DH Coding for Success Review
- Published on Tuesday, 04 January 2011 00:00
- Posted by Janice Kite
The DH has published its own "Review of Coding for Success Implementation", undertaken by the Auto-ID and Patient Safety National Oversight Group (APSNOG).
A recap: ""Coding for Success simple technology for safer patient care" was published by the Department of Health in February 2007. It described ...bar-coding and similar coding technologies, and the positive impact they could have on healthcare, particularly patient safety... [and] ...that the GS1 Standards for coding should be adopted throughout the healthcare system in England, both for manufactured products and for coding systems used within healthcare settings, such as patient identification codes on wristbands..."
A key role was given to Connecting for Health (CfH) (now strengthed by Information Standards Board for Health and Social Care (ISB) various standards for coding); CfH has the contract with GS1 UK and the review acknowledges the progress made with 300 trusts now registered with GS1 UK and that numerous "demonstrator" projects have been undertaken (eight interesting examples are included in the document)... where "Benefits have tended to be broadly similar across all projects...includ[ing]reduction in errors... increased traceability... quicker, easier and more accurate process of identif[ication].... Patient safety... cost and timesavings, effort reduction and have led to services becoming more patient-centric... [and] improvements to staff wellbeing and patient satisfaction...." In addition "Connecting for Health has taken on the task of undertaking work to determine the current use of auto-identification technologies in the NHS, particularly evaluating the benefits. Work has just started and will form part of Connecting for Health's business continuity work."
The benefits shown from the demonstrator projects will be of no surprise to those familiar with the benefits that implementation of AIDC technologies can bring to organisations. However, as highlighted in my prior post, the E-Health Insider article "Judgement day arrives for CfH and NPfIT" states "...CfH will disappear as a brand and the already much reduced agency will be dramatically scaled back... Many of the responsibilities of CfH are expected to be taken on by the Department of Health Informatics Directorate...".
Is there a disconnect between the earlier article and the review? Perhaps. More likely getting the review approved for publication was less of a priority than getting the White paper (Equity and Excellence: Liberating the NHS) and related documents (e.g. the Arms Length Bodies Reform (probable source of the eHealth article)) published...
But as CfH has (had) such a key role, how will that affect continued progress and continued, wider implementation across the English NHS? Additionally, it is not clear if the "...work to determine the current use of auto-identification technologies in the NHS..." will happen either!
As well as CfH, the NPSA was a victim of the Arms Length Bodies Reform too. They have had a pivotal role in improving patient safety. The Coding for Success review acknowledges this: "The [NPSA] has played, and continues to play, a key role in the development and promotion of technologies that can lead to safer services...". I continue to be concerned about how, beyond the NHS Board, the vital patient safety work of the NPSA (an organisation envied across the world) "...will be supported...". Particularly as there is a long way to go to ensure that English NHS organisations have implemented NPSA Patient Safety Alerts (see: 13th August post: AvMA Report: Implementation of NPSA Patient Safety Alerts).
Before considering the supplier community, the review acknowledges that "...considerable progress has been made to introduce a coding culture to the NHS..." BUT "...there is still more work to do..."
On the supplier side the review accurately reflects that identification of pharmaceuticals leads the identification of medical devices; which reflects a global trend. Largely because of the number of adverse events related to and counterfeiting of [particular types of] pharmaceuticals has, and continues to be, more prevalent than that of medical devices. In addition the diversity and packaging of medical devices presents identification challenges (e.g. how to identify a product that is regularly re-processed so that the identification is maintained).
In addition to local tender requirements (e.g. of NHS Supply Chain) to adopt GS1 Global Trade Item Number (GTIN) mention is made of a few of the numerous regulations for product identification (e.g. EU Pharma. Package, EU Recast of Medical Device Directives (MDD), US FDA Serial Number Identifier (SNI), US FDA Unique Device Identifier). There are others, e.g. India, Brazil, Canada, Australia...) that are driving the increased adoption of GS1 standards globally.
One item that I can provide an update on is that the work between ICBBA (for the ISBT 128 standard) and GS1 has successfully concluded, see GS1 Healthcare press release of 15 Sep 2010: "New guideline enables safer delivery control process for plasma derivatives"
The Gs1 Healthcare User Group (GS1 HUG UK), the group established to provide the link between the NHS (providers, CfH, NPSA etc.) and Suppliers is hosted by GS1 UK and, as there is nothing in the review to indicate its demise, one can assume that it will continue.
As one of the first two Co-Chairs (along with Rachel Hodson-Gibbons, ex-Head of eProcurement at NHS PaSA), I hope that assumption is correct as the review confirms it is fulfilling its original brief, i.e. "...to be a single source of knowledge, best practice and implementation support for data standards to all UK healthcare providers, trade organisations (manufacturers, wholesalers, distributors) and regulatory agencies. It also provides input and direction to the development of global standards in the healthcare industry supply chain."!
The review's conclusion is reasonable and the final paragraph states "We need to ensure that unique coding standards drive the application of codes across the NHS, and the Department of Health has this as part of its ongoing work programme to continue to push the requirement for GTINs and encourage NHS to utilise technologies in the procurement process."
There's the rub!
Unfortunately, due to publication of the White Paper (Equity and Excellence: Liberating the NHS) and the Arms Length Bodies reform, in particular the changes affecting CfH and NPSA, it is not clear how the progress made will continue...
Like every aspect of the NHS, I guess it is watch this space! I will be!