Changing behaviour will be harder to achieve than IT
implementation.
The joint head of the world's largest civil IT-led scheme says that
changing human behaviour and culture in the NHS outstrip
technological matters as the biggest challenge now facing the
£2.3bn project.
Aidan Halligan, joint senior responsible owner of the national
programme for IT in the NHS, made his frank comments to Computer
Weekly as the Department of Health prepares to go live this summer
with the initiative's first national systems.
His remarks, coming less than two months after his appointment was
announced, mark a significant shift in emphasis. Major statements
on the programme in the past focused on the initiative's potential
benefits, successes in meeting project milestones and achievements
in putting in place outsourcing deals.
But Halligan, a practising clinician and deputy medical officer at
the department, says the success of the programme will depend on
much more than IT.
"The biggest challenge is a fundamental understanding that
successful implementation depends on far more than automation and
attention to hardware, software and networks," he said.
"The most significant obstacle in similar projects has been the
lack of attention to the human element of changing behaviour. The
obstacles are not technological or resource but cultural."
His warning is consistent with statements from, among others, the
Health Informatics Committee of the British Computer Society, many
of whose members work in the NHS. The committee pointed out in this
year and last that changing working practices of thousands of
nurses and doctors to exploit new systems may be a bigger task than
introducing new technology.
Last week Glyn Hayes, BCS Health Informatics Committee chairman,
said, "We are delighted that real issues are being recognised,
always the biggest part of surmounting a problem. We would go
further and stress the need for all clinical, technological and
other health professionals to be 'on side' - involved, motivated
and competent to make the implementation deliver."
Halligan said the timescales set by the programme were "tight".
"Our first simple goal must be to identify and develop the local
transition leadership team."
Openness amidst ongoing secrecy
Halligan's frank and open approach contrasts with continuing
secrecy in parts of the national programme. For example, executives
have refused to publish some technical and project details on the
national care records service, although these were set out in
complex slides presented at the Healthcare Computing conference
last month. A programme spokesperson said, "We have not published
our slides as these are being regularly updated as [the national
programme for IT] moves towards implementation. Instead, we have
published the NPfIT brochure and newsletter, which contain all the
relevant information."