of the most complex issues facing patients and the health service. The tech firms involved include Verily (formerly Google Life Sciences), IBM and Philips.
Frontline health and care workers in the chosen areas will pioneer and evaluate the use of novel combinations of interconnected devices, such as wearable monitors, data analysis and ways of working intended to help patients stay well and monitor conditions themselves at home.
There are remarkable opportunities to harness technology in healthcare, as long as the NHS is open to change, says Giles Peel, Head of Governance Advisory Practice at DAC Beachcroft.
“Technology saves time and money in all areas of life,” says Peel. “But what you don’t want is the market rapidly becoming unregulated, with all number of people offering services online or by app and you have no idea of what their quality is. The health profession has got to embrace it, lest they lose control of it.”
He goes on: “There are quite a lot of areas where technology has advanced so much that things can be done in a fundamentally different way. There are apps that are staggering in their versatility and importance.”
Mental health is one area that is benefiting from new technology. Moodnotes is an app developed by UK-based firm ustwo [sic] as part of a joint venture with US developer Thriveport.
Launched in August 2015, it is a mood tracking CBT (cognitive behavioural therapy) and journaling app for people to track their moods and develop healthier thinking habits.
Designed with clinical psychologists, the app is intended to help people become more aware of their moods, help them identify which thinking traps they are falling into and to facilitate an experience that helps them develop more positive thinking habits.
Dem Gerolemou, a product designer for ustwo, is a firm believer in the potential of apps to help improve healthcare.
“Currently we have a lot of lifestyle-type data being recorded that I suspect we are not particularly aware of. Being able to pass this on to healthcare specialists could potentially mean they see things that they may have [otherwise] missed or may not have been able to tell just from a check-up. It’s opening up the door to a multi-textured, rich image of our lives through technology.”
Capturing data safely and securely through apps is an issue that still causes concern. Andrew Rankin, Associate at DAC Beachcroft, says: “Developers and suppliers of apps need to comply with the requirements of the Data Protection Act 1998, and to that extent apps are no different to the use of any other technology. However, complying with legal requirements can present extra challenges where, for example, a user interface is presented on a small screen, and the user wants immediate convenience.”
There is also an element of age profile that plays a part in this debate, according to Peel.
“There is a generation from about [age] 45 onwards who are very fussy about having their personal details shared, but I think the app generation don’t care as much [about that].
“The technological leaps that are possible with a population that doesn’t mind its details being shared – including medical confidentiality – is a hugely important change. And it is one that I don’t think the regulators, government or the health service have really got their heads around,” adds Peel.
To discuss the issues raised in this article, please contact Andrew Rankin on +44 (0)161 934 3220 or firstname.lastname@example.org
New EU Data Protection Regime – what are the implications for employers as data controllers?
Previous alerts have covered the broader aspects of the GDPR. In this month's editorial, as we approach the formal adoption of the GDPR, Khurram Shamsee, employment and data protection specialist, focuses on some of the key implications of the GDPR for employers as data controllers.
Click download to view the full alert.
The Criminal Justice (Offences Relating to Information Systems) Bill 2016, more commonly referred to as the "Cybercrime Bill", has finally been published by the Department of Justice. The purpose of the Bill is to implement the European Union's harmonising legislation introduced by European Union Directive 2013/40.
While the Bill as published introduces the required aspects of the Directive, albeit not doing so within the required timeframe for transposition of the Directive, it is perhaps a missed opportunity on behalf of the Department in respect of other areas of cybercrime.
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Although the concept of IT outsourcing (and indeed business process outsourcing) has been around for many years now, it is easy to forget that it often happens within a very complex context – market developments, technological change, cultural changes to the use of technology and sharing of data as well as economic and political trends, all play their part.
Given the economic climate of the last few years, the ever-growing clamour for better quality and more integrated service provision and the demographic changes that are reshaping thoughts around provision of healthcare in the UK, it is perhaps surprising that the NHS has taken so long to come to the realisation that it really must focus back in on its core business and, for non-core tasks and activities, join the ranks of other organisations that have long since seen the sense in using outsourcing as a means of maintaining flexibility and responsiveness to change whilst maximising the opportunities to benefit from economies of scale.
So, as a relative newcomer to the field, what are the basics that an NHS organisation should be thinking about if the idea of IT outsourcing appeals?
