The challenges facing the Local Health and Care Record (LHCR) programme in GM.

Scott Watson, Director of GM Interoperability, leads on the architecture for the Local Health and Care Record (LHCR) programme.

In this post, Scott sets out some of the background for the development of the LHCR and the challenges his team need to overcome.

Over the last two years working with the GM Health and Social Care Partnership, I’ve been presented some of the most substantial digital challenges of my career. I deeply empathise with clinical and care colleagues when they share frustrations about wanting to do what should be simple. Our personal lives have been enriched with TV and music streaming services, online shopping, and super computers in our pocket with an App for almost anything we can think of. Why can’t we share a clinical record between two organisations looking after the care of a single patient?

The challenges we face in health and care don’t require new technologies to be invented. Proven tools very much exist and given the opportunity, our public health services can be equivalent to the rest of our modern digital lives. The issue we face is the huge legacy of technical debt built up over decades of independent, non-standards based solutions and suppliers who feel if they constrain the sharing of data, they control the market. This is going to take some time to unpick.

Recently I heard someone very senior within the health system suggest that organisations will resolve this issue themselves over time, and that intervention at a ‘system’ level is unnecessary. Unfortunately, organisations are barely keeping their head above the digital water line as it is. The demands on organisations’ IT teams has grown considerably over the last two decades and unfortunately investment hasn’t matched this. It’s the citizens with pathways across the organisations that desperately need an advocate to take up the digital mission. Programmes like LHCR are yet another demand on overstretched resources and a tough sell to a CIO. However, that doesn’t mean it is the wrong thing to do.

So how can LHCR help? The NHS England programme has given us a mandate to do something different. The aspiration is not to buy or build another health mega-suite (surely we’ve learned that lesson enough times now), but to create a core digital foundation for others to innovate at pace. We desperately need to scale the opportunity for new partners to help us solve the problems. To work with suppliers, SMEs, university students, whoever; to develop new solutions on bedrock foundation of a core record and supporting technical services that guarantees high availability and clinical safety.

The brilliance of the NHS needs to be expressed through unleashing the clinicians, patients and carers into a digital environment that empowers them to innovate.

My job is to establish the digital plumbing and boring bits, so others can transform the lives of the citizens of Greater Manchester. The success of LHCR will be the innovation that follows. It’s difficult to enthuse people about an empty sporting stadium, but when it’s at capacity and the best in the world are on display, that’s the magic.

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