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 134.

    Incompetence runs through NHS msnagement like a stick of blackpool rock. And its these people who decide were efficiency savings can be made ie: frontline staff.
    They have their cushy jobs and think they can sit back and wait for retirement. Occasionally making stupid rules to justify their existance.

    God help the NHS.

  • rate this

    Comment number 133.

    The NHS is enormous and a very complex organisation, IT solutions aren't easy and are bound to be expensive. Money saving is the worst reason to implement, care improvement the only valid motivation.

  • rate this

    Comment number 132.

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

    I've just seen some pigs go flying past my (NHS) office window!!!

  • rate this

    Comment number 131.

    Where there's chaos there's money to be made.That's why the shares of companies involved in healthcare perform so well.The HMSO used to purchase everything the Government needed unbelievably cheap because the quantities were huge,and different departments just submitted requests to HMSO.Now it's individual departments(includes NHS'trusts')so ordering is expensive chaos.Thatcher's dream continues.

  • rate this

    Comment number 130.

    Here's a little joke:

    Doctor: "This IT system will never work, it's rubbish, waste of money,
    they want to get that Australian software it's brilliant."
    Me: "This is the Australian Software!"

    Doctor: unconfortable silence
    Me: much laughter

  • rate this

    Comment number 129.

    Too many captain's. . . . . .
    NHS should, and is supposed to be about treating the sick . . . . . . In the meantime we'll just sit and watch them waste £'s of our cash while the figure out 'technology'

  • rate this

    Comment number 128.


    This was a deliverable under the previous gov not the new health secretary, anyway the contract has been finished by the gov so exactly what the hell does he want?

    Ah! a continuation of the political football

  • rate this

    Comment number 127.

    There's a daft notion that the overall needs in say Kent are significantly different from Bristol and Cumbria - hence local decision making.

    This produces "postcode prescribing", and each area and Trust doing their own thing with IT (and many other things). Even where an initiative is national (e.g. electronic prescribing), unless mandated by DoH each area/Trust decides its own priorities.

  • rate this

    Comment number 126.

    There's no sharing of information,because the NHS was broken up into regional independant 'trusts' who all work differently.Just like the civil service,broken up into self governing departments.The £4000 laptop for the MoD thats only £400 for another department scenario happens across all NHS trusts.Anyone who was an adult in the 1980's should remember all those changes happening at that time

  • rate this

    Comment number 125.

    "... it seems to be the administration which is dragging their feet, the medics want it!"

    The medics do want "it", but they find it almost impossible to agree between themselves what "it" should be, and they all insist on having their say.

    And then ... every Trust has the power (and its clinicians the egos) to do its own thing in its own way.

  • rate this

    Comment number 124.

    There are so many excuses, but so many things which could be done immediately.
    The local NHS here still communicates overwhelmingly by letter, for appointments etc. It would be so easy to do so by text and mail, just for a start. Data being sent around in envelopes isn't well protected or sure to arrive.

    I suspect the problems are cultural and self-serving. Stupidity and job protection. Very NHS.

  • rate this

    Comment number 123.

    One reason for the lack of progress is total paranoia about confidentiality of patient data. Getting the information governance 'right' is a huge obstacle to be overcome in very many instances.

    The reality is that it's ridiculous. Really, the vast majority of us wouldn't be 'harmed' in any way if our data leaked. But in practice many hoops must be jumped through.

  • rate this

    Comment number 122.

    Being a computer professional, I have found that any time I have contact with 'real' medical personnel (i.e. the doctors and nurses) they want to quiz me about how they could use IT to effect in their work (which is quite surreal when you are waiting to go into the operating theatre!) - it seems to be the administration which is dragging their feet, the medics want it!

  • rate this

    Comment number 121.

    Continual interference from ignorant 'civil rights' activists has prevented the development of a properly integrated IT system for the NHS. They seem to think that a loose leaf folder, with deficient info, laying around for all to pick up, is better than a full computerised record properly 'locked'.

  • rate this

    Comment number 120.

    The NHS is a backward and insular organisation that has still not 'learned' that feeding patients is a necessity to preserve life. Medical records are not passed from one institution to the other and ambulances do not cross regional boundaries to assist the critically injured if it is found they are actually just beyond that boundary. Hopeless.

  • rate this

    Comment number 119.

    I found out this week that 'choose and book' is a nightmare after treatment. 4 years ago I had some treatment under choose and book at two different hospitals, one NHS, but privately run, one private, but undertaking NHS work. This week I went to our local major teaching hospital and the consultant had no records of my previous treatment and also had no idea as to where they could be.

  • rate this

    Comment number 118.

    117.iKnappy - "The software works very well everywhere else in the world!...."

    I;d be interested to know in which countries they do have successfully running IT sstems that do everything promised by the new Health Secretary.

  • rate this

    Comment number 117.

    The software works very well everywhere else in the world!

    So how come it doesn't work in the NHS?

    Ivory towers, numerous gov dept's, and nobody willing or the power to say yes

  • rate this

    Comment number 116.

    a) incompetance via employing low-paid juniors to do tendering, leading to mis-specifications that change month on month.
    b) cost-cutting in the extreme leading to the cheapest choice, rather than the adequate choice, and
    c) Not enough testing (especialy parallel paper and computer systems) leading to no effective debugging.
    d) gross political interference and fiefdoms in the NHS destroy unity.

  • rate this

    Comment number 115.

    add to 111, we have online appointments in Henley on Thames too. The GP has all reports,Xrays etc on the screen in an integrated manner. Fairly impressive.

    A lot of issues arose from choosing lowest cost rather than best value at the time of tender. Several rated suppliers declined to bid.


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