NHS and IT, we all know what is going to happen. I predict at least half of that money will be wasted on systems that get dumped before being rolled out.

So these contracts will go to the likes of Fujitsu-Siemens, Cap Gemini etc, they will go massively over these already mad budgets… and then won't work at the end.

It boggles the mind how they fail to ever get things done properly.

Having worked on the previous attempt, all I can say is ‘good luck’.

I'm sure there will be some contractors that will ride yet another public sector gravy train….

Have seen this all before, will end up way over budget and probably not finished at all.

£4b to be wasted on a bespoke IT system while patients wait in huge queues and doctors talk about striking.

Glad they got their funding in order…..

When the Government is pushing ahead with I'll thought out and invasive investigatory powers the last thing i want are for my medical records in the digital realm.

When the big companies donate to political parties, it's not because they've suddenly discovered altruism. They're fully expecting to make money from it and guess who pays ?

Public payments, private profits.

Of course, soon Wales, Scotland and Northern Ireland will get a few bil each for theirs and then we'll have 4 totally separate IT systems and need to spend another few bil to join all together and of course in the mean time the government will change(c'mon you know this isn't taking less than a decade) decry Tory waste and cancel the whole thing again.

In the meantime areas that don't create jobs for the boys, y'know actual healthcare will remain dangerously poor;

Eldest brother's dad dead because the nurse “didn't have time” to find out what kind of diabetic he was after his stroke and just shot him full of insulin,

Mate's wife waited 2 weeks for a prescription for painkillers for her fractured vertebrae, her husband ended up buying some off a local dealer. Not to mention however long they left her with a spinal fracture she'd been going about the back pain for months,

Mum left with life changing injuries and MRSA because appendicitis was too difficult a condition to diagnose within a week in a former nurse who walked in and stated “I have appendicitis” and cleaning is still beyond them,

Best mate given antibiotics for renal failure. Thankfully he survived but it was so close his mum was told to say good bye to her comatose son, the doctor said he'd never seen someone survive with such high potassium levels,

All this in the last couple of years which brings it onto me, the mental patient; during part of this the stress pushed me over the edge and I suffered a psychotic episode a few days after i'd recovered(with no help from them, despite my family begging and a couple of ambo's), I got a phone call, threatening to section me if I didn't see a consultant, (not my consultant the one I trust, no he resigned in disgust). I agree and am given an appointment in 3 months time. 3 months for someone they consider so dangerous he needs sectioning.

Cherry on top; when I finally see my new consultant, who barely speaks English, gets my name wrong and his first question “Why are you here?”, “Because you threatened to deny my freedom if I didn't come!”. Within 5 minutes of meeting me; he comes to the conclusion that I've been misdiagnosed my whole life and actually I don't have any serious conditions. Apparently I just have anger management issues. I mean why else would I be so angry with them? What I really need is breathing exercises. :rolleyes:

In case you were wondering, no I'm not seeing him again and my trust is now in special measures.

Disgrace, but yeah free wifi and replacing the fax machines with email that'll totally fix it.

I can think of better ways to spend £4bn. You know, maybe on doctors or hospitals or ambulances or stuff like that. Or given that £250k per month to run an air ambulance… that's a fleet of air ambulances around the country for a few years.

It makes sense for patient records to be accessible from whatever hospital you happen to be admitted to, particularly if you have a chronic condition.

I have hospitals numbers for three trusts, and non can see my records of the others, and my GP can't see them either, resulting in letters flying to and fro and a whole load of unnecessary administrative tasks. How much simpler if my GP could see the results of tests, or that each hospital could see the results od previous tests, saving repetition.

The problem is the enormity of the database to hold this data (considering just how big an imaging file might be) and ensuring security (in all its aspects, availability, authenticity and confidentiality).

Sadly big IT infrastructure projects understandably generate bad press when they go wrong, but that is not a reason not to attempt it. Computer science is progressing, and unless something is done to automate processes, the NHS will continue to sink under he weight of paper records.

I'm in a charitable mood today so I think the proposed upgrades sound very sensible and plausible now that technology makes them feasible. Should we judge a sensible idea in advance by the almost certain incompetence in the implementation that is to follow?

peterb
It makes sense for patient records to be accessible from whatever hospital you happen to be admitted to, particularly if you have a chronic condition.

Even moving patients between wards in the same hospital generates a small pile of paperwork.

Perhaps somebody can explain to me the medical benefits of free WiFi? As nothing can be plugged in without PAT testing, it will not serve long-term patients, just visitors and those waiting in casualty for a strike to finish.

