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Auditor says more funds needed for Welsh patient record



Report highlights problems behind painfully slow progress in plan to pull together patient data from different systems into an electronic record

Wales Audit Office has said the Welsh Government and NHS “face tough decisions on funding and priorities” to develop a national electronic patient record (EPR) in a reasonable timeframe.

The country’s central public sector auditor has published a report, Informatics systems in NHS Wales, that says the plan for an EPR has not received the necessary resources and there is no clear plan for funding or a timeframe.

There has also been a disagreement within NHS Wales about the balance between local discretion to develop new systems and the delivery of national systems, along with weaknesses in the governance and oversight of NHS Wales Informatics Service (NWIS).

NHS Wales has had plans for an EPR since the publication of the Informing Healthcare strategy in 2003 – a vision that was updated in the more recent strategy of 2015. It involves the creation of an electronic record by bringing together information held on different systems, rather than a single digital system.

Under the plan, clinicians and, where appropriate, patients will be able to access information through patient record applications that can communicate with each other.

Weaknesses and delays

But Wales Audit Office says that progress has been painfully slow, with key weaknesses in the arrangements to support and oversee the delivery, and delays in the development of some of the new systems that will support the EPR. As a result, significant additional funding is required.

In response, it has made a number of recommendations, including that the Welsh Government should define the balance between national and local systems, ensure that national and local implementation plans reflect the implications for funding, and develop a set of common standards to ensure the different systems are compatible.

There should also be a clear set of priorities for national informatics and a review of the informatics market, along with an appraisal of the options to strengthen the governance of the NWIS.

Tough decisions

Auditor General Huw Vaughan-Thomas, said: “We know that better access to information leads to better outcomes for patients and fewer mistakes by clinicians. Putting the vision of an electronic patient record into practice means all parts of NHS Wales, including the Welsh Government, need to take some tough decisions, particularly on funding, priorities and enabling clinicians to have the time and space to lead on this agenda.

“Unless it addresses the issues identified in my report, the NHS risks further frustration amongst frontline staff and ending up with systems that are already outdated by the time they are completed.”

Image from Wales Audit Office

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