NHS: As the government embarks on a £5bn spending initiative to overhaul IT in the health service, we launch a campaign to ensure the money is not squandered
Computer Weekly's campaign to monitor how the NHS spends its £5bn windfall gained strong support from doctors working across the health service. Here they pass judgement on the government's plans for a national IT strategy.
Centralised IT plan will fail
"A top-to-bottom IT strategy is likely to fail and is just another expression of dinosaur thinking. Software must be easily adaptable to suit local needs. I think the people in charge of this strategy have no personal knowledge of real-life medical work.
"There is [also the challenge] of software platforms that can deal with providing a centralised core structure and localised adaptations. I am absolutely certain that the costs of implementation (training, maintenance, reliable quality support) are not being looked at, rather the focus is on the relatively insignificant hardware costs. Unsolved questions regarding data protection and litigation arise from this."
IT investment as important as cancer waiting lists
"IT is a neglected topic, but it is as important as cancer waiting lists. The implications for the audit- and evidence-based practice of medical care are enormous."
£5bn on IT is obscene
"£1bn is an obscene amount of money to spend yearly on IT. Surely there must be a more sensible and cost-effective approach to this much needed service?"
Keep it simple
"It is a vital project but it needs clear direction, robust leadership and a simple style. The precise aims must be straightforward and basic, driven through in a defined time. My reservations about in-house commissioning relate to expertise and leadership; my doubts about outsourcing are that control may be lost and the project become too clever by half."
Another rip off
"Another scheme running away with massive amounts of money, which has not been piloted or discussed at the pit face. I understand that their is no computer company currently in the UK with the expertise to provide the software/hardware. Another rip off."
Local IT needs ignored
"As usual, people on the ground are not given a say or the resources/incentives to develop IT further. GP computing has moved forward thanks to dedicated GPs, not politicians. Funding over the past three years has proved very difficult. It appears money is being siphoned off for other projects either at strategic health authority or primary care trust level."
Clinicians are too busy
"Busy clinicians do not have time to spend on data entry; managers want more electronic data to meet the government's ridiculous demands to measure so many things in the NHS. Those two viewpoints are so far apart in so many cases that to reconcile them is nigh on impossible."
Industry experts speak out
Richard Barrington, director of industry, Office of the E-Envoy
"You can impose technology from the top down, but without fundamental people and process change it will fail to deliver. Within a health environment, that is so critical to everyone that we have got to get it right. To make these massive projects a success we need a national effort and it is great to see Computer Weekly taking a leadership role."
David Roberts, chief executive, Corporate IT Forum (TIF)
"Understanding how best value in IT can be attained in the NHS through using proven technologies with proven practices and proven suppliers is vital to driving down costs. In terms of its IT complexity, the NHS rivals that of the largest blue-chip company so it must understand through sharing knowledge how commercial organisations operate and achieve excellence in IT."
Brian White, MP, chairman of the Parliamentary/Industry IT group, Eurim
"Eurim looks forward to working with Computer Weekly and its readers over the year ahead to promote constructive debate on the many actions and decisions that will be needed at all levels to ensure that such a massive spend on IT does indeed improve patient care and quality of life as well as working conditions, productivity and efficiency."
Philip Virgo, strategic advisor, Institute for the Management of Information Systems
"The cost of downtime in health care systems can be measured in pain, suffering and even death. Computer Weekly is in a unique position to help the IT industry understand what it must do to earn the trust of professionals who have learned not to trust the promises of enthusiasts. Imis therefore greatly welcomes this initiative."
Alastair Bellingham, chairman, the NHS information Authority
"The central strategy, with its investment in IT for the health service as demonstrated by the national programme, is the way forward for a service essential for NHS requirements in the near future. As outlined in the Wanless Report, the story of IT has been negative, but now, with co-ordination and investment, the programme is turning positive."
Computer Weekly comment
The NHS is about to embark on the biggest IT investment programme ever seen in the UK, spending up to £5bn over the next five years.
We at Computer Weekly strongly welcome this huge investment. We believe IT has enormous potential to improve patient care and save lives. But we fear that the programme could end in disaster, producing systems that fail to deliver and wasting billions of pounds of taxpayers' money.
Why are we so concerned? First, because of the appalling track record of the NHS on major IT projects. In the 1990s the Wessex Regional Health Authority lost up to £63m after trying to impose complex integrated systems on more than 100 hospitals. The Hospital Information Support Systems project lost up to £100m for similar reasons.
Second, because there are already signs that the new programme is heading down the same doomed path. The problem with clinical codes we reveal on our front page is a classic example of an over-ambitious national project becoming mired in complexity. And the fact that 93% of GPs surveyed say they do not have enough information about the IT initiatives suggests the NHS has not shaken off its "we know best" culture.
So we are launching a campaign designed to help steer the NHS IT juggernaut away from the cliff edge. We will:
- Track the programme week by week
- Highlight problems the NHS may be reluctant to air publicly
- Debate the best way forward, bringing you the views of experts in IT, healthcare and from our own award-winning team
- Inform those in a position to influence the programme, including MPs and key decision-makers in the Department of Health, through briefings and hosted discussions.
We believe that the culture of secrecy and cover-up that usually prevails in major public sector IT projects prevents serious problems being identified and dealt with effectively. If the Department of Health is not going to give healthcare and IT professionals a true picture of the challenges and a chance to influence decisions, we will.
The NHS IT investment is probably the biggest opportunity our profession has ever had to show how it can make a real difference to people's lives. Let's make sure it doesn't end up as another example of IT promising big and delivering little.