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The NHS spends £1.1bn a year on IT, which accounts for 1.5% of its total budget, but the report, by former NatWest chief executive Derek Wanless, was savage about what this spending has achieved.
"ICT budgets - which have, traditionally, been allocated locally - have frequently been used to fund other areas of spending to relieve short-term pressure," wrote Wanless.
"There has been inadequate setting of ICT standards from the centre, resulting in a diverse range of incompatible systems across the health service."
The Department of Health and the National Health Service Information Authority are trying to overcome this legacy.
They signed an NHS-wide licensing deal with Microsoft and are rolling out a national payroll and human resources system across the UK. The NHSIA is also trying to encourage local NHS bodies to buy "shrink-wrapped" solutions rather than bespoke applications
Wanless backed calls from the Royal College of Nursing, which called for stronger central direction on standards and accredited solutions as well as the suggestion from US outsourcer EDS, which argued that local NHS IT procurement resulted in expensive "reinvention of the wheel".
Doubling spending would boost basic ICT infrastructure and lead to the adoption of applications such as the electronic patient record, electronic booked admissions, patient smart cards and electronic staff records.
It could also support developments in telemedicine and telecare, clinical governance support systems and staff training.
Getting IT right is crucial to the future of the NHS, said Wanless. "National integrated ICT systems across health and social services can lay the basis for the delivery of significant quality improvements and cost savings over the next 20 years," the report noted.
"Without a major advance in the effective use of ICT (and this is a clear risk given the scale of such an undertaking), the health service will find it increasingly difficult to deliver the efficient, high quality service which the pubic will demand."
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