As to the remainder of the expenditure, does anybody believe it will be £4bn after a couple of false starts and all of the likely overruns?

aidanjt
Even moving patients between wards in the same hospital generates a small pile of paperwork.

Indeed, so anything that reduces the beaurocracy for clinical staff allowing them to do their primary function is to be welcomed.

Brian224
Perhaps somebody can explain to me the medical benefits of free WiFi? As nothing can be plugged in without PAT testing, it will not serve long-term patients, just visitors and those waiting in casualty for a strike to finish.

As to the remainder of the expenditure, does anybody believe it will be £4bn after a couple of false starts and all of the likely overruns?

Well if you have ever spent a long time in hospital…

Private equipment does not have to be PAT tested (PAT testing is not a legal requirement anyway). And there are benefits if patients can keep in touch with families etc. Many hospitals have WI-FI anyway, both for patients and for clinical staff, so the cost of extending that will be minimal.

£4billion huh, I'll head down the bookies tomorrow and see what the odds are for at least half of that going to MS for extended windows XP support lol.

I got a job in my local hospital in 2007, and at the time was told it was all going paperless within a couple of years. Fast-forward to 2016, and nothing has happened. In short: I'll believe it when I see it.

Might as well invest in training British Doctors with that money rather than importing Doctors with dodgy certificates from 3rd world countries who do a 1 year course here and then become your Doctor!

Read an article yesterday about some Pakistani lady who is wanted by Interpol , yet she continues to be an anesthetic at Queens hospital Romford!

OilSheikh
Might as well invest in training British Doctors with that money rather than importing Doctors with dodgy certificates from 3rd world countries who do a 1 year course here and then become your Doctor!

Read an article yesterday about some Pakistani lady who is wanted by Interpol , yet she continues to be an anesthetic at Queens hospital Romford!

Couldn't agree more. My local trust has been a bugger for doing this for years. I've had a couple who I'm pretty sure weren't actual Doctors. Including one who didn't know where the liver is(upper left enclosed by the ribs according to him and no he didn't have an answer to where my left lung would go) and another I had to explain the concept of a differential diagnosis to. A conversation we got onto because he hadn't heard of the DSM or ICD :eek:

I wish that Queens hospital story didn't ring so true.

Stat from my time working with GPs (and the software that paid them).

If you want patching up/fixing go black, if you want to be referred go white. It's actually nothing to do with colour of skin just the background of where people came from that matters.

chuckskull
Including one who didn't know where the liver is(upper left enclosed by the ribs according to him and no he didn't have an answer to where my left lung would go)…

Anatomical right, but left as you look it…

;)

Sumanji


Anatomical right, but left as you look it…

;)

There was pointing; he believed my right lobe to be centred around my left nipple.

Like so;

That's unfortunate. Perhaps he thought you had situs inversus.

Either way, there's plenty of room for your lungs under there.

Although from your diagram, I would be rather more worried about where exactly your heart is…

Sumanji
That's unfortunate. Perhaps he thought you had situs inversus.

Either way, there's plenty of room for your lungs under there.

Although from your diagram, I would be rather more worried about where exactly your heart is…

No that's where he thought all livers were. I can assure I'm not mistaken. I've just checked and he no longer has his job, so I'm guessing I'm not the only one who complained about his incompetence.

Brian224
Perhaps somebody can explain to me the medical benefits of free WiFi? As nothing can be plugged in without PAT testing, it will not serve long-term patients, just visitors and those waiting in casualty for a strike to finish.

I would guess Wifi is so tablets (the electronic kind) can be used for patient records. Some bright spark probably decided that adding ‘free’ to it would be a great winner with the public who can now watch iPlayer while they wait for their appointment!

peterb
It makes sense for patient records to be accessible from whatever hospital you happen to be admitted to, particularly if you have a chronic condition.

I have hospitals numbers for three trusts, and non can see my records of the others, and my GP can't see them either, resulting in letters flying to and fro and a whole load of unnecessary administrative tasks. How much simpler if my GP could see the results of tests, or that each hospital could see the results od previous tests, saving repetition.

The problem is the enormity of the database to hold this data (considering just how big an imaging file might be) and ensuring security (in all its aspects, availability, authenticity and confidentiality).

Sadly big IT infrastructure projects understandably generate bad press when they go wrong, but that is not a reason not to attempt it. Computer science is progressing, and unless something is done to automate processes, the NHS will continue to sink under he weight of paper records.

This is what I said last time on the NHS spine program. This is exactly what it was supposed to do. Unfortunately, the way that was managed and implemented was awful (speaking as someone who worked on it).

