NHS: As the government embarks on a £5bn spending initiative to
overhaul IT in the health service, we launch a campaign to ensure
the money is not squandered
Computer Weekly's campaign to monitor how the NHS spends its £5bn
windfall gained strong support from doctors working across the
health service. Here they pass judgement on the government's plans
for a national IT strategy.
Centralised IT plan will fail
"A top-to-bottom IT strategy is likely to fail and is just another
expression of dinosaur thinking. Software must be easily adaptable
to suit local needs. I think the people in charge of this strategy
have no personal knowledge of real-life medical work.
"There is [also the challenge] of software platforms that can deal
with providing a centralised core structure and localised
adaptations. I am absolutely certain that the costs of
implementation (training, maintenance, reliable quality support)
are not being looked at, rather the focus is on the relatively
insignificant hardware costs. Unsolved questions regarding data
protection and litigation arise from this."
IT investment as important as cancer waiting
lists
"IT is a neglected topic, but it is as important as cancer waiting
lists. The implications for the audit- and evidence-based practice
of medical care are enormous."
£5bn on IT is obscene
"£1bn is an obscene amount of money to spend yearly on IT. Surely
there must be a more sensible and cost-effective approach to this
much needed service?"
Keep it simple
"It is a vital project but it needs clear direction, robust
leadership and a simple style. The precise aims must be
straightforward and basic, driven through in a defined time. My
reservations about in-house commissioning relate to expertise and
leadership; my doubts about outsourcing are that control may be
lost and the project become too clever by half."
Another rip off
"Another scheme running away with massive amounts of money, which
has not been piloted or discussed at the pit face. I understand
that their is no computer company currently in the UK with the
expertise to provide the software/hardware. Another rip off."
Local IT needs ignored
"As usual, people on the ground are not given a say or the
resources/incentives to develop IT further. GP computing has moved
forward thanks to dedicated GPs, not politicians. Funding over the
past three years has proved very difficult. It appears money is
being siphoned off for other projects either at strategic health
authority or primary care trust level."
Clinicians are too busy
"Busy clinicians do not have time to spend on data entry; managers
want more electronic data to meet the government's ridiculous
demands to measure so many things in the NHS. Those two viewpoints
are so far apart in so many cases that to reconcile them is nigh on
impossible."
Industry experts speak out
Richard Barrington, director of industry, Office of the
E-Envoy
"You can impose technology from the top down, but without
fundamental people and process change it will fail to deliver.
Within a health environment, that is so critical to everyone that
we have got to get it right. To make these massive projects a
success we need a national effort and it is great to see Computer
Weekly taking a leadership role."
David Roberts, chief executive, Corporate IT Forum
(TIF)
"Understanding how best value in IT can be attained in the NHS
through using proven technologies with proven practices and proven
suppliers is vital to driving down costs. In terms of its IT
complexity, the NHS rivals that of the largest blue-chip company so
it must understand through sharing knowledge how commercial
organisations operate and achieve excellence in IT."
Brian White, MP, chairman of the Parliamentary/Industry IT
group, Eurim
"Eurim looks forward to working with Computer Weekly and its
readers over the year ahead to promote constructive debate on the
many actions and decisions that will be needed at all levels to
ensure that such a massive spend on IT does indeed improve patient
care and quality of life as well as working conditions,
productivity and efficiency."
Philip Virgo, strategic advisor, Institute for the
Management of Information Systems
"The cost of downtime in health care systems can be measured in
pain, suffering and even death. Computer Weekly is in a unique
position to help the IT industry understand what it must do to earn
the trust of professionals who have learned not to trust the
promises of enthusiasts. Imis therefore greatly welcomes this
initiative."
Alastair Bellingham, chairman, the NHS information
Authority
"The central strategy, with its investment in IT for the health
service as demonstrated by the national programme, is the way
forward for a service essential for NHS requirements in the near
future. As outlined in the Wanless Report, the story of IT has been
negative, but now, with co-ordination and investment, the programme
is turning positive."
Computer Weekly comment
The NHS is about to embark on the biggest IT investment
programme ever seen in the UK, spending up to £5bn over the next
five years.
We at Computer Weekly strongly welcome this huge investment. We
believe IT has enormous potential to improve patient care and save
lives. But we fear that the programme could end in disaster,
producing systems that fail to deliver and wasting billions of
pounds of taxpayers' money.
Why are we so concerned? First, because of the appalling track
record of the NHS on major IT projects. In the 1990s the Wessex
Regional Health Authority lost up to £63m after trying to impose
complex integrated systems on more than 100 hospitals. The Hospital
Information Support Systems project lost up to £100m for similar
reasons.
Second, because there are already signs that the new programme
is heading down the same doomed path. The problem with clinical
codes we reveal on our front page is a classic example of an
over-ambitious national project becoming mired in complexity. And
the fact that 93% of GPs surveyed say they do not have enough
information about the IT initiatives suggests the NHS has not
shaken off its "we know best" culture.
So we are launching a campaign designed to help steer the NHS IT
juggernaut away from the cliff edge. We will:
- Track the programme week by week
- Highlight problems the NHS may be reluctant to air
publicly
- Debate the best way forward, bringing you the views of experts
in IT, healthcare and from our own award-winning team
- Inform those in a position to influence the programme,
including MPs and key decision-makers in the Department of Health,
through briefings and hosted discussions.
We believe that the culture of secrecy and cover-up that usually
prevails in major public sector IT projects prevents serious
problems being identified and dealt with effectively. If the
Department of Health is not going to give healthcare and IT
professionals a true picture of the challenges and a chance to
influence decisions, we will.
The NHS IT investment is probably the biggest opportunity our
profession has ever had to show how it can make a real difference
to people's lives. Let's make sure it doesn't end up as another
example of IT promising big and delivering little.