NHS IT - something to celebrate?

Indeed, it’s not the larger systems that have had the most difficulty; what trouble there has been is being slowly overcome and takeup of systems is improving. According to CfH, N3 is rolled out. Fewer than one per cent of people have opted out of Spine. Choose and Book is now being used for about half of referrals from GPs to a first outpatient appointment, with 91 per cent of surgeries using the system to refer patients to the hospital. The electronic prescription service (EPS) is used for 17 per cent of daily prescription messages, while PACS is now live at all acute hospitals – and based on conversations with clinicians at healthcare IT events, one of the more popular systems.

The main trouble now has been rolling out local IT systems – as in, the systems that will allow all this technology at the hospital level.

England has been split into three areas – London, the Southeast, and the North, Midlands and East (basically, everything else). London has been run by BT, the North by CSC, and the South was run by Fujitsu, before they fell out with the DoH and dropped out of the project – at a massive financial cost.

While BT is largely expected to takeover running the Southeast trusts which already have their software in place, it’s not yet known which firm will be willing to take on the massive job of picking up where Fujitsu left off.

Ovum analyst Tola Fischer said: “Whichever supplier - or combination of suppliers - does eventually take over from Fujitsu, it will face many of the same challenges that led the Japanese firm to part company with SPfIT. The biggest challenge will be striking the right balance between local demands for the tailoring of software and the ideal of standard systems across the NHS in the South. As Fujitsu found, without a certain level of standardisation, upgrading and integrating systems becomes more difficult and costs escalate. Any supplier bidding to replace Fujitsu should be doing so with their eyes wide open and will expect to be suitably compensated.”

Each area has – or had – a major tech supplier running the implementation of one of two software systems, either iSoft’s Lorenzo or Cerner’s Millennium. Both systems have their critics. Lorenzo has been delayed so many times it’s reached mythical status, while Cerner’s products have been called “appalling” by former project head Richard Granger.

Overcoming these IT issues are the next big challenge for the DoH, and will decide how successful the NPfIT can be.

What went wrong

Representatives of CfH, the NHS and DoH are fond of pointing out that such a project has never before been attempted, as though that’s a valid reason to make mistakes. There’s probably a good reason no one has attempted to roll out a such a centralised database on such a scale before: it’s hard to do, and clinicians don’t really want it.

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