The Department of Health is facing criticism that it has
awarded a £64.5m contract for an England-wide electronic booking
system for hospital appointments without producing any evidence
that the software is wanted or will be used by most doctors and
consultants.
Last week the health secretary John Reid and the director
general of NHS IT Richard Granger announced that services company
SchlumbergerSema had won the five-year contract to deliver the
National Electronic Booking System. The system is one of the main
planks of the government's £2.3bn programme to modernise NHS
IT.
Once integrated with existing systems run by GPs and with new
equipment to be installed by local service providers, the software
will give patients in England a limited choice over the date and
hospital at which they attend an outpatient appointment. The first
patients will be able to have hospital appointments booked online
by next summer.
Reid said the contract marked a "revolutionary" step towards
ending the "inefficiency and mix-ups" of largely incompatible
systems within the NHS. Patients will no longer have to wait weeks
to be sent a notice of a consultation and then be given an
inconvenient date.
Granger said the procurement schedule for the award of contract
had been ground-breaking. There were only 190 days between
advertising and award of contract, which was "unprecedented" for
such a system, he said, adding that there had been a high degree of
clinician involvement in the evaluation of systems.
But Jean Roberts, lead for the British Computer Society's health
committee policy group, said she was concerned about the speed with
which the contract had been awarded. This may haveallowed too
little time to secure the commitment of consultants and doctors to
using the systems, she said.
Grant Kelly, a GP and IT consultant, said, "Patients will be
offered a set a choices but they will be fairly limited because of
difficulties with capacity."
He also pointed out that replacing current methods for booking
appointments with rule-based systems could cause a great deal of
disruption by reducing human intervention in the process.
IT expert witness Stephen Castell said that perhaps not enough
attention had been paid to the changes that doctors would need to
make in their working practices to make good use of a national
booking system.
In June, when healthcare market research company Medix surveyed
more than 1,000 doc-tors about the national programme for IT, many
welcomed a scheme for electronic patient records but few expressed
support for electronic booking systems.
What's in store for NHS systems?
The National Electronic Booking System is one of four main
projects in the national programme. The others are: Integrated Care
Records Service (patient records), a new infrastructure and
e-prescriptions, contracts for which have yet to be awarded.
Five local service providers are due to be appointed by the end
of December 2003 to build and run patient records. They may also
provide equipment to help GPs connect to national booking
systems.