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 114.

    I am a nurse and in my hospital I have long been confused as to why nurses have no access to Oasis, our bed managing programme. This often means that patients go missing in the hospital if they are moved after the ward receptionists have gone home.

    Even on the ICU where I work each patient has over £100,000 of machinery by their bed, but we only have 3 computers for the 20+ staff on each shift.

  • rate this

    Comment number 113.

    Its perfectly obvious why the NHS has crap IT provision. The NHS has for years been broken up from a large organisation into many smaller ones in the name of efficiency. Thus there is no central control and no economies of scale in purchasing or overall control of IT. This has been done for ideological purposes not to improve patient care. The Balkanisation of the NHS is ruining it.

  • rate this

    Comment number 112.

    How odd, my wife and I, resident in Florida, have this week gone to various doctors clinics and spent more time filling out pages of forms re our address, history, drugs, etc., than seeing a doctor (or more likely nurse), even though we have been to the clinics before. Where are these wonderful bands containing all our relevant medical records and information? In wish-fulfillment I assume!

  • rate this

    Comment number 111.

    For some time we have been able to book and cancel appointments and order repeat prescriptions at Rolle Medical Practice in Exmouth. If one GP practice has this, why is it not more widely available?

  • rate this

    Comment number 110.

    We have built an integrated electronic health care record a year ago. We're meeting all accreditations and comply with all ISO standards and NHS regulations. The system is built so that the patient owns all their medical data, they choose who to share it with (including the system). The service is FREE to all NHS patients. NHS doesn't seem at all interested. Try making sense of that...

  • rate this

    Comment number 109.

    'The NHS's troubled relationship with technology'

    If you ever speak to anyone unfortunate to have been involved with work to improve the IT in the NHS (I regret to have been among them) you wil discover that the NHS has been ripped off sideways by a number of private IT contracors over the years, leaving a bunch of semifunctioning local networks that will never be compatible with each other.

  • rate this

    Comment number 108.

    The most fundamental reason for the health services and NHS avoid IT is that medical record would come under the Data Protection Act. Patients would have a right to know what is stored.

  • rate this

    Comment number 107.

    Most of the software the NHS wants is available off the shelf and is tried and tested having been used in other countries.
    There is greed and corruption within the NHS and government, they give contracts to friends in return for favours and ensure the hardware is expensive and comes with expensive support contracts.
    Its a data base for gods sake, its not rocket science.

  • rate this

    Comment number 106.

    The NHS is a milch cow for IT companies and lessons must be learned from the expensive systems in use now. New software should be open-source so that contractors can more easily be replaced to sort problems left by others' bad design and systems integrated easily during the disruptive changes that afflict the NHS. I could go on... intuitive to use so that minimal training is required

  • rate this

    Comment number 105.

    A play on words here... Take the 'N' (for nasty) and then put the rest of the letters together in ANY order you think the 'IT' helps the NHS!

  • rate this

    Comment number 104.

    Typical political interference in something they know nothing about. The NHS is no longer NATIONAL, therein lies a problem.

    GP/Hospital Appointments - A holiday company booking system ?

    Medicines/equipment - basic stock control, ask any major supermarket for a system

    Medical records - nothing more than an online filing system.

    Get a proper IT Company to link the three together, job done !

  • rate this

    Comment number 103.

    Sorry for trolling but I look around at work and despair.

    The environment agency came to check how we disposed of our waste.
    The day before signs went up segregating our waste. And I saw our waste manager for the first time in 7 years. The agency came and went satisfied. Yet No training was given and many asked "what goes in where?"
    And we only have two bins to put the waste in.

  • rate this

    Comment number 102.

    I also take deliveries from drivers who are all wielding electronic scanners.
    When the system goes down and they have to use the paper back up, they get the job done alot quicker.

    But then management cannot spy on their employees if the system is down.

    To many overseers and task masters.
    Not enough common sense.

  • rate this

    Comment number 101.

    Spending billions on IT systems to solve the problem of the NHS is fundamentally flawed. Not because the IT systems don't work, but because the until the NHS is organised and governed for satbility, the IT solution will forever chase a moving target..

    Money should can be saved by process re-engineering. But getting all trusts to play ball is near impossible. Only then can IT do it's work.

  • rate this

    Comment number 100.

    98 continued.
    Our computers are slow and I have had to reduce the screen resolution to be able to read the main program I use.

    No body has ever discused with the users how they would like systems set up. Its all decided by people who rarely if ever use the programs.

    Plus these systems are never flexible enough to tweek to the users preference.

  • rate this

    Comment number 99.

    I've spent forty years watching the American company who came after HAL draining billions of pounds out of this country by using misrepresentation and bribery to pervert ignorant bean counters. They ruined the British and French companies who could easily have provided better solutions and continue to do so today.

  • rate this

    Comment number 98.

    Where I work, we still use fax machines. We have no idea if the recipient has received the fax so we call them after to tell them we sent a fax.
    My email is better than this, I can see if my message has been read or not.
    We also have a robot, which breaks down daily. Unfortunately everything is geared to it working properly, so when it breaks its like walking through mud to get things done

  • rate this

    Comment number 97.

    I think it largely because big government organisations contracted the cheapest (rather than the best value) company on face value. rarely do they turn out to be that cheap either.

  • rate this

    Comment number 96.

    The NHS is "managed" by people who are under-skilled and overpaid, the latter ostensibly to "compete" with industry for "talent". Add to this the continual interference by less skilled and even more overpaid politicians PLUS the fact that funding comes from the unaccountable bottomless pit of taxpayers money and you have a recipe for disaster. The NHS holy cow is being milked to death.

  • rate this

    Comment number 95.

    The problem is that the project was dreamt by NHS people who hardly knew about IT and then ill advised by IT professionals who had their own vested interests in mind. I knew a guy working as a contractor who boasted that money was great and easy. I did ask how was the progress and the reply was: 'We just do out bit and count our cash rolling in. I wonder if this (project) will ever work...'


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