While the public appears to accept a higher level of investment in
the NHS as necessary, we should be sure that any such investment
delivers on the promise of change.
IT expenditure can be broadly split into four types: salaries,
depreciation, maintenance and projects. In many organisations most
of the first three of these are required to maintain the status
quo.
Doubling expenditure on IT in the NHS could mean further investment
in infrastructure and people, with no particular re-engineering of
the systems and processes. Such expenditure may stay at higher
levels in the future with no apparent improvements in service to
NHS patients.
Unfortunately, it may be tempting to invest further in an existing
infrastructure rather than to embark on a programme of
change.
Alternatively, doubling expenditure could mean a change programme
for improving service delivery. Project expenditure in many
organisations is between 10% and 15% of the overall IT cost.
Therefore, an increase in expenditure could translate into a
sevenfold to tenfold increase in the funds available for change
projects, which creates an opportunity to re-engineer how the NHS
uses IT.
To implement change and gain the benefits achievable, it will be
necessary to engage people with the correct skills and give them a
clear vision. Choosing the wrong route may increase the costs,
deliver no apparent benefits and create higher ongoing costs,
ensuring the additional funds for a change programme will never
again be seen as affordable.
We should expect a more efficient NHS and not an increasingly
costly one. My advice to the Government is get it right or don't do
it - you won't get a second chance.
Owen Williams is head of IT at Knight Frank