By John Thornton | 5 July 2011
The NHS IT Programme promised integrated care records but eight years on hospitals are still relying on patchy paperwork. So what went wrong?
I was in hospital recently, nervously waiting to be taken to the operating theatre. The nurse and porters arrived and began feverishly searching for paperwork. A vital piece of paper was missing and without it the operating team would shout at them. My concerns multiplied and I couldn’t help thinking that this might lead to the wrong operation or the removal of body parts that I would prefer to keep.
This exemplified my experiences with the NHS: the people are generally incredibly good but the processes and information systems are patchy, unreliable and usually paper-based.
It wasn’t supposed to be like this. Over the past ten years I have attended countless presentations on the £11.4bn NHS National Programme for IT. This was launched in 2002 to revolutionise the way that the NHS in England uses information to provide services and improve patient care.
In my case, one minute I was aggressively shovelling snow, an hour later I was in A&E, which led eventually to admission and the operating theatre. Throughout the process I was much better treated and cared for than I had been led to expect, but at each crucial stage they couldn’t find records of previous treatments and tests, or there was only partial information.
Central to the IT programme was the creation of a fully integrated electronic care records system, designed to share and collate patient information. This should have quickly and accurately brought together my medical history from the various sources.
But a National Audit Office review has found that the £2.7bn spent so far on the care records system is not value for money – and the auditors are not confident that the remaining £4.3bn will be any different.
This represents a massive missed opportunity. The health care, technology and pharmaceutical sectors globally are among the most innovative and progressive industries. Over the past ten years there have been huge advances in these sectors. NHS technology could have been a hotbed of innovation and progress.
Politicians took the brave decision to invest billions of pounds in developing and building a world-class technology infrastructure for the NHS – but the results do not justify the huge expense.
To be fair, there are huge challenges in terms of data capture, scale, information governance and cultural resistance. The Department of Health can also point to positive outcomes.
But the truth is that the programme has failed to deliver on the expectations that justified the huge investment. Worse still, it has effectively acted as a barrier to progress, freezing expectations and blocking many areas of innovation.
What we need now is a structure that encourages innovation and rapid progress, not quite the ‘let 1,000 flowers bloom’ approach but much closer to it.
This needs to be done within a framework that rewards success and the sharing of successful projects and that uses national standards to achieve data sharing and good information governance.
Smartphones, social networking and data mashing were not available when the IT programme was conceived. There has been a revolution in data storage and electronic communications, plus there is a new generation of tech savvy doctors and managers. Is it time for a radical rethink?
Like many of you, I will probably need to use the NHS again in the next few years. It is in the interests
of all of us that it finds better ways of using information and technology to improve its processes, efficiency and patient care.
John Thornton is a director of e-ssential Resources, and an independent adviser and writer on business transformation, financial management and innovation
The NHS IT Programme promised integrated care records but eight years on hospitals are still relying on patchy paperwork. So what went wrong?
I was in hospital recently, nervously waiting to be taken to the operating theatre. The nurse and porters arrived and began feverishly searching for paperwork. A vital piece of paper was missing and without it the operating team would shout at them. My concerns multiplied and I couldn’t help thinking that this might lead to the wrong operation or the removal of body parts that I would prefer to keep.
This exemplified my experiences with the NHS: the people are generally incredibly good but the processes and information systems are patchy, unreliable and usually paper-based.
It wasn’t supposed to be like this. Over the past ten years I have attended countless presentations on the £11.4bn NHS National Programme for IT. This was launched in 2002 to revolutionise the way that the NHS in England uses information to provide services and improve patient care.
In my case, one minute I was aggressively shovelling snow, an hour later I was in A&E, which led eventually to admission and the operating theatre. Throughout the process I was much better treated and cared for than I had been led to expect, but at each crucial stage they couldn’t find records of previous treatments and tests, or there was only partial information.
Central to the IT programme was the creation of a fully integrated electronic care records system, designed to share and collate patient information. This should have quickly and accurately brought together my medical history from the various sources.
But a National Audit Office review has found that the £2.7bn spent so far on the care records system is not value for money – and the auditors are not confident that the remaining £4.3bn will be any different.
This represents a massive missed opportunity. The health care, technology and pharmaceutical sectors globally are among the most innovative and progressive industries. Over the past ten years there have been huge advances in these sectors. NHS technology could have been a hotbed of innovation and progress.
Politicians took the brave decision to invest billions of pounds in developing and building a world-class technology infrastructure for the NHS – but the results do not justify the huge expense.
To be fair, there are huge challenges in terms of data capture, scale, information governance and cultural resistance. The Department of Health can also point to positive outcomes.
But the truth is that the programme has failed to deliver on the expectations that justified the huge investment. Worse still, it has effectively acted as a barrier to progress, freezing expectations and blocking many areas of innovation.
What we need now is a structure that encourages innovation and rapid progress, not quite the ‘let 1,000 flowers bloom’ approach but much closer to it.
This needs to be done within a framework that rewards success and the sharing of successful projects and that uses national standards to achieve data sharing and good information governance.
Smartphones, social networking and data mashing were not available when the IT programme was conceived. There has been a revolution in data storage and electronic communications, plus there is a new generation of tech savvy doctors and managers. Is it time for a radical rethink?
Like many of you, I will probably need to use the NHS again in the next few years. It is in the interests
of all of us that it finds better ways of using information and technology to improve its processes, efficiency and patient care.
John Thornton is a director of e-ssential Resources, and an independent adviser and writer on business transformation, financial management and innovation
