Sun 15 Oct 2006
IT and Modernisation: New Statesman roundtable
Posted by bill under billstuff
Last month I chaired one of the New Statesman’s regular roundtable debates where they get a group of people together to talk for a couple of hours about an issue of the day, record the results and print an edited transcript as a supplement.
The topic we discussed was IT and Modernisation, looking particularly at public sector IT. Stephen Timms, Chief Secretary to the Treasury, was there, as was Richard Granger, who is charge of the NHS IT programme. And my old boss from The Guardian, Tony Ageh - now at the BBC - had some interesting things to say about public sector constraints.
You can download the PDF from the Stateman website, and it isn’t behind the paywall.
October 16th, 2006 at 12:23 pm
Dear Bill
I was interested to read Mr Grangers assessment of implementing NPfIT in the NHS but resonated more with Barbara Kitchenhams view that;
“Technically, one way of getting
large trustworthy systems is to start with small involvement systems…”
Having worked in NHS IT for many years I know that any clinical end-user software will always need to be one-off if it is to be adopted. What Mr Granger doesn’t see beyond, when commenting on the BMAs union mentality, is that clinical specialties differ at the point of delivery between areas and regions. The BMA doesn’t admit this, but it is true and usually because of historical factors, personal consultant style or the way specialties have developed regionally.
Mr Granger has already hinted that the Enterprise Wide Arrangements (EWAs)with the existing suppliers might need to be extended if clincal end-user systems are ever going to be adopted but this change of heart does not go anyway near far enough.
When I built a clinical system for an area specialty within the NHS it was adopted enthusiastically because it was built to the exact specifications of the Clinical Director. I doubt if this system could have been applied wholesale to a neighbouring sector supplying the same clinical service because of variations in service delivery between areas.
Two things still need to happen before clinical systems can be rolled-out that replace paper records.
1. The BMA must acknowledge that service delivery and processes vary between areas.
2. The Connecting For Health EWAs need to be enlarged substantially so that the patchworked Detailed Care Record can be constructed.