U.K. NHS mandate includes expansion of health IT, PHRs and mobile health

By Anthony Brino
08:19 AM

The U.K.’s Department of Health has issued the National Health Service a two-year list of priorities, laying out goals for improving care, in part through the expansion of health IT systems and mobile health.

Under the objective of enhancing quality of life for people with multiple chronic conditions, the mandate, as it’s being called, spells out a number of goals for health IT. By 2015, everyone will have access to their online records and be able to book general practitioner appointments, email their GP and refill prescriptions online.

The NHS executive board is going to promote national standards for health information system integration, and with consent, the NHS will be able to follow all U.K. residents receiving NHS care or enrolled in the social care system. By 2017, the mandate also plans to bring mhealth, or what Europeans often call telehealth, to the 3 million U.K. residents with long-term conditions.

With the 65-year-old NHS facing the challenges of an aging population, increased healthcare costs and public budget shortfalls, Health Secretary Jeremy Hunt, a member of the British Conservative Party, wrote that the mandate is needed to keep the NHS “relevant and trusted in a rapidly changing world.” The challenge of providing care for patients with long-term chronic conditions in particular, Hunt said, is “rewriting our relationship with health and care.”

Hunt emphasized that the mandate would not change the NHS’s founding principles: “The most important of these is that the NHS remains comprehensive and universal, free at the point of delivery, and available to all based on clinical need.”

Hunt and the NHS called the 28-page mandate “the first of its kind in the world,” outlining goals for GPs and local NHS offices to meet, without being overly prescriptive.

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The health objectives include improving standards of care, especially for the elderly and terminally ill, improving the diagnosis and treatment of dementia, supporting people with multiple long-term physical and mental health conditions, preventing premature deaths and seeking economic growth by supporting employment for people with chronic health conditions.

Hunt said nearly a third of the U.K.’s 62 million residents have at least one chronic condition, and that by 2018, nearly three million people are expected to have three or more conditions all at once.

The NHS Confederation, the membership group of organizations that provide or commission NHS care, mostly welcomed the mandate. Mike Farrar, chief executive of the NHS Confederation, said it “represents a major sea change for the NHS,”

"It was really important that the government avoided stuffing the mandate to the gunnels with detailed targets for every condition under the sun,” Farrar said in a media statement. “While that might have looked superficially attractive, it would have meant more top-down prescription and less innovation and responsiveness to local needs. The real challenge for the government now is to stay true to its word and use the mandate to give the NHS stability, rather than use it as a tool to reset priorities on a regular basis."