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Learn from the Past

It's been a while since I last posted. Personal matters, my workload and the departure of the muse are among my excuses.

I am back at a time of transition. The NHS waits for the official line of the NHS National Programme for IT (NPFIT). The Department of Health’s November 2009 deadline for Local Service Providers (LSP) to have made significant progress is here.

Perhaps the plans for the NPfIT Southern Cluster are a hint to the future of ICT implementation in NHS. In limbo since the departure of its LSP, Fujitsu, it seems Southern cluster organisations might be allowed to select systems from the pre-competed framework contract, the Additional Supply Capability and Capacity (ASCC).

I have always suggested that allowing organisation to choose their own systems adhering to reasonable standards--whether from NPfIT, the ASCC or by independent procurement-- is where the NHS would end up. Indeed, some foundation trusts have already gone and done it, and the tide of trusts preparing to do the same threatens to end the 7 year interregnum imposed by NPfIT anyway. For many organisations the years of waiting for NPfIT to deliver while their existing systems became obsolete proved too long.

I may have suggested independent choice was the way forward, but I didn't say it would be a panacea. Successfully implementing major health IT is difficult. However, a legion of consultants and assorted contractors wait to help trusts through these challenges, particularly since LSPs have been downsizing.

During a recession, you can hardly blame people and organisations for presenting their experience in the most positive way, but the head of NPfIT's office must have been very crowded if all of the people and organisations who, according to their biographies, played a 'major role' in it were accommodated there.

Aldous Huxley quipped the most important thing we learn from history is that we never learn from history. We risk repeating the mistakes of the past if we simplistically believe that a different approach will be a better one, particularly if we (again) accept the advice of those who have little or no real experience of the challenges of major healthcare IT procurement and implementation.

If you are considering an independent procurement or are simply assessing your options take advice from someone who has at least implemented a major healthcare system and learned from the experience.

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