Don't scrap NHS IT project

Writing in today’s Guardian, Vic Lane, a visiting professor of health informatics at London South Bank University, responds to an article by Andy Beckett [system failure?]. Lane says that Beckett’s article on the £12.7bn NPfIT was “too negative”.

Lane writes:

“…’Should the IT project be scrapped?’ No! Let’s keep the gains, such as ‘Choose & Book’, which patients like because it allows them to organise their first hospital appointment.

“President Obama has recently committed $19.2bn for EPR systems in the US. The Americans appear to think it is worth striving for aims similar to those in the NHS project.

“[Richard] Granger resigned two years ago, leaving a good foundation. Perhaps the new management can bring the IT programme to a successful completion. ‘No other country has managed to connect up its health-care systems,’ says Beckett. Can England be the first?”


Lane’s article

Homerton rejects NPfIT FOI request – IT projects blog

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You mention the Choose & Book system which I feel now works and fulfils its intended purpose for the initial appointment. The trouble for the patient starts when trying to find out where they are at on the system. Slot availability is also an issue.The Y&HSHA reported last month that 13 of its 14 Acute Trusts using Choose and Book were failing to meet targets due to Slot availability. It is a nightmare to operate, from the patients point of view, when this is the case. So yes, I think the NHS IT project will be abandoned soon.The NHS is there to serve its patients not worry about if the systems are going to work or not.

IMG and the 1992 IM&T strategy had the same problems: no credit given for successful parts of the program but failures due to changes in technology or requirements castigated.

Take infrastructure: in 1992, this included connectivity via N2, messaging/email using EDIFACT and the new NHS number.

IMG and its successor NHSIA delivered N2 (but hadn't specified an Internet portal..), NHS Mail using X400 (don't know when SMTP came in) and both had problems: the NHS number was developed and delivered: persuading hospitals to use it has been more difficult!

NPfIT has delivered N3 (with an Internet portal), NHS Mail, smart card and RBAC and PACTS - and success here is ignored.

It has had more trouble with more complex systems such as C&B, GP2GP (persuading GP suppliers other than EMIS and INPS to implement it), ETP (complex and poor pharmacy uptake), and, of course, the NCRS: if an organisation doesn't have the systems to support EPRs (both GPs and the NCRS regard these as being a total replacement for paper medical records) then clinicians in those organisations will not be able to keep EPRs - even if they can look at information from elsewhere e.g. GP EPRs.

Concentrating on monolithic solutions instead of interoperability has, it would seem, led to a situation in the development of secondary care EPRs where there is, by design, no competition and the prospective purchasers are forced to wait until the monopoly suppliers manage to deliver to the NHS: Lorenzo, apparently, is freely available in Germany..