The NHS's troubled relationship with technology

A man uses his smartphone The public are used to having most aspects of their life just a click away. But in the NHS it is a different matter

When you think how technology has reshaped everything from the way we shop to how we communicate with friends, the lack of progress made by the NHS is astonishing.

While booking holidays and doing the weekly shop online has become routine for many, making appointments to see a GP in such as way has not.

And in an era when companies hold a host of personal information, the fact remains an ambulance can still respond to an emergency call, ferry a patient to hospital but doctors will still have little knowledge of their medical history.

Since the 1990s report after report has called for more innovation.

But time and time again the NHS has failed to live up to expectations - at least in the way the health service interacts with patients and shares information (a much stronger case can be made for its use of technology in areas of medicine, such as robotic surgery).

The £12bn NHS IT project is a case in point. Launched in 2002, it was meant to revolutionise the way technology was used in the health service by paving the way for electronic records, digital scanning and integrated IT systems across hospitals and community care.

But more than a decade on it the national programme has effectively been disbanded with many of its ambitions yet to be realised.

Local parts of the health service - hospitals and the new GP-led groups - have now been asked to push ahead with the changes and the speech by Health Secretary Jeremy Hunt on Wednesday is an attempt chivvy that along.

Some progress

Admittedly, progress is being made in some areas.

Telehealth and telecare, which covers everything from specialist equipment to help a patient monitor their condition to sensors in the home to detect falls, has been piloted quite successfully in several areas.

But the number of people benefiting is still limited to the tens of thousands.

Meanwhile, online appointment booking is at least two years away and some of the most innovative ideas deployed in other countries are but a distant dream.

For example, in the US electronic bracelets are in use that can be scanned by doctors enabling them immediate and easy access to the patient's medical history.

And as the NHS plays catch up, other sectors continue to push the boundaries of what is possible.

It poses the question: Why?

Julia Manning, chief executive of the 2020health think-tank, says the lack of success in embracing technology is "crazy".

She believes the barriers are related to culture more than anything else.

Indeed, the private sector has often complained that the commissioning and purchasing systems in the NHS have proved too complex to encourage innovation.

The NHS IT project was the government's attempt to apply some central control.

But after that struggled the NHS is back to devolving responsibility down to a local level.

Everyone will be hoping the health service is more successful from now on.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 14.

    Like most government departments by the time systems are designed, installed and full roll-out complete the technology is out of date. Loss of in-house expertise has not helped plus, the failure of staff to get to grips with IT in general. Finally, systems are implemented with no thought to the training of staff burden and cost.

  • rate this

    Comment number 13.

    Do NOT get 'business managers' involved. They contribute very little but dress it up in fancy words, supported by the PR we pay for, this is called 'transformation'. In reality it's a scam.

    1) Ask users what they want 2) Ask management what they want. 3) Re-use what is freely available online. 4) Get the easy stuff done nice & early. 5) Speak to people, don't do it all by website and email

  • rate this

    Comment number 12.

    A better question would be to ask why IT has been a thorny issue for all branches of Government AND for many big buisnesses.... is less about the what & seemingly more about the sheer scale.....

    ....internet companies such as Google, Facebook & Amazon are entirerly computer based so spend the billions necessary for big IT projects....

  • rate this

    Comment number 11.

    The solution to solving the NHS's IT problems is helping SME's compete for work; they have an incentive to innovate. Enabling real competition will help drive a fair and innovative market. Intelligent use of tech can and will still improve the experience for patients and save hospitals real money at the same time.

  • rate this

    Comment number 10.

    Ministers require that too many government IT projects are too ambitious for the capabilities of sponsors, consultants and contractors.

    Consideration should be goven to addressing fewer objectives at a time and then move forward combining more ojectives within a tried and tested, and thus better understood, environment.

  • rate this

    Comment number 9.

    Possible causes of failures:
    Easy access to data and security of data are close to being mutually exclusive, so the Data Protection Act and the penalties in it are a huge hurdle.
    IT offices are usually considered Back Office/Management and are often decimated or more, and usually the more competent leave, and good IT staff can be hard to come by.
    Goal posts keep on being moved.

  • rate this

    Comment number 8.

    Surely a major part of this has to be MPs.

    The scope of projects gets changed, changed, changed again. New technologies are introduced before the project is complete and then altered because of cost cutting / requirement changes / because the minister wants to stamp their name on it.

    Just like the Edinburgh Tram fiasco, really.

    Expensive, poorly designed and never quite reaches the goal

  • rate this

    Comment number 7.

    Clueless commissioning and a healthcare system that is a political football means any IT attempt is doomed to failure. Nationalised industries are not known for their successful track record, and that is just what the NHS is. Been working in it for over 25 years.

  • rate this

    Comment number 6.

    Run by idiots get some real business managers in there! They get shafted all the time with great new IT products sold by Cameron's relatives and friends. Will someone tell us how much money they have wasted? Bring back the paper system it will be cheaper for now.

  • rate this

    Comment number 5.

    I work for my local NHS Trust in a GP Practice.My main job is to improve the ICT services the Practice provides. Patients can now order repeat prescriptions and book standard and emergency appointments online. We also offer a patient email service. We have advertised these services greatly however only 20% of patients have signed up. For online NHS services to improve Patients need to act!

  • rate this

    Comment number 4.

    Failure of NHS IT is probably easy to explain because it shares the same features with many other failed IT projects.

    1. Specification by a centralised committee not by users
    2. Many changes in specifications.
    3. Minimal attempts to involve clinicians
    4. Over reliant on bespoke software.

    Take a simple example - Patient records. Fundamentally this is nothing more than a very big database

  • rate this

    Comment number 3.

    By adapting new technologies that NHS staff are already familiar with, i.e Apple, Android, BlackBerry and Windows devices would surly help minimize the issue of culture change and attitude towards technology. What is needed though is an actual solution that works, saves time and money, and essentially creates more Time to Care - right across the NHS!

  • Comment number 2.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 1.

    Here we go again. Not content with the billions of pounds of NHS cash which already bled away into fruitless IT projects over the last 20 years, the IT industry is making another concerted effort to subvert the NHS budget for its own ends. The method is a tried and tested one: call in the IT-friendly consultants, who conjure up a mirage of huge cost savings which of course are never ever acheived.


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