The British Computer Society has backed calls for a
technical review of the health service’s £12.4bn IT programme,
questioning whether the scheme’s centralised approach will work in
the complex structure of the NHS.
Among other concerns, the BCS says it has doubts about what it
calls the “monolithic central national spine” – the BT-built
database which is due to hold summary records on about 50 million
patients in England. The spine is pivotal to the National Programme
for IT (NPfIT).
The concerns are expressed in a private letter to a group of
academics who have called for an independent technical audit of the
NPfIT.
The BCS’s comments are not consistent with public comments it
had earlier made in defence of Connecting for Health, which runs
the NPfIT. And they will add to pressure on the Public Accounts
Committee to initiate a fresh review of the programme despite the
publication of a positive report by public spending watchdog the
National Audit Office.
Computer Weekly has obtained copies of three earlier drafts of
the NAO report on the NPfIT. They contain large passages of text
critical of the programme which were omitted from the final report
and cast doubt on the reliability and independence of the final NAO
report.
Some of the BCS’s concerns are set out by Glyn Hayes, chair of
the society’s Health Informatics Forum, in a letter sent to Martyn
Thomas. Thomas, a visiting professor at Oxford University, was one
of 23 senior academics who wrote to the House of Commons Health
Committee calling for an independent technical audit of the
NPfIT.
Hayes’ letter says the BCS is greatly concerned that a
centralised IT approach will not work in the complex organisational
structure of the NHS. He tells Thomas, “I do indeed support your
proposal for a review of NPfIT.”
And Hayes says the BCS health forum has “major problems with the
lack of architectural planning about the detailed structure of the
electronic health record”.
The letter says, “Obviously such a centralised system could be
made to work technically, although they are having major problems
doing so because of the scale and scope of the NHS.
“Our main concern [is] that a centralised system will not work
in the complex organisational structure of the NHS. A distributed
architecture would have been much more flexible. We also have major
problems with the lack of architectural planning about the detailed
structure of the Electronic Health Record. As you know, this is an
entity which does not fit well with other technical IT
methodologies and needs considerable thought.”
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Changes to NHS report
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