The British Computer Society has backed calls for a technical review of the health service’s £12.4bn IT programme, questioning whether the scheme’s centralised approach will work in the complex structure of the NHS.
Among other concerns, the BCS says it has doubts about what it calls the “monolithic central national spine” – the BT-built database which is due to hold summary records on about 50 million patients in England. The spine is pivotal to the National Programme for IT (NPfIT).
The concerns are expressed in a private letter to a group of academics who have called for an independent technical audit of the NPfIT.
The BCS’s comments are not consistent with public comments it had earlier made in defence of Connecting for Health, which runs the NPfIT. And they will add to pressure on the Public Accounts Committee to initiate a fresh review of the programme despite the publication of a positive report by public spending watchdog the National Audit Office.
Computer Weekly has obtained copies of three earlier drafts of the NAO report on the NPfIT. They contain large passages of text critical of the programme which were omitted from the final report and cast doubt on the reliability and independence of the final NAO report.
Some of the BCS’s concerns are set out by Glyn Hayes, chair of the society’s Health Informatics Forum, in a letter sent to Martyn Thomas. Thomas, a visiting professor at Oxford University, was one of 23 senior academics who wrote to the House of Commons Health Committee calling for an independent technical audit of the NPfIT.
Hayes’ letter says the BCS is greatly concerned that a centralised IT approach will not work in the complex organisational structure of the NHS. He tells Thomas, “I do indeed support your proposal for a review of NPfIT.”
And Hayes says the BCS health forum has “major problems with the lack of architectural planning about the detailed structure of the electronic health record”.
The letter says, “Obviously such a centralised system could be made to work technically, although they are having major problems doing so because of the scale and scope of the NHS.
“Our main concern [is] that a centralised system will not work in the complex organisational structure of the NHS. A distributed architecture would have been much more flexible. We also have major problems with the lack of architectural planning about the detailed structure of the Electronic Health Record. As you know, this is an entity which does not fit well with other technical IT methodologies and needs considerable thought.”
Read article: Changes to NHS report
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