Make cuts, but don’t leave hospitals without computers
There are some sensible savings the government could make in its IT spending. The NHS National Programme is not one It would be easy to cut billions from government IT spending: cancelling identity cards and the National Identity Register would save more than £2bn over 10 years, for example. But instead, the chancellor, Alistair Darling, is aiming his scissors at health service computing. "The NHS had a quite expensive IT system that, frankly, isn't essential to the front line. It's something that I don't think we need to go ahead with just now," he told Andrew Marr yesterday. There are a few odd aspects to this. The first is that it is far too late for the government not to go ahead with England's National Programme for IT, which is a set of linked systems rather than one. Some parts are years behind schedule, but other elements are finished, working and largely paid for. The £554m lifetime cost of the N3 broadband network run by BT to link NHS sites has all been spent, according to the Department of Health, while the electronic appointment booking system, Choose and Book, has been running for some time. The programme is several years late in providing local patient record systems to NHS trusts, and as it pays suppliers by results, these could be delayed or cancelled (although the suppliers – BT and Computer Sciences Corporation – could well demand hefty cancellation fees). With only £4.5bn of the programme's £12.7bn projected cost by 2014-15 spent by March this year, the temptation for the chancellor is clear. The big problem is that IT in many NHS trusts, particularly hospitals, is antique and in some areas non-existent. While most GPs paid to computerise their patient records some years ago, many hospitals wards still use paper. The idea of the National Programme was to introduce new computerised systems, focusing on electronic patient records, to every NHS trust in England
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Make cuts, but don't leave hospitals without computers
NHS computerisation: lessons from what the bosses never learned | Michael Cross
Engineers are trained to learn from their profession's mistakes – however inconvenient the lessons. NHS IT should, too As the song goes, a man hears what he wants to hear and disregards the rest. Of all the indictments in the Conservative-sponsored independent review of the NHS's £12bn computerisation programme, the most damning may be its account of the way that the programme's originators wilfully disregarded painfully acquired wisdom. The new study, led by the healthcare informatics veteran Dr Glyn Hayes, observes that the National Programme for IT followed closely on the heels of two important reports. The first was on a series of IT pilot projects at 19 NHS demonstrator sites between 2000 and 2003
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NHS computerisation: lessons from what the bosses never learned | Michael Cross
Medical privacy: Dr Google will see you now
Essential in life, Google may soon play a part in death.
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Medical privacy: Dr Google will see you now
System failure?
The £12.7bn NHS computer programme is five years behind schedule and beset by criticism, viruses and fears over patient privacy. So should the world's biggest IT project be scrapped? Andy Beckett investigates At some point last November, an infection began to spread unnoticed through the three hospitals that make up Barts and The London NHS Trust in east London. This was not MRSA but the Mytob worm, a common but potent computer virus. It steadily slowed and choked the 4,700 PCs of the trust's network. By noon on 17 November, a Monday, the network was effectively crippled. The following day, the trust declared an "internal major incident". Ambulances carry-ing accident and emergency patients were diverted to other hospitals. Operations were postponed. The appointments system was suspended. Access to clinical information - usually quick and electronic - was maintained only by the slowest and most old-fashioned of methods: "runners" drafted in from the trust's administrative departments pounded the hospitals' endless twisting corridors with paper notes and printouts. Scores of computer technicians from the private sector and from other London NHS trusts were brought in to eradicate the virus, but the PCs had to be decontaminated one by one. It was a week before the crisis was officially declared over, and a fortnight before the hospitals, some of the busiest in the capital, returned to normal. Afterwards, an official report found the virus had been able to infiltrate them because their anti-virus software "did not reach all [their] PCs and ... was configured incorrectly on some". The whole episode, the report concluded, had been "entirely avoidable". The Barts incident, and a series of similar virus attacks on British hospitals since 2007, is the subject of an investigation by More4 News to be broadcast tonight. The More4 report reflects a longstanding concern about the vulnerability of the NHS to computer viruses and hackers.
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System failure?
