Political pressure on NHS trusts to use immature database

The first NHS trusts to upload medical details to a national database as part of the £12.4bn National Programme for IT (NPfIT) were pressured for political reasons to push ahead quickly despite the immaturity of the technology, an independent report is set to reveal.

The first NHS trusts to upload medical details to a national database as part of the £12.4bn National Programme for IT (NPfIT) were pressured for political reasons to push ahead quickly despite the immaturity of the technology, an independent report is set to reveal.

A year-long study of the summary care record early adopter programme - a key part of the NPfIT - will show how politics and large, complex IT projects can be a toxic mix.

The study is expected to find that most users in the first trusts to go live with the system were broadly enthusiastic about giving doctors online access to medical records in an emergency and out of hours.

But the researchers at University College London found that the summary care record remains an immature technology which staff describe as clunky, which interfaces poorly with other systems, and which many staff have given up using until it works better.

UCL's report is also likely to reveal that IT executives in early adopters were pressured to implement the system to redress what had been described as a worrying lack of progress on the NPfIT.

In public, government ministers have repeatedly defended the progress and success of the NPfIT.

In February 2007, civil servants at the Department of Health told the then prime minister, Tony Blair, that much of the NPfIT was complete.

But the main deliverable of the NPfIT - a national system of ­electronic health records to replace paper files, which are often lost or un­available when needed - is nowhere near ready.

The government promised a full national health record service would be "accessible nationally for out-of-hours reference" by the end of 2005. But plans are at least three years behind schedule.

It is not known when, or if, the summary care record will be up and running nationally because of uncertainties over the technology, data security and whether NHS staff will want to use the system.

The UCL study was paid for by NHS Connecting for Health, which runs large parts of the NPfIT and was criticised by the independent report. Connecting for Health executives said they felt under pressure from the government, in part because of the NPfIT's high profile.

The report evaluated live trials of the summary care record at trusts in Bolton, Bury, South Birmingham and Dorset. The system will take extracts of local medical records held by GPs. Any medication or allergy information will be uploaded onto a national database, called the "spine", which is run by BT.

The UCL research is expected to report resentment among participating primary care trusts that Connecting for Health pushed forward on a tightly managed, largely non-negotiable timetable for implementing the summary care record despite the immaturity of technical solutions.

There was further resentment from GP practices pushed excessively by primary care trusts in turn.

The report also found that the public doubted whether the summary care record system was worth the money being spent on it.

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