BCS calls for major changes to NHS IT strategy

The huge amounts of money being pumped into the NHS IT Programme aren't bearing visible fruits, particularly when it comes to front line systems, most likely because a one-size-fits-all approach has been applied to technology projects.

So says the British Computer Society (BCS), which has published a report today calling for major changes to redress the balance and provide value to patients and other key stakeholders.

Critical of some of the current programme's failings, the BCS has set out some key recommendations for how the NHS' IT strategy should move forward and pinpointed changes that need to be made to start ensuring investment equals results.

The NHS Connecting for Health (CfH) programme still has a very valid and valuable contribution to delivering patient care, according to the BCS.

But key issues remain that need resolution.

NHS CfH needs to work towards becoming more of an open partnership between NHS managers, users, patients and the IT industry, based on the foundations of trust and respect.

In addition, concerns regarding the sharing of electronic patient data must be alleviated without allowing technical issues to overshadow the debate.

The society's Health Informatics Forum Strategic Panel (BCSHIF) does agree with the Wanless report's recommendation that four per cent of NHS turnover should be channelled into business-led IT.

However, it feels that this investment should be more carefully directed towards relevant systems that are interoperable rather than monolithic technology giants that don't cater for the needs of individual users.

"IT enables change, is sometimes a catalyst for change, but it is not an end in itself," said Dr Glyn Hayes, chair of the BCSHIF.

"This misconception has been a prime cause of large scale IT project failure since computers first became common place. The problem has been heightened by NPfIT's top-down nature; the patchy reflection of NHS requirements in the procurements in 2002; and the subsequent changes in those requirements to meet the government's NHS reform programme.

"We believe that this is one reason why so many NHS staff have yet to see NPfIT as a key enabler of business change and it has thus discouraged the local ownership of NPfIT implementations."

Dr Hayes added: "One of the fundamental goals must be to support the diverse business processes that recognise local constraints and individual patients' values, and focus on delivery and implementation at trust level.

"Instead of the current monolithic systems intended to meet most of the needs of users in a local health community, we need a range and choice of more innovative and agile solutions contributing to a common purpose, encouraged within national standards to deliver functionality in whatever way suits the users and suppliers. This should not be interpreted as ruling out adoption of local server provider (LSP) products where they fit the business requirements."

The BCS recognises that sustainable and successful change can not occur overnight. Nor does it want it to. Instead, the society advises that the new strategy comes about in an evolutionary, rather than a revolutionary, fashion.

"We appreciate that some of the issues it faces - information governance for example - are not of its own making and predate NHS CfH, although it has inevitably raised their importance," said Dr Hayes.

"Others - for example: the need for it to be accompanied by significant local business change; the integration of social and healthcare; and the changes in clinical data recording, quality and management it relies on - must be recognised as major challenges in their own right.

"The government has committed very significant resources for NHS informatics but relatively little has yet been spent and less still is visible in front-line informatics. We wish to see this commitment play its proper and vital role in the new NHS. Starting from where the NHS and NHS CfH are now, our report is intended to start a constructive, urgent and open dialogue to support this goal."

CfH was unavailable for comment.

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