This is just going to make a number of folk rich and fatten the pockets. :/ And leave us muppets in longer q's when the systems fail.

Macman
This is just going to make a number of folk rich and fatten the pockets. :/ And leave us muppets in longer q's when the systems fail.

So what is the answer? Do nothing and go back to mountains of paper records that need secure storage, and leave us waiting while they are looked for, or worse, go missing permanently? Or waste time while yet another set of patient records are compiled?

I think our healthcare professionals deserve better than that, as do patients.

b0redom
This is what I said last time on the NHS spine program. This is exactly what it was supposed to do. Unfortunately, the way that was managed and implemented was awful (speaking as someone who worked on it).

The problem is the management and implementation (as well as a tightly specified and controlled programme management. There have been some significant successes in Government IT systems, although not without initial teething problems. However the successes are rarely reported in the mainstream press.

(Sorry, I'm being reasonable again :))

chuckskull
No that's where he thought all livers were. I can assure I'm not mistaken. I've just checked and he no longer has his job, so I'm guessing I'm not the only one who complained about his incompetence.

Did he say where the alfalfa beans and the chianti were?

The bullet points missed something:

* ~ £1 bn to cover the costs of all those middle management meetings (tea, coffee, etc.) and then further meetings about meetings and other meetings. No actual work. (source: someone I know at the NHS) :P

LeetyMcLeet
The bullet points missed something:

* ~ £1 bn to cover the costs of all those middle management meetings (tea, coffee, etc.) and then further meetings about meetings and other meetings. No actual work. (source: someone I know at the NHS) :P

So you have never worked in project management then? :)

There's a big difference in attitude (if that's the right word), between those in the private sector and those in the public sector though. Yes, these meetings are needed, of course they are, but those in the public sector MILK the hell out them. I know 3 people (two are family) who work in the sector and believe me, they waste ALOT of time milking these meetings. This would simply NOT happen in the private sector or people would lose their jobs.

Time for my fav NHS story……..

New IT system in a walk in centre, I asked the project manager why there were no chairs…..

She answered ‘because we haven’t been trained on them'

peterb
It makes sense for patient records to be accessible from whatever hospital you happen to be admitted to, particularly if you have a chronic condition.

I have hospitals numbers for three trusts, and non can see my records of the others, and my GP can't see them either, resulting in letters flying to and fro and a whole load of unnecessary administrative tasks. How much simpler if my GP could see the results of tests, or that each hospital could see the results od previous tests, saving repetition.

The problem is the enormity of the database to hold this data (considering just how big an imaging file might be) and ensuring security (in all its aspects, availability, authenticity and confidentiality).

Sadly big IT infrastructure projects understandably generate bad press when they go wrong, but that is not a reason not to attempt it. Computer science is progressing, and unless something is done to automate processes, the NHS will continue to sink under he weight of paper records.

I can back this up. When I moved to uni I had to register with the local doctor who did not have my records. When I went back to my original doctor over the holidays my GP had lost all of my records from my GP at university and the records he originally had. It's ridiculous.

b0redom
This is what I said last time on the NHS spine program. This is exactly what it was supposed to do. Unfortunately, the way that was managed and implemented was awful (speaking as someone who worked on it).

I also worked (on the sidelines) of that massive project. It was a catastrophic fail. Can't see this being any better tbh…

All singing and dancing IT system - every patient record online and searchable.

Then the Tory boys will sell it to insurance companies.

“All your details are belong to us”

Yeah I know what you mean. The worrier in me wonders if the gov is setting up a lovely database for when they privatise the NHS and we go all American and have to get insurance, and pay for care. Sounds like a lame idea to me when staffing levels are so bad to spend this much money on IT. It doesn't help provide more doctors. It MIGHT help the ones we have do more, but I doubt it. Not one of my working medic friends (and I know many highly qualified folk working on the front lines at various ranks) has said the biggest thing they need is wifi and a tablet. They have all said they need more staff of better calibre. That and cleaning staff who give a damn. Outsourcing cleaning has removed the ability of hospital staff to lay the smack down and maintain standards.

