September 05, 2011

Is That it Then?

The NHS National Programme for IT (NPfIT) seems to have come to an anomalous end. No-one seems to be clear about what is happening to it. The most likely scenario is that the contracts for the local service providers will be allowed to run their term, because it will be too costly for the NHS to exit. This will leave large sums of money tied up--money that could be invested by NHS organisations to procure information systems to help them to realise the £20bn of economies expected of them. But that isn't the worst outcome.

Worse is that a new generation of ICT manager and Directors have spent the last 9 years in meetings watching Gantt charts slide to the right as NPfIT deliverables were continually rescheduled. Existing ICT systems became obsolete; strategic and procurement skills grew weaker, because the world's biggest IT programme would take care of everything.

The NHS will now have to learn all of the old skills again from those left who still remember.

December 07, 2009

NPfIT to be Scaled Down

The Chancellor, Alastair Darling, has announced that the NHS National Programme for IT (NPfIT) will be reduced in scope. Apparently, cuts will affect IT not essential to the frontline.

NPfIT has been incessantly critised since its inception, but you cannot run a £100bn healthcare system with little more than quill pens and ledgers, so I wonder if the cuts will arouse as much discontent as planned expendiure did...

June 11, 2008

NPfIT: full circle?

The departure of Fujitsu from the NHS National Programme for IT (NPfIT) dealt the Programme another body blow. Where does NPfIT go from here, if anywhere?

Perhaps the Southern Programme for IT should be handed to one of the remaining huskies . But this summary from the UK's Guardian newspaper leads to the conclusion that would not be easy because of the alleged poor reception of the Cerner Millennium system.

Yesterday I attended a talk at the Smart Healthcare 2008 conference in London. Last year a similar talk was packed to capacity. This year the same venue was barely half full.

Although the speakers were meant to address healthcare transformation, I heard little evidence of it. The speaker from NHS Choices came closest showing the NHS Choices website had the potential to increase the power of patients by providing them with real performance data on healthcare providers. But the CIO of the London Programme for IT gave a history lesson on NPfIT and implied that NHS organisations would play an even greater role in the choice and implementation of IT.

Now I have tried a few times to read James Joyce's Finnegans Wake. I have never succeeded fully, but I know, set in world between dream and reality, it begins and ends with the word "riverrun" having come full circle: "riverrun, past Eve and Adam's, from swerve of shore to bend of bay, brings us by a commodius vicus of recirculation back to Howth Castle and Environs". So it seems with healthcare IT.

For decades NHS organisations implemented their own choice of IT systems before the intervention of NPfIT. Is the dream ending and flowing back to a parallel reality having run full circle?

June 17, 2007

Thin Ice

Picture of a husky.Hindsight being a perfect science, I can see why Richard Granger, Director General of NHS IT, seemed more relaxed than I have seen him before at the presentation the other day. Times Online reports he is moving on by the end of this year.

Mr. Granger's most quoted comment likens the NPfIT's suppliers to huskies pulling a sled. The weaker dogs would be shot and fed to the rest to sustain them and as an example. Certainly, some well-known huskies are gone, Accenture and IDX being two. Lead dogs have also fallen to the back of the tugline. But will the remaining huskies survive the departure of the sled driver? And will they be challenged by new teams pulling different sleds? We'll see.

April 29, 2007

To Go and To Come?

In its editorial the Health Service Journal of the 19 April 2007 says Mr. Richard Granger, the Director General of NHS IT is "expected to leave soon". Now how many times have I heard that in the last 2-3 years? Nonetheless, the recent mostly critical report on NHS National Programme for IT by the House of Commons Public Accounts Committee (PDF 4.5Mb) cannot have strengthened his position.

The HSJ also refers to a report by Professor Sir Ara Darzi, the national advisor on surgery and one of the medical profession's rare technological innovators. In Saws and Scalpels to Lasers and Robots Professor Darzi suggests 80 percent of local surgery could be carried out in health centres and large GP practices.

