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 54.

    The problems with IT are simply support, licenses, upgrades and hardware all of which have limited life cycles built in by the product houses/manufacturers.

  • rate this

    Comment number 53.

    Another 'self-managing' service, desperately in need of technology and wholesale reform.

  • rate this

    Comment number 52.

    They should be a bit smarter about it.

    Make an NHS social network. That way everyone sets up their own accounts instead of mass data entry. The NHS can then harvest the data from people's inane updates about headaches and back pain and depression etc and get a day to day feed of moaning Brits.

    They could also collate the data to find out about epidemics + use it to advertise hence making money.

  • rate this

    Comment number 51.

    It is a side effect of bureaucracy that it tends to pick the cheapest system to start, which inevitably ends up the most expensive to maintain.

    The real concern here is training, because computer systems are only as reliable as the people who use them.

  • rate this

    Comment number 50.

    41. Horse Meat Tesco
    "Hands up who thinks the NHS is safe in Jeremy Hunt's hands ?"

    Look what happened when he had a bell and he tried to ring it for an Olympic celebration and the bell came to pieces. Probably a good analogy of what will happen to the NHS in his hands.

  • rate this

    Comment number 49.

    A job this big needs to be done in bite sized pieces. From what I saw there were endless consultants and managers trying the old method of trying to spec the whole lot before starting. Inevitably, during the job you'll think of something that was missed.

    First deliver a simple system of centralising or transferring records with limited access. Then try it out, and build on that.

  • rate this

    Comment number 48.

    It's not rocket science, so please keep it simple & resilient!
    Interesting that big outfits like E-Bay, Amazon, Tesco etc all have millions of happy clients merrily using their 'intuitive' IT systems.
    The NHS 'just' needs a glorified online CRM system with plenty of file storage capacity. As others have suggested, a suitable system probably exists already - ask our American or German cousins!

  • rate this

    Comment number 47.

    The NHS should stop commissioning big IT systems. Instead, they should define the standards for the way any NHS IT system talks to any other one. That way, for example, all X-Ray machines provide X-ray pictures in the same way and other IT systems can make use of them. Once they've done that they should let the market operate. The banks work this way and look how amazingly interconnected they are?

  • rate this

    Comment number 46.

    Used to drink with a computer scientist . Typical beard and sandals type .
    One day he turned up at the pub white faced and shaking . He had just been put in charge of a nine figure hardware budget for the last NHS unified system attempt .
    He might have been a damn good scientist bit he could barely manage 10 students . Doomed to fail.

  • rate this

    Comment number 45.

    You can't entirely discount the size or complexity. This is the world's fifth largest employer. It has in excess of 60,000,000 patients, with histories of up to 100 years, and NHS records of up to 60 years. The number of treatments is immense: there are complex relationships between patients, medical conditions, and physical, chemical and psychiatric treatments. Entity-relationship diagram anyone?

  • rate this

    Comment number 44.

    The only real problem writing software is keeping it simple. The bigger the project the harder it is to achieve simplicity. As they say - any fool can write clever code, only the clever can write simple code.

  • rate this

    Comment number 43.

    Problem is too many overpaid project managers/consultants (often glorified administrators who have many numerous pointless meetings and produce irrelevent paperwork and don't really understand how technology should work and are unable to produce design docs) then too much work outsourced to overseas where they have no concept of the NHS is or how it should work and rely on the poor design docs.

  • rate this

    Comment number 42.

    The NHS has been taken for a ride by large IT service providers for years. The classic counter-claim from the IT providers is that the NHS keep changing requirements. Both are to blame. The NHS have been too ambitious in their Programme Scoping; lumping together IT Changes Into unwieldy chunks. Large IT companies bamboozle the NHS Project teams. Result: too little delivered for too much cost.

  • rate this

    Comment number 41.

    Hands up who thinks the NHS is safe in Jeremy Hunt's hands ?

    Anyone ?

    Dust ?

  • rate this

    Comment number 40.

    The numbers are not the problem. Top grade IT systems can eat those numbers for breakfast.. However a top grade IT system across the NHS would swallow GNP - even in a time of economic prosperity.

  • rate this

    Comment number 39.

    1. luddite1955 "the IT industry is making another concerted effort to subvert the NHS budget for its own ends."

    Unfair. Invariably NHS bosses/politicians have no clear idea about what's needed or feasible or they change their minds constantly and so push up costs. They also go to the same companies every time but that's not the fault of the IT industry that's just a rubbish procurement process.

  • rate this

    Comment number 38.

    I worked for an IT company which won a government contract to implement an "NHS" system. It later emerged that central government could not compel individual NHS trusts to buy or use the system. The company couldn't cover the cost of selling the new system to all of the individual trusts and without a guarantee of purchasers, they eventually ended the contract. The trust structure is a problem.

  • rate this

    Comment number 37.

    Any large IT project that takes more than a year to get from idea to build is going to be outdated before it's implemented.
    And there is never enough money to pay for a bit of extra flexibility because that's 'a waste of money'.
    The sensible way is building a modular system, designed for change and updating.
    Successive governments have toed the Treasury line and scuppered any chance of that.

  • rate this

    Comment number 36.

    We don't need to pay out billions to re-invent the wheel.
    Surely such systems already exist in the world.
    Health depts in other developed (and rich) countries must have a system.
    Or take a regularly updated system from an industry with similar documentary requirements.
    Couldn't we rent or buy the use of one of these and just pay extra for the required 'tweeks' to be made.

  • rate this

    Comment number 35.

    I think this is a wider problem than just technology. Previous comments have highlighted the culture issue which I believe to be at the heart of the problem. Look at any ad for interim help and it always states that previous experience of the NHS is a must. AKA we know you won't rock the boat! So where do new ideas come from and how will they be sustained?


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