BT faces multimillion pound writedown on NHS computer upgrade
Huge writedown expected next month, along with news of thousands of job losses BT Group will next month become the third major contractor in as many years to take a multimillion pound writedown on its work with the government's crisis-stricken £12.7bn overhaul of the NHS computer system. The writedown at BT's struggling Global Services division is expected to be accompanied by news that thousands more jobs will be lost as BT is forced to slash costs. Some reports have suggested that more than 10,000 jobs could go, though BT described the figure as "speculation". Meanwhile analysts believe that annual contributions to BT's pension scheme will need to at least double, to between £500m and £1bn. The challenges facing the group have put its dividend in doubt. The National Programme for IT – the largest non-military computer project on record – has already lost two of its four regional contractors , Accenture and Fujitsu. Both quit contracts similar to BT's work in the London region, writing off hundreds of millions of pounds. A poor-performing BT contract to install NHS computer systems in the capital will be the main element in a £1bn-plus package of writedowns when the company reports full-year results next month. Global Services last year announced a £336m provision against 15 of its 17 contracts, but the two remaining deals – widely believed to be the NHS and Reuters – are thought to be the most troublesome. The NHS-related writedown comes despite BT two weeks ago winning highly lucrative bolt-on deals, including a contract to manage IT systems at eight hospital trusts across the south of England installed by Fujitsu before the Japanese firm quit
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BT faces multimillion pound writedown on NHS computer upgrade
Michael Cross on Wales’s Individual Health Record system
In an echo of his predecessor John F Kennedy, Barack Obama has set his nation a massive technological challenge. In his first weekly presidential broadcast, he pledged: "We'll computerise the nation's health record in five years, saving billions of dollars and countless lives." Compared with Kennedy's 1961 ambition to send a man to the moon "before the decade is out", the goal of computerising health data may seem unheroic. However, in many ways it is a more daunting challenge. The moon programme was a triumph of human endeavour, but it was based on rock-solid principles: in 1961, scientists knew exactly where the moon would be nine years hence and roughly how they would go about getting there. Moving target Experts planning the computerised health record enjoy no such certainty. The "nation's health record" does not even exist as an entity today and it would be foolhardy to predict what it will look like in five years' time. For a lesson in how to manage the programme, Obama might do well to look across the Atlantic. Not to the NHS in England, where a £13bn-programme is this year reeling from its latest parliamentary battering, but to Wales. Earlier this month, Edwina Hart, the Welsh assembly's health minister, approved a plan to extend a system called the Individual Health Record (IHR) across the country. The decision comes seven years after the equivalent announcement in England, but no one need apologise for the delay. The Welsh IT team says that, by eschewing political deadlines and working with the NHS rather than trying to impose technology, it has created an electronic medical record that is not only more useful than its English equivalent but will cost a fraction of the price. The secret, says Gwyn Thomas, chief executive of the agency Informing Healthcare, is to listen to users. The contrast with the gung-ho English programme, now enervated by contractual rows and political grandstanding, is graphic. In the latest report, the chairman of the Commons public accounts committee, Edward Leigh MP, said: "Essential systems are late, or, when deployed, do not meet expectations of clinical staff; estimates of local costs are still unreliable; and many NHS staff remain unenthusiastic." Wales and England started off with the same goal - to make computerised medical records available where they are needed. However, the two countries went about it in wildly different ways. In England, the NHS took it for granted that the right technology was available and that staff were enthusiastic about adopting it. The central challenge was seen to be procuring the technology on the best terms, and implementing it to timetable
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Michael Cross on Wales's Individual Health Record system
New £12.7bn NHS computer system on brink of failure, warn MPs
Key parts of a £12.7bn programme to upgrade the NHS's information technology are on the brink of failure, a powerful cross-party group of MPs warned today. The Commons public accounts committee (PAC) said recent progress in deploying a new care records system to hospitals across England was "very disappointing". The system was supposed to link 30,000 GPs to nearly 300 hospitals across England, providing NHS staff with instant access to the medical notes of 50,000 patients at every stage of diagnosis, treatment and discharge. The NHS is currently forecasting a completion date of 2014-15 - four years later than originally planned. But the MPs said even this revised schedule looks over-optimistic. By the end of last year, no hospital was yet able to use the Lorenzo version of the care records software, which had been due to operate throughout the north, Midlands and east of England. The committee said: "There must be grounds for serious concern as to whether Lorenzo can be deployed in a reasonable timescale." Plans to instal an alternative Millenium system in the south of England were also in doubt after the government terminated the contract of the service provider Fujitsu. The committee said: "The programme is not providing value for money at present . . . Unless the position on care records system deployments improves appreciably in the very near future (ie within the next six months), the Department of Health should assess the financial case for allowing [hospital] trusts to put forward applications for central funding for alternative systems." The MPs also called on the department to spell out how it will punish staff who breach the security procedures that are supposed to stop patients' confidential medical information falling into the wrong hands. They said: "Ultimately data security and confidentiality rely on the actions of individual members of NHS staff in handling care records and other patient data. To help provide assurance, the department and the NHS should set out clearly the disciplinary sanctions that will apply in the event that staff breach security procedures." Edward Leigh, the PAC's Conservative chairman, said: "It is worrying that, if trusts decide not to deploy the patient care records systems, the taxpayer can still be obliged to make payments to the suppliers concerned." Responding to the committee, the NHS Confederation said hospitals are frustrated by delays in introducing the care records system. Nigel Edwards, the policy director, added: "The time is quickly approaching to make tough decisions on what the future of the project should be ... Many of our members still do not know if they are going to get a system that works or does the things they want it to." The Department of Health defended the IT programme. It said: "New IT systems in the NHS are delivering better, safer and faster care. Current costs have declined because of the delays to implementation due mainly to adding extra functions to the system. Costs are also controlled by the contracts which only pay to providers once the service has been successfully delivered." NHS Health Health policy Inside IT Computing Politics and technology guardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
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New £12.7bn NHS computer system on brink of failure, warn MPs