It seems if anything is going to drive NHS modernisation it will be public expectation combined with the march of technology--with or without a centrally led IT programme.

April 15, 2007

Improving IT Better?

As reported here more than a year ago, the NHS National Programme for IT is being reorganised. As part of the National Local Ownership Programme, responsibility for implementation is being devolved from NHS Connecting for Health to England's ten fledgling Strategic Health Authorities. Staff are also being transferred.

E-Health-Insider reports the process is delayed. Given the NPfIT's turbulent past, that isn't surprising. What is surprising is we seem to think that transferring the same staff and same suppliers to SHA's will make NPfIT different.

We need more change than that. It seems only a matter of time before NHS trusts are free—within reasonable constraints and complying to reasonable standards—to create their own care record with their own choice of supplier.

March 17, 2007

Forward, Back or Blight?

Picture representing decision making.I have been occupied with work outside healthcare and it may be true what they say: distance enhances review. What I notice is how quiet the sector seems. Even the ever-alert E-Health-Insider is reduced to writing about the lifting of bans on mobile phone use. Nor am I the only one to comment on this. I have also come across a number of healthcare consultants taking similar time out. All mention frustration and lack of progress in the sector.

Has the leviathan that is NPfIT cast a giant restraining shadow over healthcare IT? A colleague recently described the situation as 'planning blight'. But it reminds me of a passage from Lord Macaulay's poem "Horatius at the Bridge" that my class read with Mr. Walker when I was about 11: "But those behind cried ‘Forward!’, and those before cried ‘Back!’".

I am preparing to go forward back to Harrogate for the HC 2007 Conference where I am chairing a debate. Last year in the plenary sessions speakers from NHS Connecting for Health hinted at reorganisations. This year speakers from NHS CFH's top team have withdrawn from the conference, generating considerable speculation. Nonetheless, Lord Hunt the minister in charge of NHS CFH's NPfIT will be speaking. Many will listen carefully to what he says.

June 24, 2006

NHS IT Project: media responses to the NAO report

Please compare two articles on the E-Health-Insider website that respond to the UK's National Audit Office report on the NHS Connecting for Health's National Programme for IT—which was generally positive.

The first is by the Guardian Online's Mike Cross: Press gang.

The second by Jon Hoeksma editor of EHI: Healthy Optimism.

I will allow you to draw your own conclusions.

June 18, 2006

Changing the System: NAO’s report on the NHS IT project

For weeks the UK’s media have been cleaning and oiling their guns preparing to lay a broadside on the NHS IT Project.

Last Friday, on the morning of the release of the National Audit Office’s report on the NHS National Programme for IT (NPfIT), even my favourite BBC Breakfast news presented by the elfin Sîan Williams and the grounded Bill Turnbull could not resist a ranging shot: the NAO report would “criticise” the NHS IT project.

Continue reading "Changing the System: NAO’s report on the NHS IT project" »

June 04, 2006

NHS: back to quill pens and ledgers?

Picture of quill pen.Lord Warner announced last week that NHS Connecting for Health’s National Programme for IT (NPfIT) was likely to cost closer to £20bn than the much-quoted £6.2bn. This has brought out the emotive in journalists and the hoped for response from some members of the Public.

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May 21, 2006

Blundering the NPfIT?

Last week, I attended a presentation by David Craig (a pseudonym) who wrote Plundering the Public Sector, which criticises the cost, justification and management of NHS Connecting for Health's National Programme for IT (NPfIT). Book and presentation contain nuggets of wisdom tarnished by uneveness and inaccuracy.

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April 09, 2006

Connecting for Health: awaiting the winds of change

Connecting for Health faces the winds of change.Political and technological winds of change whistle through NHS Connecting for Health's National Programme for IT (NPfIT). They may erode the notion of a single, comprehensive, monolithic system serving GPs and acute, community and mental health care settings and deposit the spores of innovation, clinical inspiration and supplier diversification.

Continue reading "Connecting for Health: awaiting the winds of change" »