Darling to shelve NHS IT system

[AtW]

It is also, by it's very nature, insecure as it is having to pass over a public network that the client has no control over, even if the data is encrypted.

SSL power online ecommerce that is responsible for many times over the amount spent on this project: it's secure enough to conduct sensitive transactions, something of great interest to criminals who would not care less on what your Xray looks like.

I just hope you've never had to work on a project where any personal data was involved.

Relax I am not.

[Board Game Geek]

I'm not going to launch personal attacks on board members, since it's unnecessary and childish.

I am going to tell you my story, however, working in NPfIT for the last 5 years.

These are my observations and ground-level experiences, being involved at the front-line of technical deployment, and also day to day fire-fighting.

Lets go back a few years, when surgeries, hospitals, and other healthcare providers were just starting to get "computerised systems".

It was a mass free-for-all to adopt technology, with no definable roadmap. Many vendors launched their own products to market, and jumped in to bed with the NHS.

At this stage, the internet was barely born, and no one was looking at joining all these systems together.

So, you had Site A with Software X, next door to Site B with Software Y and neither systems were inter-operable. No one saw the need. There were a good half dozen closed clinical systems out there from their respective vendors.

Thus, in a demographic area, say West Yorkshire, you might have 50 surgeries and 5 hospitals, and of those 50 surgeries, 14 would use System A, 20 System B, 12 system C, etc.

Why was it allowed to get in such a mess ? Because, to be frank, no politicians had the balls to mandate a single system across the UK.

They were scared of being accused of getting in to bed with a sole supplier, and that's not a good thing for a politician. So they said to the DOH, let's have GPSOC (GP System of Choice), and let the surgeries and other providers choose who they want to choose.

And lo and behold, a fragmented market was born, with no clear strategy, apart from allowing each healthcare provider to go their own way.

Of course the clinical vendors rubbed their hands with glee. They had an open market to tout their wares, little to no control from the PCT, and they watched as their cash cows grew in size. Oh, Hard Disk failed on a server ? £600 for a new one, plus another £400 call out fee. They had the adoptees of their tech by the balls.

Fast forward to the beginnings of NPfIT, and some people started to make noises about inter-operability, and other such good things that would positively enhance patient care.

Except that the vendors were not happy about this at all. Some were years away from developing such systems, if at all. Some vendors saw market share butchered because they were slow to adapt to changing requirements (and also had some embarassing financial problems, that were well documented in the press. Yes, I'm looking at you Torex.)

Others hastily adapted and offered enhanced versions of their products, to meet GPSOC level requirements (eg, off-site hosted solutions). Having used all of these systems, some of the enhancements feel like jury-rigged bodged code, and some do seem elegant, having been designed from the ground up with off-site in mind.

Gradually however, systems have started to merge in various areas, and there have been successes in the overall programme. True, it doesn't all work yet, but neither does it not all work either. Lots of projects have borne fruit and are enchancing patient delivery and care.

The playing field is levelling out though. Some vendors have gone, others are hanging in by their teeth, and there are dirty tricks campaigns going on. (Hello Mrs Practice Manager. We heard you were moving clinical system. How would you like 2K's worth of free document management software from another company that also works with the existing system you have by us ?)

In a nutshell, the NHS IT programme is hideously complex, but has delivered several successful projects. It's constantly hampered by politicians who think they know more about IT than the engineers on the ground, who deal with the real problems and also come face to face with the other vendors who make like difficult.

Eg, migrating email to NHS.NET which is our own, in house email system, and will save us money from having to pay a 3rd party to look after email. Except that now the 3rd party want £xx,xxx because of loss of business.

Hence, in a rare situation, we really do see the bigger picture at a local level and believe me, the politicians would be absolutely shocked.

Then again, they manoeuvered us in to this position, mostly through inaction, so it's little wonder that things are complex.

There are too many fish-hooks in the whale to find a path in which the NHS can extract itself from every vendor, so it's a matter of choosing the most painless route in order to deliver the service that it is tasked to do.

This doesn't even beging to cover how complex the National Programme is, but might go a small way in explaining the history of the past, in order to understand the present.

Remember. For every solution you propose, for every workaround to circumvent a problem, there will be a rule, an edict, a person or an organisation who appears out of nowhere who will try to counter it.

[minestrone]

As far as I know none of the surgeries have moved a way from their own systems, the trusts are still buying them and the GPs are very happy with what they have from the ones I have asked.

As AtW said they should have created an API and made the vendors go with that, would have taken less than a year for the vendors to change.

From my experience the surgeries are just as angry about being forced into changing systems.

[pzz76077]

Isnt the real issue that health professionals don't particularly want a new IT system??

This seems to be more about central government control freaks trying to measure and publish everything in league tables to justify their existence?? You could do that in Excel probably.


PZZ

[minestrone]

Isnt the real issue that health professionals don't particularly want a new IT system??

This seems to be more about central government control freaks trying to measure and publish everything in league tables to justify their existence?? You could do that in Excel probably.


PZZ

Nail on head.

From what I know they were all very happy with what their options were and what they got. There was actually a lot of brand loyalty with systems and I know a surgery that were forced to change and they were pissed off.

The NHS system has yet to hit your average surgery.

[threaded]

What I did was first define a document format.

The rest is a trivial exercise.

HTH

[pzz76077]

So, selling tulip to folk that don't want the tulip.
Need a Bulldozer...... Brown aint it.
The buck stops at him me thinks.

£170Bn, hell people should be in prison now....


PZZ

[TheFaQQer]

So, selling tulip to folk that don't want the tulip.
Need a Bulldozer...... Brown aint it.
The buck stops at him me thinks.

£170Bn, hell people should be in prison now....


PZZ

Where does the £170Bn figure come from? Everywhere else I've seen said £12Bn over 10 years, but I haven't seen that one anywhere else apart from CUK.

[pzz76077]

Where does the £170Bn figure come from? Everywhere else I've seen said £12Bn over 10 years, but I haven't seen that one anywhere else apart from CUK.

From the OP:
They say Labour has spent £100bn on IT since 1997 and contracts worth another £70bn are due to be renewed or commissioned in the next two years.


Let me know if you need more detail. I have MS Excel 2007.

PZZ

[Mr.Whippy]

Gradually however, systems have started to merge in various areas, and there have been successes in the overall programme. True, it doesn't all work yet, but neither does it not all work either. Lots of projects have borne fruit and are enchancing patient delivery and care.

And this is where alot of the ignorance with regards to NPfIT comes.

They only see the delays/problems (usually with Millenium/Lorenzo) but never the good parts of the programme that are in, working and delivering benefits already......when was the last time you saw PACS in the news? never...you dont, because it's up and running nationally and is doing what it was intended to. Yet 99.9% of people won't have even heard of it.

I did 2 years on NPfIT, I left a few years ago so I'm a little out of touch with it all but it seems like it's all start to come together (albeit slowly and expensively) so it's a real shame if it's canned now.

Isnt the real issue that health professionals don't particularly want a new IT system??

One of many issues facing the programme yes.. Healthcare professionals seem particularly resistant to any change for some reason.