The Government could be underestimating the need for highly
qualified and experienced IT management at local level to make its
proposed NHS IT upgrade programme work, according to BCS experts,
writes John Kavanagh.
"While we have no doubt that effective IT can both significantly
reduce medical errors and improve patient care, we see some issues
to achieving this which are not being fully addressed by the
Department of Health's recently published strategy," says Glyn
Hayes, chairman of the BCS Health Informatics Committee and a
former GP.
The BCS says the current proposals centre on establishing a
director general of IT who will set up preferred-supplier consortia
using big, mainly US companies and combine facilities management
with specialist applications from current NHS IT suppliers.
But the BCS warns against simply providing systems without allowing
for significant local user involvement in introducing them.
A real problem comes from NHS staff's lack of awareness of the real
potential of IT, plus a lack of enthusiasm and even fear of IT
systems, the BCS says. It believes this common problem, found in
many industries, can only be resolved by education and
training.
Hayes says there is "a patchy information culture in the NHS".
"Trust boards frequently hand IT over to finance departments, and a
natural result is emphasis on the management of resources rather
than direct patient care," he explains.
"Although the new strategy proposes the appointment of chief
information officers at strategic heath authority level - which we
very much welcome - we feel that qualified, experienced IT managers
also need to be employed at the individual trust board level to
have the necessary impact on day-to-day care.
"In addition to handling day-to-day IT management issues, this
would send out the message that information is key to reducing
patient damage and improving individual patient care, and is very
important to each NHS trust."
The BCS says it recognises the "significant successes" in NHS IT so
far, and is concerned that these could be lost in the new approach.
These successes include primary care computing, where it says the
UK leads the world; several acute sector initiatives; and all areas
where an information culture has clearly been nurtured. These are
excellent examples for the future, the BCS says.
"When a major programme like this is announced, there is always a
risk that existing initiatives lose their development focus while
new processes are discussed and put in place," the society says.
"The BCS sincerely hopes this does not happen to the excellent work
done in these areas to date."
The BCS Health Informatics Committee would like to see wider
consultation on the programme; the sponsoring of a corporate
knowledge culture and the use of previous experience across the
NHS; inclusion of lessons from developments outside the NHS in
England; and local priorities for tailoring systems within a
national framework.