Some of the good and bad at HC2008 - a summing up


My highly subjective overview of some of the good and bad at HC2008, the annual Healthcare Computing conference in Harrogate..

The bad:

Some of the speeches were, as in previous years, optimistic, which is not a bad thing if they take account of the problems facing IT executives day to day in NHS trusts.

In 10 years, however, there may still be Whitehall officials talking of what a national programme for IT should or will deliver. They may still be talking about how they’ve taken on board what clinicians want.

There will probably still be road-shows and deliberative events to engage with doctors and NHS staff, and to understand their needs. There will be statistics on the success of Whitehall’s initiatives.

There may even be the talk at Harrogate about building on the lessons from early adopter trials of national electronic patient record initiatives. It may sound ridiculous that people will be talking in 10 years about what they’re talking about today.

Yet an excellent book released at HC2008 by the British Computer Society – UK Health Computing – shows that a project to build a “lifetime summary and in-depth episode records of hospital care on computer” began at King’s College Hospital in 1969. There was a first attempt to link GPs to hospitals by Royal Devon and Exeter in 1972.

Today we’re still waiting for lifetime electronic hospital records (and for all GPs to have links to hospital systems).

Whitehall officials still talk as if it’s all just around the corner. Shouldn’t plans be made as simple as humanly possible, demonstrably realistic and achieveable, rather than wonderful, transformational, fully integrateable, world-beating – and utterly improbable?

The excellent BCS book I mentioned – UK Health Computing, recollections and reflections – is edited by Glyn Hayes and Denise Barnett.

The Good:

The questions from the floor – including those from GP Mary Hawking – who brought the visions of some speakers back to earthly reality.

And thanks to Matthew Swindells, the Department of Health’s departing, acting chief information officer, who said some inspirational things that were also grounded in reality. It’s a pity he’s leaving.

This is some of what he said:

“We need to take our obligation to train people seriously. At the Royal Surrey [County Hospital, where he was chief executive] the only thing they will remember about me is that I was the guy who used to go portering once a month, doing a real job.

“That sense of our staff being disconnected from the grand vision is paralysing for the NHS when it is trying to drive change. When I was a porter I discovered that porters at the Royal Surrey had to come back to [base] every 20 minutes because the batteries on their radio went flat, and it had been like that for five years. £5,000 later the technology supported them in doing their jobs rather than was a pain in the neck.

“It takes a degree of honesty and engagement to say that our staff need technology to help them do their jobs because many of their jobs are onerous, boring and many come to work to earn enough money to get on with of the rest of their lives; and if we dump IT on them which is simply rubbish then all we do is devalue them as contributors to a better NHS.”

He also spoke about how to engage clinicians and staff (apart from delivering technology they want). He said:

“We should remember when we deliver technology they [NHS staff] need to understand why this helps patients, not why it helps finance managers. If we can get that right, if we can describe that coherent story about making peoples’ lives better, then we will be able to take our staff with us. If it’s just another thing we tell them to do because we are management, and we can, then we won’t take them with us.”


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