Future Developments in the UK National Health Service

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Chapter: Pharmacovigilance: The General Practice Research Database

The UK government has initiated a large programme called the National Programme for IT (NPfIT) that is being implemented by an Agency called “Connecting for Health” (CfH).


FUTURE DEVELOPMENTS IN THE UK NATIONAL HEALTH SERVICE

The UK government has initiated a large programme called the National Programme for IT (NPfIT) that is being implemented by an Agency called “Connecting for Health” (CfH). This programme is designed to change the IT systems of the NHS in England to foster seamless and improved care delivery. The implica-tions for the GPRD of NPfIT and similar programmes in other parts of the United Kingdom are immense and are only beneficial to the utility of GPRD in pharmacovigilance and in the wider field of phar-macoepidemiology. Traditionally, a patient’s medical record was stored on PC/server systems within the general practices. The future model is one in which the IT infrastructure is more centralised. This enables more rapid changes and updates to systems, coding changes and drug dictionaries as well as providing high-level IT service to all practices regardless of size or location. The main objective is to allow seamless health care with a patient medical record being avail-able appropriately across the health service. Thus, the GPRD will be obtaining data through improved and more simplified methods. The huge challenge for the GPRD will be the data size. The estimate of the size of the GPRD in 5 years is about 5 terabytes 5 × 1012 bytes ; a pile of printed A4 pages 20 km in height. Within 10 years, GRID computing is expected to have become the standard for storing and analysing huge databases. In GRID computing, the original data sets do not leave their original server, but special middleware interrogates each server and downloads only data that are specifically needed or it may even run without actually downloading the data. It is diffi-cult to predict how this future system will work related to NHS data, but these changes offer unique opportunities for the GPRD to maximise the use of the UK population-based cradle to grave data for pharmacovigilance and other pharmacoepidemiologi-cal studies. The MHRA is an Executive Agency of the Department of Health and as such is working closely with those involved in implementing these obviously beneficial IT changes.

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