The best efficiency saving the NHS can make is a cull of the middle managers in the NHS and relevant parts of the civil service who leach money out of the system. It worries me that I knew people who went into the civil service (for health) and are now coming up with these dumb ass ideas and who have the medical training and understanding that comes from a geography degree. They didn't even get a good grade in that! They've never worked in a hospital. Never volunteered on a ward. They might once have snogged a drunk medic at a uni party. And they are shaping policy on the NHS? You want savings? I know where I'd look…

ik9000
…

In fairness, a significant proportion of clinical staff's time is tied up in paperwork, if they can cut down on paperwork and data replication then there'd be less need for more clinical staff (although arguably they should still hire more clinical staff and implement this). I also have concerns about privatisation and data security, especially with May's nonsense. But I try not to conflate those issues with this.

amdavies
When the big companies donate to political parties, it's not because they've suddenly discovered altruism. They're fully expecting to make money from it and guess who pays ?

Public payments, private profits.

Well, let's look what those companies do…

Keep people in employment. (Good news for developers and system integrators)

Pay tax on profits

Pay dividends to the owners - who are the shareholders, which in many cases are the pension funds of of ordinary people with private pension plans.

peterb
Pay tax on profits

Not as much as you'd think.

One of the biggest tax havens going is the City of London.

Spreadie
Not as much as you'd think.

One of the biggest tax havens going is the City of London.

I think we need to wait and see who wins the contracts before any generalisation like that can be made, and as this is a Government contract, there will be scrutiny of the tax status of the companies tendering.

Not withstanding the tax, there is still the employment factor (and those employees will be tax payers.

It's very easy to sneer at these projects, particularly with something as emotive as the NHS, but the NHS itself is an incredibly complex system, relying g both on clinicians who deliver the service, and those managers who are required to manage a complex system, while clinicians to what they are good at.

Naturally there will be interaction between the two, neither can operate in isolation, so, to get back to the topic, clinicians should be involved in the system specification.

There are two big problems with this. The first is whether to attempt to integrate the various disparate systems, or to start again from scratch, with the problem of data migration.

The other us the change of requirements half way through the procurement process - and can be a major cause if cost escalation. It arises either from poor understanding of the task, and/or a poorly defined initial project specification.

Getting these right can take longer than expected, and that too can lead to time and budget over-riding.

aidanjt
In fairness, a significant proportion of clinical staff's time is tied up in paperwork, if they can cut down on paperwork and data replication then there'd be less need for more clinical staff (although arguably they should still hire more clinical staff and implement this). I also have concerns about privatisation and data security, especially with May's nonsense. But I try not to conflate those issues with this.

As a clinician I fully support centralised electronic records. Without an investment of some sort there can never be the efficiency savings we desperately need. This will directly benefit patients. No more more missing charts inevitably leading to prescription errors, no more mountains of ancient paperwork to trawl through, remote access to live patient data accessible by any specialist to give advice remotely. This means safer and quicker patient care. I can give specific examples if requested.

Of course the way it is implemented be absolutely vital. It is unbelievably complex and what makes it worse is the resistance (intentional or unintentional) from the incumbent system providers. There is also no doubt there will be transitioning and education issues but with more people adept at using technology I hope this is less of an issue. Furthermore the issue of privacy is of great concern. Safeguarding this is another potential barrier to the success of a system like this.

It's required but do I trust the current (or any previous government) to manage this properly? Unfortunately no.

Amusing NHS story two….

While talking to an admin assistant I asked what she did…

'I do basic filing, dictation, word processing, disaster recovery planning and keep the terrorism/bomb policy up to date'.

Obvously in a PCT of >100 surgeries, >1000 employeers, 100s of doctors you get someone on 15k a year to do the disaster planning :P

WestHej
It's required but do I trust the current (or any previous government) to manage this properly? Unfortunately no.

Which begs the question, “who would you trust?” Given the importance of this measure.

The NHS is a Government organisation, and has its own IT department. In effect you are saying that you don't trust the NHS to manage the implementation of its own system…

Except this won't be done by the NHS IT department will it? It'll be done by the lowest bidder. Probably ATOS who did such a stand up job on their last contract.

chuckskull
Except this won't be done by the NHS IT department will it? It'll be done by the lowest bidder. Probably ATOS who did such a stand up job on their last contract.

The over site and customer side project management will be done by the NHS so their responsibilities will be to draw up the tender documents, assess the tenders, and then manage the contract, holding the successful bidder to account for any failings in the delivery.

A big part of why I don't trust the current government is because of the way they are handling the NHS's assets both human and physical.

I sincerely hope the person(s) assigned to oversee this project will has no vested interests outside the NHS.

WestHej
A big part of why I don't trust the current government is because of the way they are handling the NHS's assets both human and physical.

I sincerely hope the person(s) assigned to oversee this project will has no vested interests outside the NHS.

OHHHH my boy, have you not seen yes minister?…. educational void right there!