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 74.

    What a petty, one sided and mean spirited article!

    "Meanwhile, online appointment booking is at least two years away..."
    I have been fortunate not to need the NHS much in recent years but about 18 months ago my GP recommended a scan and gave me a website address and a reference number. I was able to book an appointment for just few days later at a time of my choosing, so its not all bad.

  • rate this

    Comment number 73.

    I have found that the key point at which any technical project begins to fail is when the managers and bureaucrats start to tell the technical people (i.e. the ones actually DOING the work) how to do their jobs. People whose only qualification is a management degree shouldn't be allowed anywhere near a project like an NHS IT system.

  • rate this

    Comment number 72.

    I think people would have to spend time working in the NHS (as I do) to fully appreciate the dog's breakfast being made of this issue.
    Fault does not lie in any one area. That said, the biggest two, IMO, are the procurement processes, exploited or mismanaged (or both) by all involved and the fact IT experts tend to have no idea about clinical need & those advisng them are generally donkeys.

  • rate this

    Comment number 71.

    How Labour can argue against this is beyond me - I appreciate their position of being the opposition, but shouldn't be for the sake of being so. A comprehensive IT system/protocols for data transfer and sharing are the most obvious way to make the NHS more efficient and enable doctors and staff to better utilise their time. Jamie Reed, shame on you - centralising systems is the best way forward.

  • rate this

    Comment number 70.

    I think the dilemma is not understanding what is required from a computer system in a clinical setting.
    On wards, in clinics and theatres requirements are vastly different. Resources to have suitable, with fast logins, that are easy to clean, at times portable and have tech support. These are just not things the NHS is willing or able to invest in. I have worked overseas and it can happen.

  • rate this

    Comment number 69.

    The 12bn NHS IT project failed because it was attempting to create a gigantic, rigid, top-down system.

    They should've just created data transfer and storage protocols and standards and left it up to area health services or even individual GPs to buy IT systems based on those standards. You'd then have a free-market of companies providing different 'NHS-compatible' systems.

  • rate this

    Comment number 68.

    @ 65. Shaun the Faun
    "the fundamental problem in the NHS is the doctors"

    If doctors are the problem then I hope you never have to see one. The problem is the useless managers who can do nothing except ensure that their severance packages are superb. The NHS has been ruined by protocols and policies that have no evidence or public benefit and are just public relations exercises & political tools

  • rate this

    Comment number 67.

    Coming up with a "standard" patient data taxonomy seems a good starting point. Business has XBRL (eXtensible Business Reporting Language) - why not create XNHSL? This would allow technology-independent/resistant categorisation of patient data, accessible via secure browser connections. Agreeing on the basics before looking at the technology is critical to success for any large scale project.

  • rate this

    Comment number 66.

    The NHS is highly resistant to change, because the people with influence are all doing very nicely from the status quo. Consultants, GPs, Managers etc do extremely well financially as things currently stand. (Thank you very much Mr Blair) Why change anything?

  • rate this

    Comment number 65.

    Whilst there's a lot of truth in some of what's been said, the fundamental problem in the NHS is the doctors. Very many don't see them themselves as part of the NHS, but as providing a service to the NHS. GPs are independent and not employed by the NHS! Woe betide any NHS manager who seeks to manage doctors! They know best and all have different views on what is the RIGHT computer system. Chaos!

  • rate this

    Comment number 64.

    Where I volunteer we have new all singing software for records, bookings, producing statistics etc. It is horrible. Why because it is trying to do too much and it often takes about 10 clicks to get to the page I want. Trying something new and it is half an hour clicking to work it out!
    IT should be kept simple and not try to do too much.
    A real computer user since 1967 (IBM 7040 mainframe)

  • rate this

    Comment number 63.

    Paper records are a pain at times.


    They still work during powercuts

    The cannot be wrecked by a computer virus or being remotely hacked

    You dont need a computer to view them (Limited number on wards etc)

    It is ALOT harder to write information about another patient (accidental keystroke/name/number) in them by mistake because they are checked before they get to the ward etc

    I could go on

  • rate this

    Comment number 62.

    The first step in successfully achieving a task is to sufficiently understand what is needed

    Then you need to employ suitably experienced/qualified organisations & be able to explain it to them

    This is why many government contracts fail in IT/Defence/railways

    Incompetent (& unaccountable) people in charge who do not understand what is required, making selections based solely on lowest bidder

  • rate this

    Comment number 61.

    Much of the problem is that nobody directly employs competent IT staff because they're believed to be too expensive. Users are insulated from implementers by over-promoted clerks (a.k.a. 'management') on both sides leading to project goals that are of no practical value.

    IT projects so commonly fail that the post-modern goal is 'administrative success' (a great report into where the budget went).

  • rate this

    Comment number 60.

    If you could get all parts of the NHS to agree a standard electronic patient data record, then progress could be achieved quite quickly in small steps. I wonder if this has ever been attempted?

  • rate this

    Comment number 59.

    Other sectors have made progress but they have also made mistakes which in the context of the NHS and peoples medical records could potentially be very serious. It might sound like an easy task but invariably politicians especially the current bunch completely underestimate the task in hand such is their naivety when it comes to technology and its use in complex environments like the NHS.

  • rate this

    Comment number 58.

    A district nurse close to me has found it impossible to connect her laptop for the past two years despite repeated requests for assistance from IT.
    A few less managers and a few more doers might be a starting point....

  • rate this

    Comment number 57.

    Maybe they just don't like the sound of some hacker running around with everyone's personal medical records. Something that is quite simply bound to happen!

  • rate this

    Comment number 56.


  • rate this

    Comment number 55.

    please add .
    several existing systems .
    No coherent it hardware standards .
    Time for retraining impossible to find .
    Getting it wrong costs lives .

    Needs doing , but will be a unique task .
    With intangeable rewards and guaranteed failures


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