There are two problems; confidence and money.
The NHS and social care have lost their confidence in procuring healthcare technology systems. Recent initiatives from NHS Data to assess the state of NHS tech have revealed a patchwork of un-readiness. With no specific leadership from NHS authorities, no clear priorities, difficulty in identifying suitable systems to invest in and a very confused future, NHS managers see procurement as a risk.
The common law of business logic might tell you that an organization the size of the NHS, with its buying clout, would make its mind up, buy a lorry load of good stuff and have it delivered to every hospital for someone to plug-in and make connected healthcare work. Instead there is a labyrinth of business case duplication, hesitation and few real high-end skills. A convoluted tangle is putting it mildly.
Ultimately, buying IT has become too risky; just ask Cambridge FT. They installed a new patient administration system. It was years in the planning, months in rehearsal and weeks of support and back up for staff. Minor glitches were seized-on by the press and regulators, culminating in one of the best NHS chief executives throwing in the towel.
And that brings us to the money problem. Why take the risk especially at a time when the best of all possible excuses is known to the entire nation? ‘There’s no money for this’. Perhaps the NHS should be responsible for finding the money. Moreover, suppliers have to make it easier to buy.
Companies like IMS Maxims have pioneered open source software. The NHS should be forming a queue at their door but unfounded suspicion and caution about ongoing commitments means progress has been slow.
Alternative funding ideas are also needed. Why not just install systems for free and every time a user presses F10, or whatever the key, 0.001p is spent? Pay to use could be a revenue solution to a capital problem. The prospect of the hardware and software licenses staying on the vendors books and the attraction of capital and corporation tax relief seems to pass them by.
Even should this happen, it may be redundant. New technologies are overtaking us. Cloud storage will make servers redundant, Apps replace screens and terminals. Staff will bring their own device to work and use it for all purposes using simple software that connects them, confidentially to records and data, and wipes the information as they leave the building. RDF technologies tracking nurse-patient facing time, all interfaces blue-toothed to the record system and WiFi ubiquitous throughout the estate. Performance dashboards on the Chief Exec’s desk and displayed in real-time on the website… and then the alarm rang and I woke up!