It was fun to write a piece for Computer Weekly’s 50th anniversary on NHS IT from 1966 to the present, but a depressing pattern emerged. One part of the NHS brings in some state-of-the-art computing; most of the rest of the NHS carries on regardless; progress is not, on the whole, made. The National Programme for IT showed that imposing complicated IT systems from the centre tends to fail, but so has letting the local NHS do its own thing.
GP surgeries are the best section of the health service for IT. They had to computerise years ago in order to be paid for work by the government. In the last few months, my local surgery has introduced the option of online booking, repeat prescriptions and access to records, courtesy of its Emis software – several years behind banks and retailers, but welcome nevertheless.
In England GP software is centrally paid-for but locally chosen under the GPSoC deal, a model that seems to work. The equivalent for NHS trusts would be for the Department of Health to require, and fund, a satisfactory level of electronic patient record system but let trusts choose and implement these. But the trusts would have to have adequate IT if they wanted to continue to do NHS work.
As the escalating dispute between health secretary Jeremy Hunt and junior doctors shows (and regardless of your view of Hunt and his plans), it can be hard to change practices across health service. Some trusts have brilliant computing, and that’s been the case for decades. The problem is those parts that, for example, appear to see encryption as an optional extra.
Islands of excellence are great; what NHS IT needs is a sea of adequate.
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