Computer Weekly readers' give their views
NHS IT and the British Computer Society
An open letter to the Health Select Committee calling for an
independent review of the national programme for IT in the NHS and
featured front page (Computer Weekly, 11 April), contained a
seriously erroneous statement purporting to be the view of the
British Computer Society. At no stage has BCS "expressed concern
that NPfIT may show a shortfall of billions of pounds".
Although members of the BCS are perfectly entitled to express
their views or concerns individually, they are not permitted to
publish or pass them off as a BCS statement. The BCS issues
statements of concern only when officially endorsed as a qualified,
collective and verifiable viewpoint, usually on behalf of a
relevant forum. In this case I have consulted with the chair of
BCS's Health Informatics Forum, who confirmed that no statement on
NPfIT financial shortfalls have been issued or published by this
forum.
David Clarke, Chief executive, BCS
Computer Weekly replies:
We checked the factual statements made in the open letter. Last
September the BCS circulated a document "Radical Strides - Interim
Synthesis for Consultation" which said, "It is felt that there is a
medium-term funding gap estimated at over £10bn pounds that needs
to be covered locally; and there is concern about overall
Connecting for Health longer-term finance too."
This was a draft consultation paper issued by the BCS's Health
Informatics Forum on which comments were invited before the final
paper was prepared. It was written in part to provide informed,
constructive criticism on the NPfIT.
No information has emerged since which shows that concerns over
a potential gap between the cost of implementing the NPfIT and the
availability of funds have been allayed.
Future-proofing the national programme
In response to "Scrutiny is vital for NHS success" (Computer
Weekly, 11 April), we should like to emphasise that the NPfIT is
under constant review, scrutiny and audit by parliament and
government bodies.
As with any large and complex IT programme, there will be issues
and difficulties to deal with. We remain confident that the
technical architecture of the national programme - which is modern,
robust and designed to be future-proof - is appropriate and will
work.
Central purchasing of core IT systems and services will save the
NHS in England an estimated £3.8bn over 10 years. Furthermore, the
NHS IT programme uses new, innovative contracts under which the
taxpayer does not cover the cost of failure to deliver.
Crucially, at the heart of the NPfIT is the aim to deliver great
benefits for patients, the public and staff working within the NHS.
Already, benefits are evident such as more and more patients being
able to choose and book a hospital appointment at a time and place
convenient to them, and a greater number of prescriptions being
transferred electronically - over 725,000 prescriptions at the
latest count.
Further achievements include over 1,200 local service provider
system deployments, more than 200,000 staff registered to use the
new system and 14,000 connections made to the new high-speed
broadband network.
NHS Connecting for Health has invited all 23 academics to a
meeting to give them an opportunity to raise their concerns and
provide them with an overview of the programme, its progress to
date and its technical architecture.
We have every confidence that the NPfIT will be delivered and
implemented successfully by NHS Connecting for Health, and
ultimately, go towards improving patient care in the NHS.
Rosie Winterton, Minister of state for health services,
Department of Health
It's about transforming patient services
The NHS Confederation did indeed say in a briefing for our
members that "the IT changes being proposed are individually
technically feasible but they have not been integrated in this way,
so as to provide comprehensive solutions, anywhere else in the
world" (Computer Weekly, 11 April). However, this comment was made
in 2003 - I think we can all agree much has changed since then and
I would suggest a more up to date quote might be appropriate in the
future.
Furthermore, I would like to stress that the statement was not
expressed as a concern, but rather an observation. The next
sentence of the briefing actually went on to say, "[NPfIT] will
enable the NHS to fundamentally change the way care is delivered,
drive up quality and make more effective use of its resources."
I would also like to make it clear that the NHS Confederation
remains committed to ensuring the NHS has the highest-quality IT
systems that allow clinicians to share information about patients
and integrate services through the use of cutting-edge technology
such as digital x-rays.
A programme of this magnitude is bound to create concerns,
because while people regard it as an IT project, it is actually
about transforming services for patients. And the biggest outcome
that the programme will be judged on is patient safety.
One of the biggest challenges now for Connecting for Health is
convincing the service that the NPfIT can really transform care for
patients. In order to make this work there needs to be active
engagement from both clinicians and managers.
I can assure all readers that we feel improved services for
patients and increased patient safety is a goal worth pursuing. We
will continue to work closely with the Connecting for Health team
to ensure that this goal is achieved.
Gill Morgan, Chief executive, NHS Confederation
Standardisation should be at the right
level
The key issue for me about NHS IT is the paradox of Patricia
Hewitt (on Today, Radio 4, 12 April) saying that the Department of
Health is working to decentralise the management of the NHS to
primary care trusts - and at the same time centralising control of
the management information available to those same trusts.
It is time strategic planners realised that IT is just one
aspect of the communications system of a business, and that you do
not have local control of a business unit unless the unit has
appropriate control of its IT.
The overall business needs to agree how those units are going to
communicate - so there need to be agreed protocols for information
exchange. But that does not require the level of obsessive
standardisation and control underlying the NPfIT in the NHS.
We received a huge post bag in response to our articles on
the NHS national programme for IT in Computer Weekly, 11 April, and
we will be running a further selection of letters in the near
future.
Jacky Smith, Information manager in adult social
care
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