My leader article in Computer Weekly this week should have been easy to write. It’s about the new NHS IT strategy, and it would be a simple task to cut and paste pretty much every similar article about the ups and downs of NHS IT in the 10 years or so since the National Programme for IT (NPfIT) was first mooted.
There are a few key themes that would have to be included, for example:
- In this digital age, you cannot imagine not having online access to your medical records in the future.
- Medical professionals need to be involved in healthcare IT strategy from the start.
- The federated nature of the NHS needs to be central to any nationwide strategy.
- Don’t underestimate the challenge of cultural change to IT-enable a huge beast like the NHS.
- Get the contracts with IT suppliers right, to avoid costly over-runs.
At some point, every one of these has been attempted, and nobody has yet got them right.
So what about the new NHS information strategy? Well, it ticks all those boxes at least. Online access to health records by 2015, for example. “Strong contractual levers” for centralised standards, for another. Overall, there’s much in the new plan that makes a lot of sense.
But we all sort of thought that every time before.
It’s a statement of the obvious, but the challenge for NHS IT is not in the strategy, it’s in the delivery. Delivery of the core elements of NPfIT were an unmitigated disaster, embodied by the continuing legal wrangles with key supplier CSC over a contract that has failed utterly to deliver, and which is costing the vendor itself hundreds of millions of dollars in write-offs.
The proposed combination of centrally-enforced IT standards, with local decision-making and implementation, is clearly the best way forward given the greater maturity of technology now compared to 10 years ago, when big centralised systems felt like the right choice.
But now the delivery rests not on a Department of Health agency, nor on a central CIO, but on every IT manager in every NHS trust. That’s how those IT managers would want it to be, but now it’s time for them to become the real drivers of change to create an information-led health service.
The time for politics and strategizing is over. NHS IT managers have been finally empowered to deliver, as they have always wanted. The task is no less difficult, but this is their opportunity.