Taking the obvious potential upsides first, IT outsourcing presents an ideal opportunity to turn fixed costs into variable costs and at a more granular level than might have hitherto been the case. It can result in the replacement of legacy systems with far more efficient technology, provide significant service improvements, the chance to use new tools, new skills and new know-how as well as avoiding the need for upfront capital investment.
However, although all of those things may be deliverable, none of those things will be measurable unless there is some way of working out what the current service actually looks like and what it currently costs. (There may even be a happy surprise if it turns out that the existing internal service provision is both cost-effective and efficient!) This is where a lack of internal visibility and failure to plan properly can cause the unwary to very quickly become unstuck, similarly, failing to appreciate that this great new opportunity will almost certainly be perceived as a threat, by some within the organisation, can easily derail a project.
It is for this reason that considerable time and effort must be invested in bringing together a suitably skilled team for the project; preferably with board level sponsorship, and certainly consisting of financial, legal, technical and HR professionals. Ideally they will be released from their "day jobs" to focus on the issues at hand, which means that some element of back-filling will also need to be considered. The use of specialist consultants with new skills or to plug gaps in resource can be high beneficial; just as long as the organisation remembers that this is its project and the consultant will likely move on at some stage, so it cannot simply delegate responsibility and then forget about it.
That team will need to thoroughly understand the current internal service provision (both "as is" and desired future state) and its cost (the so-called "base-case") before engaging with the market to find a suitable provider. Suppliers will then use that information, whether provided in writing or presented through access to a data room, to work up their pricing. The scope of the services, transfer of existing assets and third party contracts, quality of the base case, required service levels, transferred and other risks, contract duration etc will all then inform that pricing. The importance of the quality and accuracy of the information that is provided to the supplier cannot, therefore, be overstated (in terms of ensuring that any premium that the supplier adds to its pricing to guard is as low as possible).
Of course, in the NHS there are the public procurement rules to also consider (competitive dialogue lends itself well to any outsourcing project, allowing exploration of solutions that might not otherwise have been immediately apparent) as well as potentially complex pensions issues, if staff are also transferring to the new supplier.
So, in a nutshell, what are the most likely conditions for success? In our view, having clear objectives, a sound business case, realistic expectations in terms of time, effort and resources, understanding supplier drivers, having a fair and balanced contract and investing in effective management are the most important determinants of that.
In addition to those covered in our Alert last week for Health employers on the UK Shortage Occupation List changes and the new NHS surcharge, a number of key changes to the immigration rules came into effect on 6 April 2015.
Happy New Year to all our readers. We hope you enjoyed the festive break. 2015 is likely to be a busy year for HR professionals and employment lawyers: shared parental leave and pay becomes available on 5 April and a range of employment issues will be debated in the run up to the general election.
DAC Beachcroft's Banking & Finance Disputes Journal focuses on events occurring within the banking, financial, city business and general regulatory sectors that give rise to or concern contentious matters, civil or regulatory.
In May there were a lot of interesting developments in employment law. We've already alerted you to one of these: the British Gas case concerning commission and holiday pay. There are lots of discrimination cases covered in this alert, as well as a helpful case where the EAT found the dismissal of an employee, who tested positive for cannabis, was fair and it was not necessary for her employer to carry out any further investigation.
In-scope authorities must comply with new minimum standards for products and services which are purchased, or buildings which are purchased or rented, on or after 5 June 2014. A new Procurement Policy Note (Action Note 07/14) requires compliance with set energy efficiency standards when purchasing products and services, and purchasing or renting buildings to ensure government compliance with the Energy Efficiency Directive 2012/27/EU. The PPN issued 3 June comes only just in time to meet the implementation date required by the Directive of 5 June 2014.
The PPN notes that the Directive requires the government to encourage other public bodies to follow the Central Government example but goes no further in terms of requiring steps to be taken.
For an aggrieved unsuccessful bidder, bringing a procurement challenge requires fast action in circumstances where the bidder may not be able to point to each and every breach of the Public Contracts Regulations 2006, and is often acting with little more than a feeling that something was not quite right with the process.
The Supreme Court has ruled that a solicitor who was a member of a limited liability partnership was also a "worker" for the purposes of protection against detriment and dismissal under the Employment Rights Act 1996.
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