Good project management will be the key to the success of NHS
electronic records. James Rogers reports
Experts have welcomed the latest development in the NHS' £325m
strategy for electronic staff records (ESR) but warned that strong
project management will be needed if it is to deliver the expected
rewards.
Live testing of the ESR, which is the health service's new national
pay and personnel system, began at University Hospital, Birmingham
earlier this month.
Officials predict that the ambitious project to replace 30
different systems supporting 1.2 million staff in England and Wales
will save the NHS £400m over 10 years. However, the project is
already a couple of months behind schedule.
Of the 275,000 staff who join the health service every year, more
than 200,000 have transferred from other NHS employers, according
to government officials.
Given that the NHS is one of the largest organisations in the
western world, this underlines the importance of implementing an
adequate centralised system for personnel records and payroll.
Murray Bywater, managing director of IT healthcare research firm
Silicon Bridge, said he believes that the ESR project has a great
deal to offer the NHS. But he warned that it will have to be
carefully managed.
"It is a big task to convince everyone that a standard system will
meet all their local requirements. The implementation team will
have to do a lot of work with individual NHS organisations and it
will need strong project management," he said.
NHS officials have confirmed that the ESR, which is subject to the
Government's Gateway review process for managing major IT projects,
is being carefully developed.
Philip Hewitson, chief executive of the NHS National Shared
Services Initiative said, "It is very, very important to get it
right."
Perhaps even more importantly, NHS officials believe the ESR could
serve as a model for another mammoth IT project: developing and
rolling out an electronic patient record (EPR) system across the
whole of the NHS.
"There are some major data management and scalability issues that
will be very applicable to EPRs," said Hewitson.
He also stressed the relevance of the ESR's data protection
features - a highly sensitive issue in the health service - to the
forthcoming EPR.
"The ESR has all the data protection implications that the EPR will
have - we are putting processes in place that safeguard the
individual and the organisation, which are both electronic and
management-based," he said.
The ESR is one of a number of modernisation projects being
developed by the NHS National Shared Services Initiative, which was
launched in October 1999 to explore opportunities to improve the
quality and value for money of non-clinical services in the health
service.
Health minister Lord Hunt has already predicted that the project
will save the NHS £400m over 10 years - money which will then be
redirected to front-line patient care.
Launching the staff record trial in Birmingham, Hunt said, "This is
a vital piece of work in helping to modernise the NHS.
"ESR will allow the transfer of staff details from one NHS employer
to another, cutting red tape, reducing bureaucracy and saving
time."
The ESR, however, is more than just an IT system. Projects such as
this are critical in helping to modernise the NHS, which is
undergoing a massive overhaul of its IT infrastructure.
Earlier this year, the Government announced the health service's
future technology strategy, in what promises to be the UK's largest
ever IT project.
The long-term objectives of the scheme include providing broadband
access to all NHS clinicians and support staff by December 2005, as
well as implementation of domain-to-domain encryption.
A national appointment bookings service is expected to be
implemented by December 2007, as will EPR systems in all primary
care trusts and hospitals.
Evidently, the stakes are high for NHS IT, which now finds itself
on the front line of Tony Blair's battle to modernise the health
service.
Implementing change across the whole of an organisation,
particularly one of the complexity and size of the NHS, is never
going to be easy.
Officials have admitted that the sheer scale of the ESR project has
put it about eight weeks behind schedule. However, they are hopeful
that the lost time can be made up.
In addition to the Birmingham pilot project, 15 more sites are
scheduled to test the system early next year. Officials estimate
that this stage of the roll-out will be complete by about mid-2003,
before the project is extended to the rest of the NHS over the
following two years.
Like so many other NHS IT projects, building the ESR is an
extremely complex task, although it has the potential to bring
great benefits, both for staff and patients.
"It is probably more difficult than anticipated but if the benefits
can be achieved then they will be equally great," Bywater said.
ESR consortium
A consortium led by healthcare giant
McKesson has been appointed to deliver the contract for the
electronic staff record, implementing the Oracle Human Resource
Management System (HRMS) across the NHS. Consortium members
include:
- McKesson - the prime contractor
- IBM Business Consulting Services (formerly Pricerwaterhouse
Coopers Consulting) - providing programme implementation, change
management and business process re-engineering
- Oracle - software provider
- IBM - hardware provider.