NPfIT - the good and not so good

Glyn Hayes, chairman of the Health Informatics Forum at the British Computer Society, gave a brief but frank assessment of NHS’s National Programme for IT [NPfIT] at a Westminster forum this week.

Hayes is leading a review of the NPfIT for the Conservative Party.

With Guy Hains, President of CSC’s European Group, Hayes spoke about the NPfIT to an audience of Parliamentarians, IT specialists, clinicians and others at the Conservative Technology Forum at Portcullis House, Westminster, on Monday evening.

One of his main messages to an incoming government is not to assume that an IT-based modernisation of the NHS is easy.

“Would a changed government want to cancel the programme? I think the plea is to understand one thing more than anything else: it is very difficult to implement IT into healthcare anywhere in the world and it is even more difficult in England than a lot of other places.

“It is one of the most difficult areas of human existence to put systems into. One of the major problems with the national programme is that politicians at the time thought that if they threw money at it, it would happen in a couple of years.

“It couldn’t because it is so difficult. Can they [an incoming government] please remember if it is difficult; and can they please remember there is no magic bullet.”

He added: “There is no way they can get something off the shelf which will do it all. What has been done has taught all those lessons. I would just plead that the next administration remembers that all that has been learned. We should not try to find easy answers.” 

Hayes’ speech in summary:

– The original vision of the NPfIT “is still ok”

– There have been many reviews of the NPfIT but no independent external review. That’s one reason the Conservative Party’s Health spokesman Stephen O’Brien asked Hayes to lead an [unpaid] review.

– It’s too early to judge the work of Christine Connelly, CIO at the Department of Health. There’s a danger than when people move into the Department of Health they sometimes get lost.

– A framework contract called ASCC – Additional Supply Capability and Capacity” – has not been very successful for anybody so far. Smaller suppliers find it too bureaucratic and costly. Larger suppliers complain that the framework allows maverick companies into the national programme.

– There have been successes for the NPfIT but “I do slightly worry with some of the things they claim to be a success because I know the problems they are still having out there”.

– There may be too much focus on the Summary Care Record which will make an extract of a patient record held by a GP available to the rest of the NHS. Hayes said that CfH is making a “great song and dance about that [the SCR] and yet I know there are a lot of problems with it, and I don’t know how well they are being addressed”.

– At the HC2009 Healthcare IT conference at Harrogate last month Martin Bellamy, head of CfH, spoke of learning the lessons from the go-live of the Cerner Millennium Care Records Service at the Royal Free hospital in Hampstead. Hayes said the “fairly disastrous implementation” was caused in part by staff being trained on a generic database. “The first time they saw the real system was when they went live”.

– On the lessons from the Royal Free’s implementation being learned, Hayes said: “I hope that’s true. I have no knowledge to the contrary. I am worried that there were a couple of people from the Royal Free there [at Harrogate] who were saying that they still haven’t learnt the lessons from the Royal Free. It’s not all hunky-dory. In the end no doubt they will get there”.

– The one system that will really benefit patients is e-prescribing, which some hospitals are installing. It will reduce medication errors which he said are killing hundreds of patients every year in the UK. “One of my pleas would be: let’s not wait another four years for the roll-out [of e-prescribing]. We need electronic prescribing now. This IT is there to help patient care.”

Hayes’s review has involved Gail Beer, former Director of Operations at Barts and The London and now an independent consultant, pharmacist Ian Shepherd and professors Iain Carpenter and John Williams of the Royal College of Physicians.


Conservatives commission review of the NPfIT – E-Health Insider

If NPfIT were a jumbo jet, heaven help 747 flyers – IT Projects blog   

Revolution in healthcare or expensive failure? – Ardentia

NPfIT moving in the right direction – Public sector software, services and technology

NHS progress – Dr Rant