Andrew Lansley’s NHS reforms were hardly popular to begin with, but the demolition of Primary Care Trusts threatens to unleash a firestorm of data leaks and screw-ups, writes Oliver Milne.
Concerns have been raised about a procedure that will see Primary Care Trusts transfer public health data, both anonymised and individual, to local authorities, who are to take responsibility for overseeing and commissioning public health and social services.
Local authorities are due to take over the running of public health functions from Primary Care Trusts in April 2013. They will have to integrate and transfer data with the colossal NHS information management body Connecting for Health.
The integration of patient data from PCTs, the Department of Health, local authorities and private companies providing healthcare on a contract basis is likely to be unwieldy, vastly increasing the potential for data leaks and loss, mismanagement and presenting substantial costs for the taxpayer.
Social workers and local authority staff have told The Kernel that there are serious incompatibilities between ageing local authority data management systems and NHS databases. A social worker familiar with the matter, who spoke on condition of anonymity, said:
“Primary Care Trusts benefit from having a formal relationship for data management with the rest of the NHS, ensuring harmony between clinical and public health data. Local authorities don’t have this relationship and the archiving systems are basically incompatible. This is going to be an expensive fuck-up.”
Officials are concerned about the effect Health Secretary Andrew Lansley’s reforms will have on the integrity of public health data, which will be gathered by new Clinical Commissioning Groups, bodies responsible for overseeing NHS services.
Primary Care Trusts had a defined geographic remit. Clinical Commissioning Groups, under the auspices of “widening patient choice” in a blended public and private healthcare system, are being encouraged to take on patients from other areas.
Allyson Pollock, Professor of Public Health Research at Queen Mary, University of London has expressed concern in a report for the British Medical Journal that this move away from geographically-organised population data is likely to have a devastating effect on public health as the effects of new legislation and reforms on particular areas become almost impossible to measure.
She told The Kernel: ”It will make it virtually impossible to provide resources on the basis of need and to measure access to care and coverage across groups in society. It undermines the whole basis of a universal health care system.”
Department of Health recommendations suggest local authorities, Clinical Commissioning Groups and Primary Care Trusts put systems in place to ensure effective data transfer by the end of September. But a senior source familiar with the matter says that even if the process is agreed on, the technical aspects of this challenge will be insurmountable for most councils without a cash injection from central Government.
Our source warns: “Even if, by some Herculean feat, we end up managing to transfer this data to local authorities, [Andrew] Lansley’s obsession with commissioning these services to the private sector at the local level means your data will only be safe if local authority staff who are involved in the commissioning process are familiar with the technical issues.