Informatics in a post-Francis era

 Jean Roberts has been involved in health informatics since the early 70s; in the NHS, for solution and service providers, academia and now as the Director (Standards), UK Council for Health Informatics Professions (  In a  guest blog she writes on the importance of informatics and informaticians in the light of the Francis report.

There are significant areas where health informaticians can help with appropriate information in the right context to support ongoing decision making and monitoring post-Francis.

I was delighted that an informatics-competent professional was recognised in the Francis report as a necessary asset at Board level. I hope it happens. To make the most of such a Board asset, the professional’s capability, capacity and professional principles will need to be understood.

The current focus on the faster introduction of electronic health records [EHRs] is only one area; there is a risk that the politicians and the NHS per se fall into the trap that if the systems exist all will be well -they in fact need to be designed, developed, delivered and operated by professionals who understand the health domain in all its idiosyncratic ways. Patient safety is paramount but the front-line staff need to have good decision support and that will need extraction and interpretation in the light of specific contexts.

For example looking at an ‘average’ mortality normal range is inappropriate if certain hospitals are ‘on take’ for the more complex challenging cases as well as a ‘normal mix’ of cases – sadly a larger proportion of the very sick will die than normal, but specialist locations with excellent staff and appropriate resources will save more than would have otherwise died, but it takes a skilled analyst to build and present that case, even if they have the ear of the Board.  Hence I continue to repeat that business intelligence analysts and health informaticians need to be professional, domain-sensitive and domain-literate…. and their patch will get more complex as it starts to include social care interventions and medical tourism.

One response to “Informatics in a post-Francis era

  1. Since I wrote these observations recently two further informatics-related incidents have surfaced and are being investigated (in Bolton – death rate mis-recording; and Wolverhampton – organisation wishing to reduce mortality rates, where the health informatician refused to manipulate data as requested). Professionalisation of health informatics is one very real need if the NHS is going to regain public trust.


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